Breast Reconstruction (Breast Repair) in Ankara, Turkey

Breast reconstruction is a surgical procedure performed to reshape the breast after breast cancer or in individuals with congenital breast tissue deficiency. While restoring physical integrity, it also supports psychological recovery by providing a natural-looking breast.

Reconstruction can be performed in the same session as a mastectomy (breast removal) or at a later stage. Silicone implants or the patient’s own tissue (autologous tissue) may be used. The method and tissue choice are determined based on the patient’s overall health status and personal preferences.

In autologous tissue reconstruction, tissue may be taken from the abdomen (TRAM, DIEP), back (latissimus dorsi), or buttock region. This approach provides a more natural feel and is often preferred in patients who have received radiotherapy. Blood supply is preserved and microvascular connections are performed under a microscope.

The recovery timeline varies depending on the chosen technique. In addition to aesthetic restoration, nipple and areola reconstruction can also be completed after the main procedure. Breast reconstruction is an important step for both physical and emotional healing.

What Is Breast Reconstruction (Breast Repair)?

Breast reconstruction (breast repair) is a surgical procedure intended to recreate the breast in patients who have undergone mastectomy due to breast cancer or who have experienced breast loss due to congenital conditions or trauma. This can be performed using silicone implants or the patient’s own tissues. Reconstruction may be planned at the same time as cancer surgery or after treatment, with the goal of improving physical appearance, body image, and overall quality of life.

Does breast reconstruction affect cancer surveillance or treatment?

One of the first and most critical questions patients ask is about safety: whether reconstruction could mask a recurrence or interfere with ongoing treatment. The reassuring reality supported by years of clinical experience and scientific research is that breast reconstruction does not increase the risk of cancer recurrence.

With modern imaging technologies, radiologists can evaluate reconstructed breasts—whether implant-based or autologous—without difficulty, detecting even subtle changes behind tissue or around an implant. Reconstruction also does not prevent receiving additional therapies planned by oncologists. Chemotherapy and hormonal treatments can proceed as scheduled.

Areas that are not negatively affected from an oncologic standpoint include:

• Chemotherapy courses
• Radiotherapy sessions
• Hormonal therapies
• Routine mammography follow-ups
• Ultrasound screenings
• MRI imaging

How is timing decided: Immediate vs. delayed reconstruction?

The timing of breast reconstruction is highly individualized, and we make this decision in close coordination with your breast surgeon and medical oncologist. There are two main pathways: immediate reconstruction and delayed reconstruction. Each has its advantages and suitable patient profiles.

Immediate reconstruction is performed during the same operation as mastectomy. The breast surgeon removes the breast tissue, and the plastic surgery team creates the new breast in the same anesthesia session. The psychological benefit can be invaluable: the patient wakes up with a breast already present, avoiding the trauma of experiencing a “flat” chest. This option is often preferred in early-stage cancers and when the breast skin can be preserved.

Delayed reconstruction is performed after cancer treatments are completed. If the cancer is advanced or postoperative radiotherapy is definitely required, waiting can be the safer approach. Radiotherapy can stiffen the skin and reduce its healing capacity, so reconstructing months later—after the body has recovered—often lowers complication risk.

Factors influencing timing include:

• Cancer stage
• Need for radiotherapy
• Condition of the breast skin
• Overall health status
• Personal preferences
• Smoking history

How is implant-based (silicone) breast reconstruction performed?

For patients who prefer not to use tissue from another part of the body and want a shorter operation and faster recovery, implant-based reconstruction can be an excellent option. While it shares principles with cosmetic augmentation, the technique is often more delicate in reconstruction patients. Implant reconstruction can be performed in two primary ways.

The first is a “direct-to-implant” approach. If enough breast skin is preserved during mastectomy and tissue quality is good, a permanent silicone implant can be placed immediately. This one-stage approach is practical and efficient.

The second, and more commonly used, option involves a tissue expander. If the skin envelope is insufficient after mastectomy, we first place a deflated balloon-like expander under or over the pectoral muscle. About 3 weeks after surgery, we begin gradually filling it in the clinic with saline through a port. This is typically painless, causing only mild tightness. Over several weeks, the skin stretches safely. Once the desired volume is achieved, a second, smaller procedure replaces the expander with a permanent, soft gel implant.

Advantages of implant-based reconstruction include:

• Shorter operation time
• No additional donor-site scars
• Faster recovery period
• Less postoperative pain

Who is a good candidate for a Becker implant option?

In some cases, we want to combine the expansion phase and the permanent implant phase into one device. This is where the “Becker implant” can be helpful. These implants function as both an expander and a long-term implant in a single unit. They have a silicone gel outer component and an inner chamber that can be filled.

After surgery, the implant is gradually expanded through a small port hidden in the armpit area. Once the desired size is reached, the port can be removed under local anesthesia—without a larger second operation—while the implant remains permanently in place. In selected patients (especially those without radiotherapy and with good skin quality), Becker implants can reduce the burden of multiple surgeries.

Benefits of Becker implants include:

• Reconstruction with fewer stages
• Adjustability to the desired size
• Less overall surgical intervention
• Easier symmetry planning

What do over-the-muscle placement and newer approaches offer?

In the past, implants were placed almost always under the pectoralis (chest) muscle. This was safe, but stretching the muscle could lead to more postoperative pain. It could also cause aesthetic issues such as “animation deformity,” where the implant moves with the muscle during arm use or exercise.

With advances in technique and newer approaches (including methods often described under concepts like “prepectoral” reconstruction), implants can now be placed on top of the muscle—closer to the breast’s natural plane. This is made safer by wrapping or supporting the implant with biological meshes or synthetic supports beneath the skin. Because the muscle is not disturbed, patients often experience less pain and return to arm function sooner.

Comfort benefits of prepectoral placement include:

• Minimal postoperative pain
• Faster return to social life
• More natural breast movement
• Preservation of muscle strength
• Greater comfort during athletic activity

Is breast reconstruction possible using my own tissue (autologous reconstruction)?

Yes—autologous reconstruction is one of the most advanced areas of plastic surgery and can provide some of the most natural-feeling results. In this approach, we use tissue from the abdomen, back, thigh, or buttock region to rebuild the breast.

The most appealing aspect is that the tissue is truly yours—there is no sensation of a foreign body. The reconstructed breast changes more naturally with weight gain/loss and aging. Additionally, bringing well-vascularized living tissue into a radiotherapy-damaged area can significantly improve local healing and skin quality.

Common donor sites include:

• Abdomen
• Back
• Inner thigh
• Buttock region

Why is the DIEP flap one of the most commonly preferred autologous techniques?

For many patients who want reconstruction using their own tissue, the abdomen is the first donor site we evaluate. Many women have extra skin and fat in the abdominal area after pregnancy or weight changes. With a DIEP flap, this tissue can be used to create a natural breast while also providing a flatter abdomen—somewhat like combining reconstruction with a tummy-tuck effect.

Older approaches such as the TRAM flap transferred a portion of the abdominal muscle, which could increase the risk of hernia. With the DIEP technique, we use microsurgery to preserve abdominal muscle function. Under a microscope, we carefully dissect small blood vessels traveling between muscle fibers, taking only skin and fat while keeping the muscle intact.

Key benefits of DIEP flap reconstruction include:

• Preservation of abdominal muscle function
• Minimized hernia risk
• Soft, natural breast tissue
• Improved abdominal contour
• Long-term durability

When is reconstruction with back tissue used?

Not every patient has enough abdominal tissue for breast creation, and prior abdominal surgeries may prevent using the abdomen. In such cases, the latissimus dorsi muscle from the back is often a strong alternative.

We transfer this broad back muscle (with some overlying skin) to the chest through a tunnel created near the armpit. Back tissue alone may not provide enough volume, so it is frequently combined with a small implant for additional fullness. The scar on the back is typically planned to remain hidden under a bra strap line.

Back-tissue (latissimus dorsi) reconstruction may be preferred when:

• Abdominal tissue is insufficient
• Prior implant attempts have failed
• The chest wall is radiotherapy-damaged
• The patient has higher-risk factors such as smoking
• The patient has undergone bariatric (weight-loss) surgery

Which technologies are used for safety during surgery?

Breast reconstruction—especially when it includes microsurgery and tissue transfer—can be technically complex. The key to success is excellent blood flow (perfusion) to the transferred or preserved tissue. Visual assessment alone may not always be enough, which is where advanced technology can help: SPY fluorescence angiography.

During surgery, a special dye called indocyanine green (ICG) is injected through an IV line. Using infrared cameras, we observe how well blood reaches the tissue in real time. The dye lights up areas with good circulation on a monitor. If an area has weak blood supply, the surgeon can identify it immediately and adjust the plan, which can dramatically reduce postoperative wound-healing problems and tissue loss.

Safety benefits of SPY technology include:

• Real-time perfusion monitoring
• Reduced risk of tissue necrosis
• Verification of vessel connections
• Safer surgical margins
• Prevention of healing complications

How does fat grafting improve the final result?

Fat grafting (lipofilling) has become one of the most popular and effective adjuncts in breast reconstruction. Think of it as the final brushstrokes on a painting. The main surgery creates the breast, but sometimes implant edges may be palpable, thin skin areas may remain, or minor contour irregularities can appear.

We harvest fat via liposuction from another area (commonly the abdomen or hips), process and purify it, then inject it into the breast region. This adds volume, but also improves tissue quality. Because fat contains stem-cell-rich components, it can soften and improve radiotherapy-damaged skin, making it look and feel healthier. In implant-based reconstruction, fat grafting can act like a “velvety cover” over the implant.

Common uses of fat grafting include:

• Enhancing upper pole/decolletage fullness
• Camouflaging implant edges
• Improving skin quality
• Repairing radiotherapy-related damage
• Correcting asymmetries
• Refining breast contour

When is nipple and areola reconstruction performed?

Breast reconstruction is a process, and the final stage is often nipple and areola reconstruction. Many patients prefer a rest period after the main reconstruction. We typically plan nipple-areola reconstruction about 3–6 months later, once swelling resolves and the breast shape settles, making symmetry assessment clearer.

This step is usually a minor procedure performed under local anesthesia without requiring hospitalization. Using small local skin flap techniques, we create a nipple projection. For the areola color, medical tattooing (micropigmentation) is commonly used. With 3D shading, we can create a very realistic appearance that matches the natural breast. For many patients, this stage provides the most emotional closure and sense of wholeness.

Methods used for nipple reconstruction include:

• Local skin flaps
• Medical tattooing
• Skin grafts
• “Star” or “Skate” flap techniques

What is the recovery process and what are possible complications?

Like any surgery, breast reconstruction has a recovery timeline and potential risks. However, compared to the emotional and physical burden of mastectomy, many patients experience the reconstruction phase as a more hopeful, forward-looking journey.

With implant-based reconstruction, patients often stay in the hospital for 1 night and can return to light daily activities within a few days. With autologous procedures (such as a DIEP flap), hospital stay may be 3–4 days, and home recovery may take 2–3 weeks. Early pain is typically well managed with modern medications.

Potential bumps in the road can include infection, bleeding, delayed wound healing, or capsular contracture around an implant. With close follow-up and early intervention, most issues can be managed effectively. Strong communication and trust between patient and surgeon are essential.

Possible complications and warning signs include:

• Signs of infection
• Blood collection (hematoma)
• Fluid collection (seroma)
• Capsular contracture
• Temporary sensory changes
• Scar-healing issues
• Fat necrosis nodules

Common postoperative recommendations include:

• Limiting arm movements in the first weeks
• Wearing a supportive medical bra
• Strictly avoiding smoking
• Avoiding heavy lifting
• Maintaining a protein-focused diet
• Not skipping follow-up visits