If the breast has been removed due to cancer or other disease, a breast reconstruction surgery can be performed to rebuild it. During the procedure, implants are used to form the breast and flaps of patient's tissues are relocated to make a natural looking nipple and areola.   Unless the patient is a high risk one, the rebuilding could be done immediately after the removal. Patients who smoke, have high blood pressure, obesity, diabetes or other medical problems are considered high risk and the reconstruction surgery should be delayed for them for some time. Multiple operations should to be done during the course of weeks, even months, to completely rebuild the breast.

Here are the two most common reconstruction methods used:

1-      This method, which is the more common of the two, is used with the aid of tissue-expander breast implants. A silastic implant is temporarily inserted beneath the major muscle of the chest wall. A saline solution is injected over weeks or months to slowly expand the tissue. When the desired size is reached, the salistic implant is removed and a more permanent implant will be replaced. Then the nipple and areola can be reconstructed.

2-      In flap reconstruction, tissues from the patient's body will be removed, usually from thighs, buttocks, abdomen or back.  The tissue taken from the back of the patient, which is called latissimus dor muscle flap, can be removed without losing any functionality. This tissue will be moved to the site of the breast while it is still attached to its blood supply under the armpit. The donor tissue from the abdomen can be used as well. It will be taken from the area between umbilicus and pubis with an advanced microsurgical technique. To prevent hernia and weakening of the muscle, a surgical mesh is used to cover the defect. The tissue taken is enough to rebuild a large breast.

If the nipple and areola are large enough and the breast is not reconstructed yet, the tissue will be harvested and used to recreate the nipple and areola. If not, a small flap will be used to raise the skin and create the nipple. An incision can be made around the new nipple to create the areola with suturing back the tissue. In both cases, tattooing can be used to achieve a more natural looking color.