Post-mastectomy breast reconstruction: an overview of the state of the art, challenges, and prospects


  • Ismat D. Ghazal College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
  • Chimdi Eleweke Benjamin S. Carson (Snr) College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
  • Francisca O. Aladesanwa College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
  • Bayowa O. Onabajo Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, Ogun state, Nigeria



Breast reconstruction, Breast cancer surgery, Mastectomy, Autologous reconstruction, Implant-based reconstruction


Breast cancer, which affects approximately 12% of women worldwide, is a leading cause of death and morbidity, and the majority of cases are treated surgically. The loss of one or both breasts to cancer can be devastating and it often has negative physical and psychological impact on women. In order to maintain an outward breast contour, some women turn to temporary solutions, such as breast pads, which are often unsatisfactory. Over the years, patients' perceptions of their bodies, self-esteem levels and quality of life have all improved as a result of less radical breast cancer surgeries and the growing popularity of post-mastectomy breast reconstruction. Therefore, it is recommended that women undergoing breast cancer surgeries be given the choice of breast reconstruction. Nevertheless, accessibility, acceptability, and affordability of breast reconstruction still pose a challenge. Although these limitations exist globally, they are most noticeable in low- and middle-income nations. This article gives an overview of the various considerations and surgical options for breast reconstruction after breast cancer surgery. In addition, it examines some of the challenges to breast reconstruction faced worldwide and discusses recent and future trends which are bound to improve post-mastectomy breast reconstruction techniques and outcomes globally.


Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11-30.

Ogundiran TO, Ayandipo OO, Ademola AF, Adebamowo CA. Mastectomy for management of breast cancer in Ibadan, Nigeria. BMC Surg. 2013;13:59.

Mullens CL, Hernandez JA, Conn ME, Kennedy-Rea S, Ueno CM. Closing the Breast Cancer Loop: Barriers and Perceptions of Breast Reconstruction among Rural Women. Plast Reconstr Surg-Glob Open. 2020;8(2):e2638.

Weir HK, Anderson RN, King SMC, Soman A, Thompson TD, Hong Y, et al. Heart-Disease and Cancer Deaths-Trends and Projections in the United States, 1969–2020. Prev Chronic Dis. 2016;13:160211.

Jones C, Lancaster R. Evolution of Operative Technique for Mastectomy. Surg Clin N Am. 2018;98(4):835-44.

Laronga C, Lewis JD, Smith PD. The Changing Face of Mastectomy: An Oncologic and Cosmetic Perspective A Historic Perspective: The Early Years. Cancer Control. 2012;19(4):286-94.

Nelson JA, Lee IT, Disa JJ. The Functional Impact of Breast Reconstruction. Plast Reconstr Surg-Glob Open. 2018;6(3):e1640.

Oguntola AS, Olaitan PB, Omotoso O, Oseni GO. Knowledge, attitude and practice of prophylactic mastectomy among patients and relations attending a surgical outpatient clinic. Pan Afr Med J. 2012;13:20.

Somogyi RB, Ziolkowski N, Osman F, Ginty A, Brown M. Breast reconstruction: Updated overview for primary care physicians. Can Fam Physician. 2018;64(6):424.

The American Cancer Society medical and editorial content team. Women’s Health and Cancer Rights Act. 2014.

Retrouvey H, Solaja O, Gagliardi AR, Webster F, Zhong T. Barriers of Access to Breast Reconstruction: A Systematic Review. Plast Reconstr Surg. 2019;143(3):465e-76.

Ozinko MO, Udosen JE, Ukam JS, Ozinko AM. Breast Cancer Surgery: Barriers and Perceptions of Breast Reconstruction in Post Mastectomy Patients in Southern Nigeria. J Aesthet Reconstr Surg. 2020;6(3):13.

Balogun OD, Formenti SC. Locally advanced breast cancer - strategies for developing nations. Front Oncol. 2015;5(89):1-5.

Howard-McNatt MM. Patients opting for breast reconstruction following mastectomy: An analysis of uptake rates and benefit Breast Cancer: Targets Therapy. 2013;5(1):9-15.

Juhl AA, Christensen S, Zachariae R, Damsgaard TE. Unilateral breast reconstruction after mastectomy-patient satisfaction, aesthetic outcome and quality of life. Acta Oncol (Madr). 2017;56(2):225-31.

Munhoz AM, Montag E, Gemperli R. Oncoplastic breast surgery: indications, techniques and perspectives. Gland Surg. 2013;2(3):143-57.

Bertozzi N, Pesce M, Santi P, Raposio E. One-Stage Immediate Breast Reconstruction: A Concise Review. Biomed Res Int. 2017;2017:6486859.

O’Connell RL, Di Micco R, Khabra K, Kirby AM, Harris PA, James SE et al. Comparison of immediate versus delayed DIEP flap reconstruction in women who require postmastectomy radiotherapy. Plast Reconstr Surg. 2018;142(3):594-605.

O’Halloran N, Potter S, Kerin M, Lowery A. Recent Advances and Future Directions in Post Mastectomy Breast Reconstruction. Clin Breast Cancer. 2018;18(4):E571-85.

Potter S, Conroy EJ, Cutress RI, Williamson PR, Whisker L, Thrush S, et al. Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study. Lancet Oncol. 2019;20(2):254-66.

Thiruchelvam PTR, McNeill F, Jallali N, Harris P, Hogben K. Post-mastectomy breast reconstruction. BMJ [Internet]. 2013;347(7929):28-33.

Healy C, Ramakrishnan V. Autologous microvascular breast reconstruction. Arch Plast Surg. 2013;40(1):3-10.

Myers PL, Nelson JA, Allen RJ. Alternative flaps in autologous breast reconstruction. Gland Surg. 2021;10(1):444-59.

Agarwal K, Mistry M. Autologous fat transfer for breast surgery. Br J Hosp Med. 2017;78(8):448-52.

Nelson JA, Disa JJ. Breast reconstruction and radiation therapy: an update. Plast Reconstr Surg. 2017;140(5S):605-8.

Weber WP, Shaw J, Pusic A, Wyld L, Morrow M, King T, et al. Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy. Breast. 2022;63:123-39.

Koppiker CB, Chintamani, Dixit S. Oncoplastic Breast Surgery in India: Thinking Globally, Acting Locally. Indian J Surg. 2019;81(2):103-10.

Vohra LM, Jabeen D, Ali D, Abidi SS, Zeeshan S, Sattar AK. Current perspectives of oncoplastic breast surgery in Pakistan. J Pak Med Assoc. 2022;72(1):S81-5.

Restrepo D, Boczar D, Huayllani M, Sisti A, Gabriel E, McLaughlin SA, et al. Influence of race, income, insurance, and education on the rate of breast reconstruction. Anticancer Res. 2019;39:2969-73.

Morrow M, Li Y, Alderman AK, Jagsi R, Hamilton AS, Graff JJ, et al. Access to breast reconstruction after mastectomy and patient perspectives on reconstruction decision making. JAMA Surg. 2014;149(10):1015-21.

Song WJ, Kang SG, Kim EK, Song SY, Lee JS, Lee JH, et al. Current status of and trends in post-mastectomy breast reconstruction in Korea. Arch Plast Surg. 2020;47(2):118-25.

Nayyar A, Reddy KG, Strassle PD, Moses CG, Roughton MC, Gallagher KK, et al. Temporal trends in immediate post-mastectomy breast reconstruction. J Plast Reconstr Aesthetic Surg. 2019;72(3):513-27.

Albornoz CR, Cordeiro PG, Pusic AL, McCarthy CM, Mehrara BJ, Disa JJ, et al. Diminishing relative contraindications for immediate breast reconstruction: A multicenter study. J Am Coll Surg. 2014;219(4):788-95.

Gichuru KS, Thomas Wanjeri JNP. Predictors of postmastectomy breast reconstruction in Kenya. Ann African Surg. 2020;17(1):16-20.

Kadam D. Postmastectomy Breast Reconstruction: An Exigent Need for the Impetus. Ind J Plast Surg. 2022;55(1):1-2.

Afuwape O, Ayandipo O, Abdurrazzaaq A. Initial experience in breast reconstruction with implants by general surgeons: A report of five cases. Niger J Plast Surg. 2016;12(2):43-6.

Emiroğlu M, Sert İ, İnal A, Karaali C, Peker K, İlhan E, et al. The approach of general surgeons to oncoplastic and reconstructive breast surgery in Turkey: A survey of practice patterns. Balkan Med J. 2014;31:307-12

Chhaya MP, Melchels FPW, Holzapfel BM, Baldwin JG, Hutmacher DW. Sustained regeneration of high-volume adipose tissue for breast reconstruction using computer aided design and biomanufacturing. Biomaterials. 2015;52:551-60.

Visscher L, Cheng M, Chhaya M, Madeline H, Schantz JT, Tran P, et al. Breast Augmentation and Reconstruction from a Regenerative Medicine Point of View - State of the Art and Future Perspectives. Tissue Eng. 2016;1-45.

Donnely E, Griffin MF, Butler PE. Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction. Plast Reconstr Surg-Glob Open. 2020;8(1):e2578.






Review Articles