HealthInfo Canterbury
Risks & complications of breast reconstruction surgery
Like any surgery, breast reconstruction surgery has some risks.
Breast reconstruction surgery risks
Scars
Talk to your surgeon and read about how breast reconstruction surgery is done for information on where your scars will be. At first, the scars will be narrow red lines. They usually become paler over six months to a year. A few people get raised, red and thickened scars (called keloid or hypertrophic). Tell your surgeon if you've had this type of scar before.
Implant or expander
After an implant, your breast will not drop to the side when you lie down. The shape may alter as you tense your chest muscles. You may be able to see the outline of the implant or its folds and ripples. The implant could turn around, and you might need surgery to correct this. Your breast may appear fuller at the top. Your whole breast will have less sensation. You could get an infection around the implant. If you have an expander, the opening, or port, can occasionally turn so that it cannot be reached. If this happens, you may need further surgery to fix this.
Tissue flaps
All kinds: You may have pain or permanent numbness in your breast and in the area the flap is taken from. A sore lump can develop in your breast (called fat necrosis), but this usually goes away. You might develop an infection or a collection of blood (haematoma), which needs to be drained. Your breasts are likely to be uneven. Abdominal weakness can cause a bulge (or hernia), which occasionally needs further surgery.
TRAM flap: The blood supply to part of the reconstructed breast can be blocked. If this happens, these areas can die and may need to be surgically removed. Often this is only partial and most of the reconstructed breast remains fine. You should also expect some permanent abdominal weakness.
DIEP flap: There is a 5 to 10% chance of the blood vessels getting blocked, which usually happens in the first few days. If this happens to you, you'll need an urgent operation, which has a 50% chance of unblocking the blood vessels. Unfortunately, if this isn't successful, the entire breast reconstruction can die. Overall, there is a 2 to 5% chance of this after any operation. If this happens, you can have another breast reconstruction later, but you cannot use your abdominal tissue again. There is also a small risk of long-term abdominal weakness.
General surgical risks
Blood clots
Blood clots are a serious complication. They can cause deep vein thrombosis (DVT) or a pulmonary embolism (PE). Any lengthy operation can cause blood clots, but your healthcare team make every effort to avoid them. You're usually given special stockings to wear during your stay in hospital. You may also be given special medication to minimise the risk, such as a daily injection into your tummy.
Infections
These could include chest, urine and wound infections that can be slow to heal. In some surgery, there is also a risk of infection in the blood (septicaemia) that can make you very unwell. Antibiotics will be used to treat these infections if they develop.
Bleeding
This can be an issue during surgery or afterwards. If you bleed too much, you may need to go back to theatre for more surgery and you could need a blood transfusion. You may develop a haematoma (collection of blood) that needs draining.
General anaesthesia
The risks include allergic reactions and rarely potentially fatal effects on your heart and circulation. The risk is different for each person. You can discuss these risks further with your anaesthetist.
On the next page: Before breast reconstruction surgery
Written by HealthInfo clinical advisers. Endorsed by Canterbury DHB Plastic Surgery Department. Last reviewed November 2020.
SourcesReview key: HIBRC-85838
