What are the main goals of breast reconstruction surgery?

Written by: Mr Brendan Smith
Edited by: Conor Lynch

In this article below, Mr Brendan Smith, a prominent oncoplastic breast surgeon and expert in breast cancer surgeries and reconstructions, provides valuable insights into the different types of breast reconstruction, their advantages, drawbacks, and surgical procedures.

In what scenarios should breast reconstruction surgery be considered?

Breast reconstruction is an essential consideration for women who have undergone or are preparing for a mastectomy, either immediate or delayed, as part of breast cancer treatment. It is also an option for women at a high risk of breast cancer due to genetic factors. While most mastectomy patients are eligible for reconstruction, not all choose this path due to personal reasons.


The decision to pursue breast reconstruction is deeply personal, and there is no definitive right or wrong choice. It involves a thorough discussion with your surgeon and breast care nurse to address any concerns and questions.


What are the main goals of breast reconstruction surgery?

The main goals of breast reconstruction surgery are as follows:


  1. Restoring breast symmetry when wearing a bra.
  2. Recreating breast contour.
  3. Avoiding the need for external breast prosthetics.
  4. Achieving a natural appearance both in clothing and without.
  5. Restoring self-confidence, femininity, attractiveness, and sexuality.


There are also various different limitations of breast reconstruction surgery. These include:


  1. Exact replication of the natural breast is not always achievable due to various factors.
  2. Sensitivity is usually absent in the reconstructed breast.
  3. Multiple surgeries may be necessary for optimal results.
  4. Differences between reconstructed and natural breasts may be noticeable when nude.


What are the different types of breast reconstruction surgery available?

Types of breast reconstruction surgery include:


  1. Silicone Implants in pre-pectoral or sub-pectoral positions.
  2. DIEP (or TRAM) abdominal flap reconstruction.
  3. Latissimus dorsi (LD) muscle back flap reconstruction.


What are the main factors that influence what type of breast reconstruction is performed?

There are several factors that influence the decision as to what type of breast reconstruction should be performed on a patient. The main ones are as follows: 


  • Overall health, breast cancer type, and breast size.
  • Amount of available tissue for reconstruction.
  • Desire for breast symmetry with the opposite breast.


If you’re interested in scheduling in an appointment with Mr Brendan Smith, simply head on over to his Top Doctors profile today.

By Mr Brendan Smith


Brendan Smith is a highly trained and dedicated consultant oncoplastic breast surgeon with over 18 years of consultant specialist practiceThis wealth of experience has resulted in leading expertise across the field of oncoplastic breast surgery, such as breast reconstructionbreast cancerbreast reduction, breast augmentationbenign breast diseases and revisional breast surgery.
He has an extremely strong background in teaching and training breast reconstruction techniques to those in training and consultant professionals also. He has been a course director for the level 2 Oncoplastic Breast Reconstruction Surgery course at the Royal College of Surgeons and Association of Breast Surgery of the UK and Ireland Since 2011. He is also joint course director for the Oxford Oncoplastic Breast Surgery Course, teaching on it since its inception in 2013. He is also a faculty member for the Level 1 Oncoplastic Breast Reconstruction Surgery course formally at the Royal College of Surgeons and now the Association of Breast Surgery of the UK and Ireland.

He qualified in 1991 from Charing Cross and Westminster Medical School, completed his college fellowship exams (FRCS Eng) in 1996 and achieved a research fellowship studying the ‘Detection of micrometastases in breast cancer’ gaining a higher Masters of Surgery degree  (MS University of London) in 2003. As a dedicated career breast surgeon from this early stage, he gained his senior surgical training through the University of Oxford Surgical rotation in 1996 completing his FRCS exit examination (Gen Surg) in 2004. During senior surgical training in 2003 he succeeded in gaining his first choice preference of one of the first National UK Oncoplastic fellowships at the Christie and South Manchester University Hospitals.
Throughout his career, he has been dedicated to treating his patients using modern and innovative techniques in oncoplastic breast surgery to try and avoid mastectomy, where possible, including therapeutic mammoplasty, lipofilling (fat transfer), partial breast reconstruction using perforator flap techniques and neoadjuvant systemic treatment when necessary.
 He has extensive experience in breast reconstructive techniques using nipple-sparing or skin-sparing mastectomy, pre pectoral and partial sub pectoral ADM breast reconstruction, and autologous and implant-assisted LD flap reconstruction. He also works with an experienced plastic surgeon for patients having DIEP or free TRAM flap breast reconstruction.
He was appointed as the first Oncoplastic Breast surgeon at the Royal Berkshire Hospital in 2004. He set up the oncoplastic breast unit and has continued to develop it introducing new technology and techniques over the last 18 years. He has trained many other practising oncoplastic consultants over that time many of whom now work in the Oxford surgical deanery.
Furthermore, he continues to contribute to his field in the form of research, currently focusing on extending the surgical research portfolio locally.

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