Breast reconstruction surgery

Breast reconstruction surgery involves the creation of either a new breast or both breasts (double mastectomy breast reconstruction surgery). Reconstructive surgery after breast cancer is a popular option, and it can be performed either at the same time as cancer surgery (immediate reconstruction) or after cancer surgery (delayed reconstruction), and will depend on the type and stage of cancer and the preference of the patient.

Mr Sherif Wilson MB, ChB, MS, FRCS (Plastic Surgery) is the lead clinician for breast reconstruction at Southmead Hospital in Bristol. Mr Wilson undertakes breast reconstruction both the NHS, and privately from the Nuffield Bristol Hospital, BMI Bath Clinic, Winfield Hospital Gloucester and St Josephs Newport.

Breast reconstruction surgery options

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.

Current evidence suggests that breast reconstruction, either at the time of or after cancer treatment, has no adverse effect on the outcome of a patient’s cancer. According to guidance from the National Institute of Clinical Excellence, all patients should be offered immediate reconstruction following a mastectomy.

Reconstructive breast surgery options can involve:

  • The use of your own tissues imported to the chest from another part of the body (a flap)
  • Using a breast implant
  • A combination of the above two options

Your choice of reconstruction is dependent on your aspirations balanced against your perspective regarding the risks involved.

Immediate vs. delayed breast reconstruction surgery 

One of the first choices confronting patients is whether to undergo immediate or delayed breast reconstruction.

Immediate reconstruction is performed during the same operation as the mastectomy. The benefits of immediate reconstruction are:

  • The skin of the breast can be preserved
  • Smaller breast scars
  • Only one anaesthetic and recovery period
  • Only one stay in hospital
  • No period of time without a breast

Delayed breast reconstruction happens once a patient has fully recovered from a mastectomy (usually after several months). The benefits of delayed reconstruction are:

  • Staggered surgery, resulting in an easier and shorter recovery following each procedure
  • Time to consider whether reconstruction is right for you without delaying the cancer treatment so less to deal with at once

The drawback of immediate breast construction is that after a mastectomy, the removed breast is analysed by the pathologist, who will assess the need for subsequent radiotherapy.

Radiotherapy will change the size and shape of a reconstructed breast as well as increasing the risk of complications. For these reasons many surgeons prefer to do a delayed reconstruction and import normal tissue into the breast region, which has not been altered by radiotherapy. A period of time after mastectomy will also allow you to make a more informed and considered choice as to whether you wish to have further surgery and if so how involved you would like that surgery to be.

Breast implant reconstruction surgery

When a breast is reconstructed using just an implant, a silicone implant is inserted under the skin and muscle of the chest to replace the breast volume that was removed at the time of mastectomy. The main disadvantage of breast implant reconstruction surgery is that it is impossible to create a breast with a natural shape and feel.

Latissimus Dorsi flap reconstruction

Breast reconstruction surgery using back muscle is where the Latissimus Dorsi muscle is transferred to the breast area by carefully moving it around the ribcage to the front of the body. Using this breast reconstruction procedure, any skin removed at the time of the mastectomy is replaced along with extra volume. Some patients will also need a breast implant to further augment the volume, similar to a breast augmentation procedure.

Advantages of Latissimus Dorsi Flap reconstruction:

  • Can use your own tissue for small or medium breasts
  • Reliable success rate due to good blood supply
  • Breast reconstruction surgery using back muscle achieves a more natural appearance than using an implant alone

Disadvantages of Latissimus Dorsi Flap reconstruction:

  • Frequent formation of seroma (collection of fluid) at donor site in back.
  • Often needs implant or expander to increase breast volume
  • Scar on back will be visible in low cut dresses and swim suits.
  • Needs to be sufficient spare skin on back
  • Breast reconstruction surgery using back muscle is not suitable for serious athletes especially climbers or swimmers due to the loss of muscle strength in the shoulder.

Breast reconstruction surgery diep flap

The skin and fat of the lower abdomen are often the ideal tissue for breast reconstruction, making an abdominal flap reconstruction (or Autologous reconstruction) a popular option. A large amount of skin and volume can be replaced in order to achieve a very natural look and feel. An added bonus if that the removal of excess skin and fat from the abdomen results in a Tummy tuck (abdominoplasty) for the patient.

Diep flap breast reconstruction surgery is considered to be one of the best breast reconstruction options. It produces the best shape of breast while attempting to preserve the tummy muscles. In addition, many patients are pleased to have had a tummy tuck at the same time. These benefits, however have to be balanced by the fact that if the microsurgery to the blood vessels fails, the flap can lose its blood supply and the whole flap can be lost. This will occur in about 3-5% of patients.

All breast reconstruction is a process and many patients will need further procedures to adjust their reconstruction. These are usually minor procedures such as liposuction to reduce the size of the flap, scar revisions, lipofilling or nipple reconstruction. That said, autologous reconstruction is durable and once a satisfactory result is achieved it tends to be static and permanent.


Sherif invites his clients to leave a review about the plastic surgery procedures he provides on Google (Bristol and Gloucester), as well as Doctify, RealSelf and I Want Great Care.

Please visit the Testimonials page to read all the latest reviews, or click on the links directly below this contact form. Sherif is proud to be one of Bristol’s leading cosmetic surgeons, and his five-star reviews speak for themselves.

Enquire about this breast reconstruction surgery with Mr Wilson

Jen MooreJen Moore
10:12 01 Jun 23
I recently underwent a surgical procedure at Spire Clinic on 21st March 2023, under the expert care of Mr Wilson, and I am delighted to share my overwhelmingly positive experience. From the moment I walked through the doors of the clinic until my complete recovery, the service I received was nothing short of exceptional.First and foremost, I must express my sincere gratitude to Mr Wilson. His professionalism, expertise, and compassionate approach were evident from our very first meeting. He took the time to thoroughly explain the procedure, addressing all my concerns and ensuring I had a complete understanding of what to expect. His calm and reassuring demeanor put me at ease, instilling confidence in his abilities as a surgeon.The facilities at Spire Clinic were outstanding. The clinic's clean and welcoming environment helped alleviate any pre-operative anxieties I had. The staff members were friendly, approachable, and always ready to assist me with any questions or requests. From the receptionists to the nurses and support staff, everyone demonstrated a high level of competence and professionalism.Throughout my stay, the nursing team provided attentive care, ensuring my comfort and well-being at all times. They were highly knowledgeable, offering post-operative support and guidance that played a crucial role in my smooth recovery process. Their commitment to patient care was evident in their prompt response to any concerns or discomforts I experienced, making me feel valued and reassured.The post-operative follow-up care I received was exceptional. Mr Wilson regularly checked in on my progress and provided detailed explanations about the healing process. His willingness to address any post-surgery concerns, no matter how minor, further underscored his dedication to ensuring my complete recovery and satisfaction.The administrative staff at Spire Clinic also deserve commendation. They efficiently handled all aspects of my stay, including scheduling appointments, coordinating with my insurance provider, and addressing any billing inquiries. Their professionalism and attention to detail contributed to a seamless and hassle-free experience.In summary, my experience at Spire Clinic, under the care of Mr. Wilson, was exemplary. The clinic's commitment to excellence, paired with Mr. Wilson's expertise and compassionate care, made a significant impact on my overall satisfaction with the service I received. I would highly recommend Spire Clinic and Mr. Wilson to anyone in need of surgical care, confident that they will provide the same exceptional level of service that I was fortunate enough to experience.Thank you, Spire Clinic and Mr. Wilson, for your unwavering commitment to patient well-being and for exceeding my expectations at every step of my journey!!
Millie TaylorMillie Taylor
09:06 17 May 23
There are so many options when considering surgery, it can be a bit overwhelming as it's such a huge decision. Sherif was recommended to me by a friend of a friend, who talked very highly of him and his work. My first consultation with Sherif was informative and relaxed, there was no pressure to progress with the surgery and I felt I was in good hands. I was given time and space to make my decision, and felt comfortable asking any further questions. The surgery itself went smoothly, I felt safe and well looked after. My recovery went better than I'd imagined and I was comfortably back at work within 2 weeks. I'm now 11 weeks post op and I'm loving the results - it really is life changing, and I'm so glad I did it, and chose Sherif to do it. Huge thanks to him and his team.
lauren priestleylauren priestley
21:56 01 Aug 22
At my first consultation with Mr Wilson he made me feel comfortable and after explaining how specific I wanted my surgery to look, he took so much time explaining the procedure and answered all my questions and advised me on what my best option was.I am so pleased with the results.Him and all his lovely team were highly professional, helpful and very supportive during my surgery and during my post surgery follow up appointments.I cannot express enough how talented Mr Wilson is and I would highly recommend him.
Charmaine GriffinCharmaine Griffin
11:16 28 Jul 22
The service received from Mr Wilson and his secretary has been amazing. Kim has always been prompt and professional with all of our contact. At the initial consultation with Mr Wilson, he made me comfortable and at ease. Mr Wilson has always been so kind and considerate and made sure that he explained the options available to me and what each option would include. Mr Wilson was clear about what the results of each option would likely provide and the risks involved. On the day of my surgery Mr Wilson came to see me prior to the surgery to check that I was happy. The results of the surgery were better than I could ever have imagined. I got a small infection a couple of weeks after surgery and Mr Wilson got me in to see him the same day, provided me with antibiotics and it cleared up right away. I'm now 7 weeks post surgery and feeling right back to normal.
Ashleigh GoodwinAshleigh Goodwin
22:12 04 May 22
Wow, I honestly don’t even know where to start. I guess a MASSIVE thank you to Mr Wilson, he has quite frankly changed my life. From the moment I met him I knew that he was the surgeon for me, he listened to what I wanted, was very understanding and caring, he was honest with the outcome and explained everything perfectly. I knew that I had to have him as my surgeon for my Breast Reduction, the minute I left the consultation I booked my surgery, I only had 7 weeks to wait, I was beyond excited. About a week before the surgery I came to see Mr Wilson again just to settle my nerves, and he did just that. My surgery went incredibly well, I felt amazing and just so excited to see the results, I had no complications whatsoever and pain was minimal, the heeling process was so so smooth too. One year on and I am still on cloud nine, the scars are basically non existent and my new breasts are PERFECT. I’m not over exaggerating when I say Mr Wilson has changed my life, he really has done just that, and I will be forever grateful. Will recommend Mr Wilson over and over again to anyone wanting ANY surgery with him. He is incredible!