Reconstructive Surgery

Approved by the Cancer.Net Editorial Board, 06/2018

Cancer treatments sometimes damage a body part’s function or appearance. Reconstructive surgery helps repair that damage.

Reconstructive surgery differs from cosmetic surgery because reconstructive surgery is done for a medical reason. Most insurance companies cover reconstructive surgery that is needed after cancer treatment.

Reconstructive surgery is most commonly needed after some types of surgery to remove the cancer. For example, a person may choose to have reconstructive surgery after a mastectomy. A mastectomy is the surgical removal of the breast. It is a type of treatment for breast cancer. Another example is when a surgeon replaces tissue or nerves removed during treatment for head and neck cancer or skin cancer.

Treatment centers

Reconstructive surgery is usually done at the following types of centers:

  • Outpatient center. This can be a doctor's office, clinic, or surgery center.

  • Inpatient center. The patient stays in the hospital for the surgery.

The medical team

The doctor who leads your medical team depends on when you have reconstructive surgery:

  • A surgical oncologist may lead the team if you have reconstructive surgery at the same time as surgery to remove the cancer. Many surgeons who remove cancer also regularly perform certain types of reconstructive surgery.

  • A reconstructive surgeon may lead your surgical team if the reconstructive surgery is done at a later time. He or she then works closely with your oncologist and other members of your health care team.

How reconstructive surgery works

Many reconstructive surgeries use microvascular techniques. This is also called “free flap surgery.” In this type of surgery, the surgeon takes tissue and blood vessels from 1 part of the person’s body and moves them to the damaged part. This is called transplantation. The surgeon connects the blood vessels using small stitches only visible with a microscope. The stitches connect the tissue and blood vessels to those at the new site.

For example, head and neck surgery sometimes changes the jawbone shape. A reconstructive surgeon may transplant bone from the leg to the face. This restores the jawbone’s shape and often its function.

Other types of reconstructive surgery

Other types of reconstructive surgeries include:

Skin, tendon, and bone grafts.
The surgeon transplants healthy skin, tendon, or bone to a new place in or on the body. The transplanted tissue does not have its own blood supply. This means that new blood vessels must grow.

Local flap surgery. This approach uses nearby body tissue to cover the area affected by cancer surgery. The surgeon does not disconnect tissue from the body or blood supply. He or she moves it while it is still attached to the nearby area.

Artificial implants. Sometimes an artificial implant replaces a damaged body part. Examples include breast, testicular, and penile implants.

Scar revisions. These surgeries help minimize the appearance of scars from an earlier surgery.

Making decisions about reconstructive surgery

Talk with your surgeon about your options. The type of reconstructive surgery that is right for you depends on several factors:

  • The location and severity of the damage

  • Prior surgeries

  • Your personal preferences

  • Need for further cancer treatment

  • Your overall health and other medical conditions

Often, reconstructive surgery is done right after removing the tumor. Other times you may need to wait until other cancer treatments have finished, such as chemotherapy or radiation therapy.

Recovery from reconstructive surgery

The time to recover from reconstructive surgery depends on the type of surgery. Ask your surgeon about these recovery topics before your surgery:

  • Your expected recovery time

  • How to manage any pain or discomfort you may have

  • Limitations to your daily routine and how long they will last

Sometimes, a person may have to make permanent lifestyle adjustments. For example, if the bladder is removed, a bag on the outside of the body will collect urine.

Handling the emotional side effects of reconstructive surgery

Talk with your reconstructive surgeon about how surgery will change the way you look and feel. It is normal for changes to your body to affect your self-image. The following tips can help you manage emotional side effects:

  • Seek support for managing your emotions related to your body changes.

  • Consider joining a support group for people who have experienced similar changes. You can learn from others’ experiences and share your own.

  • Consider counseling. Ask a member of your health care team for a referral to a mental health professional.

Questions to ask your reconstructive surgeon

  • Are you board-certified? Is reconstructive or plastic surgery your specialty?

  • How many reconstructive or plastic surgeries of this type do you perform in a year?

  • What reconstructive surgery options do I have?

  • What are the advantages and disadvantages of each type?

  • When can I have reconstructive surgery?

  • What are the costs involved with this type of surgery? What does my insurance cover?

  • How long will the surgery take?

  • How should I prepare for the surgery?

  • Is this an inpatient or outpatient surgery? If it is inpatient surgery, how long will I be in the hospital?

  • What are possible complications for this type of surgery?

  • How long will it take for me to recover? When can I resume my normal activities, including exercise?

  • Will I have stitches, staples, and/or bandages?

  • Will I have a scar or other permanent effects from the surgery?

  • What type of results can I expect

  • Can I look at photographs of similar surgeries?

  • What changes to the reconstructed area can I expect over time?

  • Will I need to have another surgery in the future?

  • Do I need any follow-up appointments or tests after reconstructive surgery?

Related Resources

What to Expect When Having Surgery

What is Cancer Surgery?

More Information

American Society of Plastic Surgeons: Find a Plastic Surgeon

American Society of Plastic Surgeons: Reconstructive Procedures