Reconstructive Surgery

Approved by the Cancer.Net Editorial Board, 08/2020

Cancer treatment can cause damage to your body that affects how it works or looks. In order to repair this damage, you may need a type of surgery called reconstructive surgery.

Reconstructive surgery is different from cosmetic surgery. You may have cosmetic surgery to look better or feel better about your appearance, but it is not needed for medical reasons. Reconstructive surgery is done for medical reasons. This type of surgery is usually covered by insurance, for both large and small procedures. 

Why would I need reconstructive surgery?

You are most likely to need reconstructive surgery after some types of surgery to remove cancer. For example, you might have a breast removed to treat breast cancer. You may choose to have reconstructive surgery to replace the breast with an implant. Or you might have tissue or nerves removed during treatment for head and neck cancer, skin cancer, or other types of cancer. Reconstructive surgery can help repair the changes to your body from your cancer surgery.

Where is reconstructive surgery done?

Reconstructive surgery can be done in the hospital, at your doctor's office, or at a clinic or surgery center. The location depends on the type of surgery, your general health, where your surgeon does surgery, and other factors. Ask your health care team for more information if it is unclear to you where your reconstructive surgery will be done.

Who will do my reconstructive surgery?

Reconstructive surgery may be done by the same doctor who removes the cancer. This may be your surgical oncologist, which is a cancer surgeon. Or, a surgeon who specializes in reconstruction or a plastic surgeon may do your reconstructive surgery after your cancer surgery. If you have a reconstructive surgeon, they will be part of your health care team and will work closely with your oncologist and other health care team members.

How does reconstructive surgery work?

Reconstructive surgery often uses tissue from 1 area of your body to repair another area. For example, head and neck surgery might change the shape of your jawbone. So your surgeon may take some bone from your leg to repair your jaw. This can restore the shape of your jaw and help it work normally.

The medical term for this type of surgery is "autologous reconstruction." This means that the tissue used in the surgery comes from your own body. It is a common type of reconstructive surgery.

In the new area, your surgeon will use tiny stitches to connect the tissue and blood vessels so that the tissue gets a good blood supply. The stitches are so small, you would need a microscope to see them. This is also called "microvascular" surgery.

Other types of reconstructive surgeries include:

Skin, tendon, and bone grafts. Your surgeon will move, or transplant, healthy tissue from another part of your body to the area that needs repair.

Local flap surgery. Your doctor uses tissue from a nearby area to cover the damaged area. The tissue stays attached to your body's blood supply. This can speed up healing and also reduce scarring.

Artificial implants. You might receive an artificial body part, or implant. For example, implants are available for a breast, testicles, or penis that has been removed as part of cancer treatment.

For some procedures, like jaw reconstruction, your surgeon may use a 3-D printer to build an implant. This implant will be placed in your body during surgery.

Scar revisions. This type of reconstructive surgery helps repair scars from earlier surgery.

Deciding about reconstructive surgery

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

  • Where you need cancer surgery, and how much reconstruction you need

  • If you had surgery in that same area before

  • Your personal preferences

  • If you need more cancer treatment

  • Your general health and any other medical conditions

You may have reconstructive surgery right after your doctor removes the cancer. Or you may have the reconstructive surgery at a later time, after the area heals or you finish other cancer treatments such as chemotherapy or radiation therapy. Whether you need additional cancer treatment after surgery is a particularly important factor because some treatments, like radiation therapy, can affect your reconstruction. In this case, you may have more than 1 surgery. An option may be to start with a "temporizing procedure." This is a temporary repair that is done before radiation therapy. Then, after you complete radiation therapy, your surgeon will finish your reconstruction.

Recovering from reconstructive surgery

The time you need to recover depends on the type of surgery. Before surgery, be sure to ask:

  • How long recovery is likely to take

  • How to manage any pain or discomfort after surgery

  • If you should change your daily routine and activities, and for how long

It is possible you will need to make some permanent changes. For example, if you have your bladder removed, you will have a bag on the outside of your body to collect urine. Your health care team can help you adjust to any of these types of changes.

Coping with body self-image and emotional changes

Both cancer treatment and reconstructive surgery can change how you look and feel. This may be positive, negative, or a bit of both. It is normal for changes to your body to affect your emotions and your self-image. The following tips can help you manage emotional side effects.

  • Before surgery, ask your health care team any questions you have about body changes from your surgery. Knowing what to expect ahead of time can help you feel more prepared.

  • Allow yourself time to adjust to the changes, and treat yourself with kindness

  • Seek out support for managing your emotions and accept the help of others

  • Consider joining a support group. It can be very helpful to talk with people who have had a similar experience as you.

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

Questions to ask your surgeon before reconstructive surgery

  • What is your experience doing this type of reconstructive surgery? Such as, how many have you done and how often do you perform this surgery?

  • What are my reconstructive surgery options?

  • What are the advantages of each type? What are the disadvantages?

  • How soon can I have reconstructive surgery after cancer treatment? Or, can I wait to have reconstructive surgery?

  • How long will the reconstructive surgery take? Will I need to stay in the hospital, and if so, for how long?

  • Are there things I can do to get ready for surgery?

  • Where will you do the surgery?

  • What are the possible complications and side effects of this reconstructive surgery? How will they be relieved or managed?

  • What will my body look and feel like right after this surgery? Will that change over time?

  • If tissue or graft from another part of the body is being used for my reconstruction, how will that part of the body feel or look after this surgery? What are the risks of that type of reconstruction?

  • If I'm worried about the costs of this surgery or my insurance coverage, who can help me?

General questions about recovery include:

  • Can you describe what my recovery will be like?

  • How long will it take me to recover once I'm at home?

  • What type of caregiving will I need during my recovery at home?

  • During my recovery, are there specific side effects I should let you know about right away?

  • When can I go back to my regular activities, such as work, driving, and sex?

  • Can I exercise during my recovery? What are some ways I can safely be physically active?

  • Are there certain activities I should avoid during recovery? For how long?

  • Will I have stitches, staples, or bandages? When will they be removed, and how?

  • What results can I expect?

  • Will I have a scar or other permanent effects? Will the results look different with time?

  • What will this area of my body feel like? Will that change over time?

  • Can I see pictures of similar surgeries?

  • Will I need more surgery in the future?

  • What will my follow-up care be like after surgery? Do I need more appointments or tests after this surgery?

  • Will I need any cancer rehabilitation services?

  • What emotional support services are available to me?

This list of suggested questions is a starting point to help you learn more about your specific reconstructive surgery. You are encouraged to ask additional questions that are important to you, including specific questions based on the part(s) of the body involved and the specific type of reconstruction done, such as a graft or tissue relocated from another part of the body.

Related Resources

What to Expect When Having Surgery

What is Cancer Surgery?

Cancer.Net Blog: Body Image Matters

More Information

American Society of Plastic Surgeons: Find a Plastic Surgeon

American Society of Plastic Surgeons: Reconstructive Procedures