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Originally published October 29, 2025
Last updated October 31, 2025
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For breast cancer patients, surgical treatment often means the removal of breast tissue to extract tumors and ensure a return to better health.
Afterward, many patients decide to seek reconstructive surgery to restore their affected chest region.
At USC Verdugo Hills Hospital, David Daar, MD, MBA, and Emma Koesters, MD, both Keck Medicine of USC plastic and reconstructive surgeons, often operate in tandem on breast cancer patients, helping them meet their recovery goals.
Here, they answer frequently asked questions.
There are implant-based surgeries and tissue-based surgeries, as well as a spectrum in between of lifts and reductions.
Determining which is best for a patient depends on their individual preferences, risk factors, goals and the status of their cancer treatment.
Implant reconstruction is a shorter procedure with a somewhat quicker recovery. It may be a great option for some patients, but it does potentially require more maintenance, such as increased scar tissue within the breast that could require more surgery.
Autologous tissue reconstruction, meanwhile, uses the patient’s own tissue in a flap procedure that feels a lot more natural and poses less lifelong risk of infection and other maintenance. If you’re a candidate for it, this may be a preferred option.
We like to be part of the conversation early on so that patients can gain a good understanding of what they may go through — as well as a sense of comfort.
Even though they must deal with a difficult cancer diagnosis, they may see some light at the end of the tunnel with our reconstructive possibilities.
We consider the patient’s preoperative breast size as well as their desired postoperative breast size. Then we consider any other medical conditions they may have, such as diabetes, heart disease or other medical problems that might add nuance to their treatment plan.
We also consider their expected cancer treatment: Will they likely need radiation? Are they getting lymph node dissection? All these things can affect the sequence of our recommendations.
Surgery can be done at the same time as a mastectomy, or in a separate operation.
In cases where a tumor is removed but the breast remains, there are various options for surgery, including moving tissue around to fill the space where the cancerous tissue was removed or doing a cosmetic breast lift or reduction that also helps fix the area where the cancer was removed.
Symmetrizing surgery, where the other breast is cosmetically improved to match, can also be performed.
We like to have multiple discussions with patients and allow them time to do their own research and talk to loved ones or other people in the breast cancer community.
We want patients to feel involved and comfortable with the approach we’ll take together.
When we do flap procedures, or the tissue-transfer procedures, we do have a special protocol that begins preoperatively and extends into the postoperative period.
This accelerated recovery protocol helps minimize pain and gets patients back to their regular activities as soon as possible.
We usually quote a recovery time of about six weeks. It can be less or more, depending on the patient. During that time, patients must refrain from strenuous activity or lifting anything heavier than a gallon of milk.
Sometimes patients will have drain tubes that drain fluid postoperatively. Those stay in for a couple of weeks. Patients often need pain medication and at-home assistance in the first couple of weeks. Occasionally, they may need antibiotics.
Even if they’re 90% against it, they should talk to a reconstructive surgeon to learn their options. Many people may have heard about the experience of a patient who had breast reconstruction 10 or 20 years ago, and they don’t realize the vast improvements that have been made in reconstructive surgery. Even if you decide not to go through with surgery, you should know all your options first.
You want to be somewhere you feel comfortable with your physicians. It’s important to ask, “Do these surgeons do this operation regularly? Is it a high-volume center where they take care of many breast cancer patients?”
Learn about who would be on your care team and if there is someone you can contact in the evenings and on weekends if you have questions or concerns.
Also, ask if the surgeon is a microsurgeon. Microsurgeons have specialized training to offer more types of breast reconstruction and lymphatic procedures that can help reduce the risk of lymphedema (swelling of the arm), which is a complication of lymph node removal. If they aren’t trained in microsurgery, they wouldn’t be able to offer it, which can limit your options.
Patients should know that breast reconstruction is a process. It’s almost never a one-and-done situation. We work with our patients for many months to get them to the point where they feel happy and can put their breast cancer and breast surgeries behind them.
Also, breast reconstruction can happen at any point in your care. If you’re a patient who was treated for breast cancer years ago, you’re still a candidate for reconstruction.
Or if you’re unhappy with your prior reconstruction, there are still many options to make you feel happier and more whole.
Our team is very experienced in caring for breast cancer patients. We are in constant communication with our breast surgeons, oncologists and radiation oncologists to ensure we are all on the same page with each patient’s care.
We work together frequently with the operating room staff, as well as the preoperative and postoperative care teams.
It’s well-coordinated and well-established. It’s exciting for us to deliver this care, because even though we perform many of these procedures, each patient is unique, and we love tailoring our approach to each of them.
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