Cosmetic Surgery Tips

Is Breast Reconstruction Covered By NHS

A mastectomy is an operation to remove a breast. It’s used to treat breast cancer in women and breast cancer in men.

The operation takes about 90 minutes, and most people go home the following day.

It can take 4 to 6 weeks to recover from a mastectomy.

Is Breast Reconstruction Covered By NHS

Cosmetic surgery is not routinely provided on the NHS.

It may occasionally be provided on the NHS for psychological or other health reasons. For example, the NHS might pay for:

breast enlargement (implants) – if you have very uneven breasts or no breasts, and it’s causing significant psychological distress
nose reshaping (rhinoplasty) – if you have breathing problems
ear correction surgery, including ear pinning – if a child needs it, or sometimes, if an adult has prominent ears that are causing significant distress
female breast reduction – if you’re very distressed about the size of your breasts and they’re causing problems like backache
male breast reduction – if you’ve had a condition called gynaecomastia for a long time, other treatments have not worked, and it’s causing considerable pain or distress
Generally, most people who want cosmetic surgery will need to pay for it privately.

Reconstructive or plastic surgery is often available on the NHS. It’s different from cosmetic surgery because its main aim is to repair and reconstruct missing or damaged tissue and skin after an illness, accident or birth defect.

Plastic surgery includes procedures such as rebuilding a woman’s breasts after a mastectomy (an operation to remove a breast), and repairing a cleft lip and palate.

When is a mastectomy recommended?

A mastectomy may be recommended if:

  • cancer is in a large area of the breast
  • cancer has spread throughout the breast
  • the breast is full of pre-cancerous cells

Some women at high risk of breast cancer choose to have a mastectomy even when there’s no sign of cancer.

Preparing for a mastectomy

Before having a mastectomy, you will have the opportunity to discuss the operation with a specialist breast care nurse or surgeon. You can discuss how the procedure might affect you physically and emotionally.

You’ll get practical advice about bras and bra inserts, if you need them.

Your surgeon will discuss the type of mastectomy you’ll have, the possible complications and the option of breast reconstruction. You may need to have chemotherapy or hormone therapy before the operation to reduce the size of any tumours.

The operation

A mastectomy is carried out under general anaesthetic, so you’ll be asleep while it happens.

During the operation, a horizontal or diagonal cut is made across your breast so the tissue can be removed. The amount removed will depend on the type of mastectomy you’re having.

The surgeon will usually put one or two drainage tubes in place to stop fluid building up in the breast space. These may be left in for a few days.

Types of mastectomy

Some of the main types of mastectomy are:

  • standard mastectomy – all of the breast tissue and most of the skin covering it is removed
  • skin-sparing mastectomy – all of the breast tissue is removed, including the nipple, but most of the skin covering the breast is left
  • nipple-sparing mastectomy – a skin-sparing mastectomy where the nipple isn’t removed
  • radical mastectomy – a now-rare procedure where all of the breast tissue is removed, as well as the skin covering it, the two muscles behind the breast and the lymph nodes in the armpit
  • modified radical mastectomy – as above except the large muscle behind the breast (the larger of the two pectoral muscles) is left in place

The operation usually involves removing most of the breast tissue and skin, and the nipple.

Lymph nodes

Lymph nodes play a crucial role in the body’s immune system, serving as filters that help remove bacteria, viruses, and other waste from the body. These small, oval-shaped structures are located throughout the body, with clusters found in areas such as the neck, armpits, and groin. One common location for lymph nodes is under the arm, where they help to drain lymph fluid from the breast and surrounding tissues.

In cases where cancer has spread to the lymph nodes under the arm, a procedure known as a lymph node dissection may be necessary. During this operation, the affected lymph nodes are removed in order to prevent the further spread of cancer cells. This procedure is often performed in conjunction with other cancer treatments, such as surgery, chemotherapy, and radiation therapy.

The removal of lymph nodes under the arm can have several implications for patients, both in the short term and the long term. In the immediate aftermath of the procedure, patients may experience pain, swelling, and limited range of motion in the affected arm. These side effects are typically temporary and can be managed with pain medication, physical therapy, and other supportive care measures.

Over the long term, the removal of lymph nodes under the arm can increase the risk of developing lymphedema, a chronic condition characterized by swelling and fluid retention in the affected arm. Lymphedema can be a challenging condition to manage, requiring ongoing monitoring and treatment to prevent complications and improve quality of life.

In conclusion, the removal of lymph nodes under the arm is a necessary step in the treatment of certain types of cancer. While this procedure can have both short-term and long-term implications for patients, advances in medical technology and supportive care have improved outcomes for individuals undergoing lymph node dissection. By working closely with their healthcare team and following recommended treatment guidelines, patients can maximize their chances of a successful recovery.

If pre-surgery tests didn’t find cancer in your lymph nodes, a few may be removed during the operation for further testing. If these tests find cancer, you might need radiotherapy or another operation.

Some hospitals are able to test the lymph nodes while you’re being operated on, which reduces the need for a second operation.

Breast reconstruction

If you’re having a mastectomy, your surgeon will usually talk to you about the possibility of having breast reconstruction.

Breast reconstruction is an operation to make a replacement for the tissue removed during a mastectomy. It’s often done at the same time as a mastectomy, but it can be done at a later date.

Some people decide not to have breast reconstruction.


Most people who have a mastectomy recover well. You may wake up with:

  • a drip in your arm so you can be given fluids
  • one or more drainage tubes coming from the wound
  • a dressing to help keep your wound clean

You will probably feel sore for a few days and should be given painkillers in hospital. If they don’t work, tell the nursing staff before you leave so you can try something else.

Most people find their wounds take around 2 to 3 weeks to heal, but it may be several months before your chest and arm area fully recover.

The area will be bruised, swollen and stiff at first. You may also have:

  • painless swelling around your stitches (seroma) – this usually disappears without treatment after several weeks
  • numbness where your lymph nodes were removed – this should improve with time


The scar from a mastectomy will extend across the skin of the chest and into the armpit, usually hidden by the bra cup. It will fade over time but never completely disappear. It will also feel permanently numb.

If you don’t like the look of your scar, you may be able to have some corrective surgery.

Going home

Most people go home the day after their operation, although some feel well enough to go home on the same day.

If you’ve had breast reconstruction, you may need to stay in hospital for up to a week depending on how you’re recovering.

Before you leave hospital, your doctor or nurse will talk to you about what to do when you get home. You’ll probably feel more tired than usual for several weeks and will need a lot of rest, so try not to do too much.

The results of the operation and any further treatment will be discussed at a follow-up appointment around 2 weeks after the operation.

Arm exercises

Arm exercises are recommended to encourage the full range of movement back to your arm and shoulder.

You can start to do the gentle exercises your doctor or nurse gives you as soon as you feel comfortable, usually the day after your surgery.

You may be given an exercise leaflet – here’s an example of an exercise routine from Breast Cancer Now. You may also be offered physiotherapy.

Avoid more strenuous exercise, including housework and heavy lifting, until you get the all-clear from your doctor or nurse.

Bra inserts

Before leaving hospital, you’ll have the opportunity to be fitted with a lightweight breast shape (prosthesis) to wear inside your bra.

You’ll usually be fitted with a longer-term prosthesis and given advice on bra fitting 6 to 8 weeks after the operation.


Get advice from your doctor or nurse about when to start driving. Generally, you should be OK to drive if you can make an emergency stop without discomfort in the wound.

Some people are able to drive about 3 weeks after the operation, but it may be sooner or later than this depending on how you feel.

Some insurance companies will not insure drivers for a number of weeks after surgery, so you may want to check your policy.

Returning to work

You can return to work when you feel up to it. Taking 4 to 8 weeks off is fairly typical, but it varies from person to person.

The hospital staff or your GP can supply you with a medical note for your employer if needed.


If you’re concerned your wound isn’t healing well, contact hospital staff or your GP.

Get urgent medical advice if:

  • your wound becomes infected – it may be red, painful or swollen, or ooze liquid
  • your arm and hand become swollen and sore because of a build-up of fluid (lymphoedema)
  • your wound is bleeding

Emotional support

Recovering from a mastectomy can be emotionally difficult. You may find it helpful, before and after your mastectomy, to talk to others who have had the operation.

Breast implants NHS criteria

Cosmetic surgery is not routinely provided on the NHS.

It may occasionally be provided on the NHS for psychological or other health reasons. For example, the NHS might pay for:

breast enlargement (implants) – if you have very uneven breasts or no breasts, and it’s causing significant psychological distress
nose reshaping (rhinoplasty) – if you have breathing problems

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