According to Dr. Oren Z. Lerman a plastic surgeon at Lenox Hill Hospital's Institute for Comprehensive Breast Care, and an Assistant Clinical Professor of Plastic Surgery at NYU School of Medicine;

Techniques for breast reconstruction for women with breast cancer have been evolving over the past few years with great speed. Although the number of women who undergo breast reconstruction after mastectomy is still alarmingly low (less than 40%) the techniques available to them have never been more diverse. Additionally, as public awareness of breast reconstruction options improves, so does the availability of plastic surgeons with the appropriate training to perform these newer techniques.

The team approach towards treatment of breast cancer allows for the best possible decision making by the patient. Consultations with the breast surgeon as well as the reconstructive plastic surgeon, medical oncologist, and radiation oncologist allow for the best possible planning. 

The options for breast reconstruction include the traditional techniques of breast implants as well as the most advanced techniques of transplanting healthy vascularized tissue from another part of the body to recreate a breast that is entirely natural and made up of one's own tissue such as DIEP flaps or other perforator flaps. Additionally, while plastic surgeons performing breast reconstruction have historically been involved in mastectomy cases, they are now performing new procedures that allow for improved outcomes during breast conservation (lumpectomy). These oncoplastic techniques, as they are called, are designed to avoid the defects, asymmetries and contour abnormalities that sometimes result after lumpectomy. Finally, secondary reconstruction of deformities after lumpectomy or radiation are routinely treated with techniques such as fat grafting which allow for a restoration of normal contour and fullness as well as improvement in overlying scars and tissue damage.

Although implant reconstruction remains the most common form of breast reconstruction after mastectomy, there is a growing recognition that using one's own tissue (autologous reconstruction) has many advantages over the long run in the proper patient. New perforator flaps (DIEP, GAP, TUG, and PAP flaps) preserve the muscle function minimizing morbidity and recovery and are much improved over traditional flap techniques (TRAM flap).  These procedures allow for breast reconstruction without a breast implant. Breast implants are not designed to last forever and may need to be revised or replaced multiple times over the course of one's life.  Additionally, because radiation therapy increases the risk of complications and suboptimal results from breast implants, women undergoing radiation therapy have an added advantage when choosing autologous flap reconstruction. Finally, women who have already had breast reconstruction with implants and have unsatisfactory results can usually have the implant removed and replaced with their own tissue.

Aesthetic considerations are paramount in the modern day breast reconstruction. New techniques can leave breast cancer patients feeling and looking good for the rest of their lives. The right team approach is imperative to optimize the plan of care both from the oncologic and reconstructive point of view.