Breast Reconstruction
Breast Reconstruction is one of the most meaningful areas of plastic surgery, restoring not just physical form, but confidence and wholeness after cancer treatment. It is also the area where Mr Ibrahim has invested the most concentrated effort in developing his expertise. His Clinical Fellowship in Breast Reconstructive Microsurgery at the RCSI, combined with two International Master’s Degrees from the Universitat Autònoma de Barcelona in Breast Reconstructive Microsurgery, Aesthetic Breast Surgery, and Breast Cancer-Related Lymphoedema, places him among a small group of surgeons in Ireland with this depth of subspecialty training.
Reconstruction can be performed immediately at the time of mastectomy or in a delayed fashion after cancer treatment is complete. Mr Ibrahim works closely with each patient's oncology team to ensure reconstruction is planned in a way that supports, rather than compromises, cancer treatment.
Breast Reconstruction Options
Mr Ibrahim offers the full range of breast reconstruction techniques and takes time to explain the options clearly so each patient can make an informed choice that suits her body, lifestyle, and recovery priorities.
Implant-based reconstruction uses a silicone prosthesis placed at the time of mastectomy. A biological mesh can be used to support the implant and improve shape.
Autologous reconstruction uses your own tissue to create a breast that feels natural, ages naturally, and avoids implant-related concerns. Mr Ibrahim is experienced in the following flap techniques:
DIEP Flap (Deep Inferior Epigastric Perforator Flap): Skin and fat from the lower abdomen are transferred microsurgically, with the abdominal muscles left entirely intact. This is the gold standard autologous technique and Mr Ibrahim's area of subspecialty. Surgery takes five to seven hours.
PAP Flap (Profunda Artery Perforator Flap): Skin and fat from the upper inner thigh/buttock creases are transferred microscopically, with thigh/buttock muscles left entirely intact. This approach is particularly suitable for women who have limited abdominal tissue but have more available tissue in the upper thigh region.
LAP Flap (Lumber Artery Perforator Flap): Skin and fat from the lower back are transferred microscopically, with back muscles left entirely intact. This approach is particularly suitable for women who have limited abdominal tissue or post-tummy tuck surgery but have more available tissue in the lower back and flanks.
Latissimus Dorsi Flap: Tissue from the back, usually combined with an implant. Reliable and widely used when abdominal tissue is not available or suitable.
Some patients may benefit from a symmetrising procedure after breast reconstruction, depending on the natural shape and cup size of the opposite breast before surgery. In some cases, small refinements to the reconstructed breast—such as fat grafting or gentle liposuction—can help enhance contour and achieve a more balanced result. These adjustments are guided entirely by the patient’s goals and preferences. Such procedures are typically performed as day‑case surgery under general or local anaesthetic.
Nipple and areola reconstruction is offered as a final stage once the breast mound has settled — using local tissue flaps, medical tattooing, or three-dimensional nipple tattooing for a realistic, non-surgical result.
Your Recovery
Recovery varies depending on the technique adopted:
Implant-based reconstruction typically requires one to two nights’ stay in the hospital, with return to desk work in two to three weeks.
Autologous reconstruction requires three to seven nights’ stay in the hospital, with return to work in four to six weeks and full recovery over eight to twelve weeks.
Mr Ibrahim provides detailed recovery guidance and ensures patients know what to expect at each stage
Risks & Complications
General risks include infection, bleeding, wound healing problems, and asymmetry.
Implant-specific risks include capsular contracture, malposition, rupture, and Failure/explantation.
Flap-specific risks include partial or complete flap loss — the most serious complication, occurring in approximately 1-2% of cases — along with fat necrosis and donor site complications.
Mr Ibrahim discusses in detail all risks specific to the planned reconstruction during the consultation
Frequently Asked Questions
Should I have immediate or delayed reconstruction?
This depends on whether radiotherapy is planned, your cancer treatment timeline, and your personal priorities.
Mr Ibrahim coordinates with your oncology team to help you reach the right decision.
Is the DIEP flap right for me?
The DIEP flap requires adequate abdominal tissue and no prior abdominal surgery that affects the blood supply.
Mr Ibrahim will assess your suitability carefully and discuss alternatives if needed.
Will I have sensation in the reconstructed breast?
Most women experience significantly reduced sensation after mastectomy, as nerves are disrupted.
Some sensation may return over time, but expectations should be realistic.
Mr Ibrahim will discuss this honestly.
How many operations will I need?
This varies:
Implant reconstruction typically involves one to three procedures.
Autologous reconstruction may require supplemental surgeries. This can include symmetrizing surgery to the opposite breast, plus possible refinements to the reconstructed breast.
MR SAFWAT IBRAHIM
Breast Microsurgical Reconstructive Surgeon, Dublin
Breast reconstruction is a deeply personal decision, and one that deserves time, clarity, and compassionate guidance. Mr Ibrahim welcomes these conversations - whether you are newly diagnosed, mid-treatment, or years post-mastectomy and considering delayed reconstruction. Contact his rooms to arrange a consultation.