Access to breast reconstruction in Brazil: challenges and advancements

• October 11, 2025
• By Fernando Amato

Despite being guaranteed by law, access to breast reconstruction in Brazil is still a challenge for many women. Public initiatives and medical specialization are, however, changing this reality.

💖 Highlights

• ⚖️ Breast reconstruction is a right guaranteed by law.
• 🏥 Access is still unequal across regions of Brazil.
• 👩‍⚕️ A specialized plastic surgeon is essential for the safety of the procedure.
• 💪 Real stories show courage and triumph.
• 🎗️ Early diagnosis is the main weapon against breast cancer.

🩺 Access to breast reconstruction in Brazil: challenges and advancements

Breast reconstruction, however, is a right guaranteed by law to all women who undergo mastectomy, whether total or partial. Nevertheless, access to breast reconstruction in Brazil still faces significant barriers — from the lack of specialized professionals to regional inequalities that directly affect the emotional and physical recovery of patients.

Law No. 9,797/1999 ensures the right to reconstructive surgery in the Unified Health System (SUS), and Law No. 9,656/1998 obliges health plans to offer full coverage. Even so, the reality is far from ideal.

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🌸 What breast reconstruction is and why it is so important

Breast reconstruction thus aims to restore the shape and symmetry of the breasts after cancer treatment.
Therefore, in addition to the physical aspect, the procedure has a profound psychological and emotional impact, contributing to self-esteem, feminine identity, and social reintegration.

The procedure can be performed in two ways:

• Immediate, during the same surgical act as the mastectomy;
• Delayed, months or years after oncological treatment.

Therefore, the decision should be made with the support of a multidisciplinary team, including a mastologist, oncologist, and plastic surgeon — the professional responsible for executing the reconstructive technique safely and aesthetically.

🔗 Learn more about the different types of mammoplasty and their application in reconstruction.

⚖️ Patient rights in SUS and health plans

In Brazil, the right to breast reconstruction is legally supported.
Thus, according to the Ministry of Health, every woman with a medical indication has the right to free reconstruction in the SUS, including the use of implants (check more about implants here) and expanders, when necessary.

In health plans, the procedure is of mandatory coverage. The National Agency for Supplementary Health (ANS) determines that no operator can deny the procedure on the grounds of aesthetic purpose.

However, despite legal guarantees, many women still do not know their rights. Therefore, awareness campaigns and legal guidance are essential to expand access and reduce inequalities.

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🏥 Unequal access: the portrait of Brazilian reality

Research by the Brazilian Society of Plastic Surgery (SBCP) reveals that less than half of women who undergo mastectomy in the SUS undergo breast reconstruction.
The main causes include:

• Scarcity of specialized plastic surgeons in public hospitals;
• Lack of surgical materials and supplies;
• Long waiting lists;
• Misinformation about the right to the procedure.

This inequality is particularly visible in the North and Northeast regions, where the concentration of reference centers is lower.
While in capitals immediate reconstruction is possible in up to 80% of cases, in the interior this number drops to less than 30%.

🔗 Learn more about the importance of adequate hospital structure for surgical safety.

👩‍⚕️ The essential role of the specialized plastic surgeon

Breast reconstruction is, however, one of the most complex procedures in plastic surgery.
It requires not only technique but also sensitivity to understand the emotional impact of mastectomy.

The specialist plastic surgeon, a member of the SBCP, is the most qualified professional to assess each case and choose the best technique — whether with a muscle flap, expanders, implants, or a combination of methods.

Additionally, the specialist monitors the rehabilitation process, providing guidance on post-operative care, proper diet, and pre-surgical preparation exams (learn more).

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🤝 Initiatives and advancements changing the landscape

In recent years, several initiatives have expanded access to breast reconstruction in Brazil:

• Reconstruction task forces, promoted by universities and public hospitals;
• Pink October campaigns, focusing on early diagnosis and female empowerment;
• Medical training projects, which train plastic surgeons to work in the SUS;
• Reference centers, such as Hospital Pérola Byington (SP) and Hospital de Amor (Barretos), which offer free reconstruction and psychological support.

These advances demonstrate that the union between public policies, medicine, and solidarity can transform the lives of thousands of women.

🔗 Also, check out the content on mastopexy, a technique that can be associated with reconstruction to improve breast symmetry.

💬 Stories of triumph

🌷 Luciana, 45 years old – São Paulo (SP)
“I waited a year in the SUS for reconstruction. When I woke up from surgery, I felt a part of me had returned. It was the beginning of my new life.”

🌼 Regina, 39 years old – Fortaleza (CE)
“I had reconstruction with a flap from my abdomen. The surgeon explained everything and made me feel safe. Today I’m part of a group that helps other women not to give up.”

💪 Cecília, 51 years old – Porto Alegre (RS)
“My doctor showed me that reconstructing is not vanity, it’s emotional health. I am grateful to have found a humane and specialized team.”

🌺 Final message of hope

Access to breast reconstruction in Brazil is more than an aesthetic issue — it is a human right and a matter of dignity.
Despite the challenges, advancements show that it is possible to dream of a future where every woman, regardless of region or financial condition, can look in the mirror with confidence and pride.

🎗️ Early diagnosis saves lives.
Have your mammogram regularly and seek a specialist doctor if you notice any changes.

❓ FAQ – Frequently Asked Questions (schema.org/FAQPage)

1. Is breast reconstruction mandatory in the SUS?
Yes. Since 1999, the law guarantees free reconstruction for all women who have undergone mastectomy.

2. Is it possible to have reconstruction along with breast removal?
Yes, if the clinical condition allows. This is called immediate reconstruction.

3. Can health plans refuse coverage?
No. The ANS requires plans to cover reconstructive surgery.

4. Which techniques can be used?
The main ones are with implants, expanders, or an autologous flap (taken from the abdomen or back).

5. What influences waiting times in the SUS?
The availability of professionals and materials, and the surgery queue at the hospital.

6. Is it possible to reconstruct after radiotherapy?
Yes, but the surgeon needs to evaluate the best timing and technique for each case.

7. Does reconstruction have risks?
Like any surgery, there can be complications, but with an experienced team, the risk is low.

8. How to choose a good plastic surgeon?
Look for professionals who are members of the SBCP and experienced in oncological reconstruction.

9. Is psychological support necessary?
Yes. Reconstruction is part of a physical and emotional process, and psychological support is fundamental.

10. Where can I find more information?
On the website of the Brazilian Society of Plastic Surgery (SBCP) and in oncological reference centers.

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