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Reconstructive surgery - the whole discipline, mapped.

Breast, head and neck, hand, lower limb, burns, congenital, oncologic - the reconstructive ladder from direct closure to free flap. Consultants on the GMC Specialist Register, MDT working, BAPRAS standards. The subspecialist your defect actually needs.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private reconstructive surgery costs in the UK.

Indicative ranges across our reconstructive network. The range is very wide because so is the ladder - from a local flap to a free bone flap.

In short

The ladder in numbers: £1,500 for a small local flap, up to £60,000 for complex craniofacial.

Procedure Indicative range
Local flap under local anaesthetic £1,500–£3,500
Split-skin graft £2,000–£4,500
Full-thickness graft £2,500–£5,000
Regional pedicled flap £5,500–£12,000
Tissue expansion (per stage) £4,500–£8,500
Implant-based breast reconstruction £8,000–£15,000
Free flap reconstruction £15,000–£45,000
Craniofacial reconstruction (complex) £20,000–£60,000
Burn reconstruction (per stage) £4,000–£18,000
Reconstructive consultation only £250–£450

Prices vary by subspecialty, hospital, surgeon time, ICU stay and any implants used. Post-cancer reconstruction is usually insurance covered when medically indicated.

The problem

One label, many disciplines - and the wrong subspecialist is the biggest single risk.

A hand reconstruction is not a breast reconstruction. A burn contracture is not a Mohs defect. Reconstructive surgery is a family of subspecialties - matching your case to the right one, at the right unit, changes the outcome more than any technical choice.

  • The right subspecialist, first

    Hand surgery, breast reconstruction, head and neck, burns - each is a deep discipline. We route your case to a consultant who does your defect every week.

  • Only as high as the ladder needs

    A skin graft that would have worked, replaced by an unnecessary free flap, is bad reconstruction. We climb only as high as the defect requires.

  • MDT working is a service marker

    A named oncologist, radiologist, physiotherapist and psychologist inside the team - not on call - is what tells you the service is genuinely reconstructive.

When it helps

When reconstructive surgery is the right step.

The fields we route across, plus the one red flag that means diagnosis first, reconstruction second.

  • Breast reconstruction after cancer

    Implant-based, latissimus dorsi flap or free flap reconstruction after mastectomy - immediate or delayed, unilateral or bilateral, with or without nipple reconstruction.

  • Head and neck reconstruction after tumour

    Post-resection reconstruction of the oral cavity, mandible, pharynx or facial skin - often free flap based, always MDT led with oncology and speech therapy.

  • Hand and upper limb reconstruction

    Trauma, tumour or congenital reconstruction of the hand, wrist and forearm - grafts, local flaps, tendon transfers, replantation and free flaps.

  • Lower limb salvage

    Complex tibial fractures, degloving injuries, diabetic wounds and post-cancer reconstruction - often needing free tissue transfer to save the limb.

  • Burn reconstruction

    Staged reconstruction of burn scars - contracture releases, resurfacing, tissue expansion and, in severe cases, free flaps to restore function and appearance.

  • Congenital reconstruction

    Cleft lip and palate, microtia, hypospadias, hand differences and craniofacial anomalies - usually a staged plan across childhood into adulthood.

  • Skin cancer reconstruction after Mohs

  • Red flag: undiagnosed lump or fungating wound

    A skin or breast lump, or an ulcerating wound of any duration, must be diagnosed before reconstruction is planned - same-week two-week-wait referral, not a booking with a reconstructive surgeon.

Procedure options

The reconstructive ladder - from simple to complex.

What each rung involves. The principle is to climb only as high as needed to reliably reconstruct the defect - the top rung is not always the best answer.

  • The reconstructive ladder

    The framework every plastic surgeon uses: healing by secondary intention → direct closure → skin graft → local flap → regional flap → free flap. Choose the lowest rung that reliably reconstructs the defect.

  • Direct closure and healing

    Small defects that can be sutured directly, or left to heal by secondary intention with dressings - the simplest, often best, option for the right wound.

  • Skin grafting

    Split-skin (partial thickness) grafts cover large areas quickly; full-thickness grafts give better contour and colour match for facial and hand defects.

  • Local and regional flaps

    Tissue moved from immediately adjacent (local) or nearby (regional, pedicled) sites, keeping its own blood supply - workhorse for face, hand and lower limb.

  • Free flap reconstruction

    Tissue transferred with microsurgical anastomosis of blood vessels - for defects where local tissue is inadequate. Covered in detail on the microsurgery page.

  • Tissue expansion

    Silicone balloon placed under the skin and gradually inflated over weeks to stretch adjacent tissue - used for scalp, breast, and post-burn reconstruction.

  • Implants and prosthetics

    Silicone breast implants, custom facial prosthetics, cranial implants - often combined with tissue reconstruction or used where autologous options are not suitable.

  • Composite and vascularised bone reconstruction

    Bone with its own blood supply (fibula, iliac crest, scapula) for mandibular, long-bone and complex craniofacial reconstruction.

Safety and recovery

What to expect afterwards - honestly.

Reconstructive surgery is safe and life-changing in the right hands. The two things that most affect satisfaction are realistic expectations and a properly resourced MDT.

  • Reconstruction ≠ restoration to before

    Every reconstruction is an approximation. A rebuilt breast, jaw or hand is a functional and cosmetic substitute - usually excellent, sometimes life-changing, but never identical to what was lost. Realistic expectations improve satisfaction more than any surgical detail.

  • Reconstructive vs cosmetic - a real distinction

    Reconstructive surgery restores form or function lost to disease, trauma, cancer or birth. Cosmetic surgery reshapes normal anatomy on request. The techniques overlap, but the indications, MDT working, cover and consent conversations are different.

  • Every reconstruction is a trade

    Any flap leaves a donor site. Any graft leaves a difference in colour or contour. Any implant carries long-term maintenance. We discuss the donor scar and the trade as carefully as the reconstruction itself.

  • Staged plans are the norm, not the exception

    Complex reconstruction - burns, congenital, post-cancer - is almost always staged. Revision at 6–12 months is planned from the outset, not a sign that anything went wrong.

  • Smoking and diabetes affect every rung

    Nicotine reduces graft take and flap survival. Poor glycaemic control raises infection and delays healing. Smoking cessation for 4–6 weeks and HbA1c under 7% are standard requirements for major reconstruction.

  • Bleeding, infection, wound problems

    Small risks in any operation, higher in irradiated or infected fields. Watch for spreading redness, fever, wound edge separation, sudden swelling or bleeding and contact the same-day team.

  • Long anaesthetic risk for major cases

    Free flap and complex craniofacial cases run 6–12 hours under GA. DVT, PE and pressure injuries are real risks - mitigated by warming, compression, positioning and post-op anticoagulation.

  • Psychological support belongs in the plan

    Cancer reconstruction, burns, hand injury and congenital reconstruction all carry a psychological load. A named clinical psychologist inside the MDT is a mark of a good service - not a bolt-on.

  • Red flags after surgery

    Fever, spreading redness, wound gaping, sudden severe pain, breathlessness or a flap that changes colour or temperature need the same-day team or A&E, not a routine call.

Reading your operation note

Your reconstruction note in four parts. Read the last one first.

Whichever rung of the ladder was used - from local flap to free bone - the note the reconstructive surgeon sends you keeps to the same shape.

A UK consultant plastic surgeon reviewing a patient’s reconstruction notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to walk you through the operation note and the rehabilitation plan before your review, just ask.

  1. 01 Header

    Defect, ladder rung and technique

    What was being reconstructed, which rung of the reconstructive ladder was used, and the specific technique - graft, local flap, regional flap, free flap, expander or implant.

  2. 02 Technique

    Donor and recipient site

    Where the tissue came from, how it was inset, which vessels or pedicles were used, whether nerves were coapted, and whether the donor site was closed directly, grafted or expanded.

  3. 03 Findings

    MDT context and histology

    The oncologic context if relevant - margins, nodal status, planned adjuvant therapy - and how the reconstruction fits around any post-operative radiotherapy or chemotherapy.

  4. 04 Impression

    Rehab, revision and long-term plan

    Read this first: physiotherapy or hand therapy plan, expected revision surgery at 6–12 months, prosthetic or garment fitting, oncology surveillance schedule.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Reconstruction after cancer, trauma, burns and congenital anomaly is usually covered.

Frequently asked

Everything we get asked about reconstructive surgery.

Quick answers on the reconstructive ladder, cosmetic vs reconstructive, NHS routes, cost and recovery.

  • What is reconstructive surgery, and how is it different from cosmetic surgery?

    Reconstructive surgery restores form and function lost to disease, trauma, cancer or birth defect - breast reconstruction after mastectomy, cleft lip repair, hand reconstruction after injury, burn revision. Cosmetic surgery reshapes normal anatomy at the patient’s request - rhinoplasty, breast augmentation, facelift. The techniques overlap, but reconstructive work is usually insurance-covered and MDT-led, while cosmetic work is self-funded and elective.

  • What is the reconstructive ladder?

    A framework every plastic surgeon uses to choose the simplest technique that reliably reconstructs a defect. It starts with healing by secondary intention, then direct closure, skin graft, local flap, regional flap, and finally free tissue transfer (free flap). The principle is to climb only as high as needed - the top rung is not always the best answer.

  • Which fields does reconstructive surgery cover?

    The main fields are breast, head and neck, hand and upper limb, lower limb (including trauma and diabetic wounds), burns, congenital (cleft, microtia, hand differences, craniofacial), skin cancer reconstruction, and complex oncologic reconstruction across the body. Most reconstructive surgeons develop deep expertise in one or two of these areas.

  • What does private reconstructive surgery cost in the UK?

    The range is very wide: roughly £1,500–£3,500 for a small local flap, £2,000–£5,000 for skin grafts, £5,500–£12,000 for regional flaps, £8,000–£15,000 for implant-based breast reconstruction, and £15,000–£60,000 for free flap or complex craniofacial reconstruction. Cost reflects surgeon time, theatre time, ICU stay and implant costs.

  • Is reconstructive surgery covered by the NHS or private insurance?

    NHS provision is generally excellent for post-cancer reconstruction, trauma, burns and congenital work - often through tertiary centres. Private insurance usually covers reconstruction that is medically indicated after disease, trauma or cancer, subject to policy terms. Purely cosmetic revision of a stable congenital condition or old scar may not be covered.

  • How long does recovery take?

    It depends entirely on the rung of the ladder used. A small local flap: back to office work in 3–7 days. Skin graft: 2–3 weeks with dressings. Implant-based breast reconstruction: 4–6 weeks. Free flap: 6–12 weeks off work, and 12 months to full functional recovery. Structured physiotherapy or hand therapy is essential for the more complex cases.

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