Mr. Blackburn is one of the UK's leading breast reconstruction surgeons, with over 1,000 microsurgical free flap procedures performed throughout his career. He offers a complete range of reconstructive options, guiding each patient compassionately through one of the most significant surgical decisions they will face.
Breast reconstruction does not happen in isolation. Mr. Blackburn works closely with breast surgeons and oncologists as part of a coordinated multidisciplinary team (MDT), ensuring that every patient receives their reconstruction at precisely the right point in their treatment pathway — never too early, never too late.
Many patients with breast cancer receive chemotherapy or immunotherapy before surgery — known as neoadjuvant treatment. It is essential that this systemic treatment is completed and the patient fully optimised before proceeding to breast cancer surgery and reconstruction. Mr. Blackburn liaises directly with oncologists to ensure seamless sequencing of care, so that each patient enters surgery in the best possible condition.
Beyond treatment sequencing, Mr. Blackburn places great emphasis on preparing each patient physically and psychologically for major reconstruction. This includes optimising fitness, nutrition and general health in the weeks before surgery — an approach known as prehabilitation — which has been shown to reduce complications and accelerate recovery. Read more about prehabilitation →
Breast reconstruction is surgery to rebuild the breast mound following a mastectomy or, in some cases, a wide local excision. It is an important part of the treatment pathway for many women with breast cancer, and can have a profound positive impact on wellbeing, body image and quality of life.
Mr. Blackburn specialises exclusively in autologous reconstruction, rebuilding the breast using your own body tissue. This approach produces soft, warm, natural-feeling results that age with you over time. He will assess your individual circumstances, including your cancer treatment plan, body type, lifestyle and preferences, to identify the most suitable technique for you.
There is no single "best" method; the right reconstruction is the one that is best for you as an individual. Mr. Blackburn will take the time to explain all options clearly, answer every question, and ensure you feel fully informed and supported at every stage.
Reducing operating time is one of the most important factors in improving outcomes for complex microsurgical breast reconstruction. A shorter operation means less anaesthetic exposure, less physiological stress, and less fatigue for both the surgical team and the patient, all of which directly influence recovery and the risk of complications.
In a 2024 study of 453 patients, Mr. Blackburn compared outcomes in two groups: 211 cases performed by two consultant surgeons working together, and 242 cases performed by a consultant with a senior trainee. The two-consultant group achieved a return-to-theatre rate of just 1.5% with no flap losses, compared to a 4.5% return-to-theatre rate and a 1.2% flap loss rate in the other group. This comparative audit suggests that two-consultant operating is associated with lower rates of serious complications in this series. This evidence directly informs Mr. Blackburn's practice: wherever possible, he operates alongside a fellow consultant to support optimal outcomes for every patient.
Mr. Blackburn's patients recover exceptionally quickly following microsurgical breast reconstruction. With the optimisation of Enhanced Recovery protocols, 1 in 4 patients go home the day after surgery, and over 90% of all his patients are discharged within two days — a length of stay that places Mr. Blackburn among the very best outcomes data in the world for this type of surgery.
This reflects not only surgical precision but a comprehensive approach to preparation, anaesthesia and post-operative care designed to support rapid, comfortable recovery.
Because Mr. Blackburn's experience of serious complications is exceptionally low, his research focuses on an area that matters most at the frontier of excellence: measuring and reducing minor complications. By developing robust ways to identify and quantify even small adverse events, the aim is to drive further improvements in an already outstanding safety record.
This commitment to evidence-based refinement means that patients benefit from care that is not only safe today, but continuously improving.
Breast reconstruction is best understood as a three-stage journey: Stage 1: creating the breast mound using your own tissue; Stage 2: symmetrising the two breasts and refining the result; Stage 3: nipple reconstruction and areola tattooing to complete the restoration.
Timing between stages: Mr. Blackburn typically recommends waiting at least 3–4 months between each stage. This allows the tissues to fully settle, swelling to resolve completely, and the patient to recover well before the next procedure, ensuring the best possible assessment and the most accurate surgical plan at each step.
The Deep Inferior Epigastric Perforator (DIEP) flap is Mr. Blackburn's most frequently performed reconstructive procedure, and one of the most advanced techniques in breast reconstruction. Skin and fat are taken from the lower abdomen (without sacrificing the underlying muscle) and transferred to the chest to form a new breast.
Because the tissue comes from your own body, a DIEP flap reconstruction tends to feel soft, warm and natural, and ages with you over time. The abdominal donor site also benefits from a similar improvement to that seen after a tummy tuck, with the lower abdominal scar placed within the bikini line.
The Transverse Upper Gracilis (TUG) and L-shaped Upper Gracilis (LUG) flaps offer excellent alternative options for patients who are not suitable for DIEP flap reconstruction, particularly those who have insufficient abdominal tissue, have had previous abdominal surgery, or who prefer a different donor site.
Both procedures use tissue from the inner thigh to reconstruct the breast. The LUG flap is a technique pioneered by Mr. Blackburn, using an L-shaped skin design that increases the volume of tissue available for reconstruction and places the donor site scar in a more discreet position, resulting in an easier recovery and a larger, better-shaped result compared to the standard TUG design. Mr. Blackburn is one of very few surgeons in the UK with extensive experience in both of these techniques.
📄 Read the published paper on the LUG flap technique →
Once the reconstructed breast mound has healed and settled (typically several months after the flap procedure), attention turns to achieving the best possible symmetry between the two sides. This stage may involve surgery to the reconstructed breast, the natural breast, or both.
For the natural breast, this may include a mastopexy (breast uplift) or a breast reduction to better match the reconstructed side in shape, position and volume. Lipomodelling (fat transfer) may also be used to refine the contour of the reconstructed breast, soften areas of firmness or add volume where needed. The precise combination of procedures is tailored to each patient's individual anatomy and goals.
Fat transfer (also known as lipofilling or lipomodelling) uses small quantities of fat harvested by liposuction from elsewhere in the body (typically the thighs or abdomen) and re-injected into the reconstructed or opposite breast to refine its shape, volume and symmetry.
It is most commonly used at Stage 2 to improve contour irregularities, soften areas of firmness, or add volume to specific zones of a reconstructed breast. It can also be used to improve the appearance of the natural breast and is often combined with the symmetrising procedure in a single operation.
Nipple reconstruction is the final stage of the breast reconstruction journey. It recreates the nipple projection using a local tissue rearrangement technique, and, combined with specialist areola tattooing, can restore a remarkably natural-looking nipple-areola complex that completes the reconstructed breast.
The procedure is typically performed under local anaesthetic as a day case, some months after Stage 2 has healed and settled. Areola tattooing is carried out by a specialist medical tattooist and can achieve a highly realistic colour and appearance, completing what is often a profoundly positive transformation.
Women who carry a high-risk gene variant — including BRCA1, BRCA2, PALB2 and other hereditary breast cancer genes — face a significantly elevated lifetime risk of developing breast cancer. For many, a risk-reducing (prophylactic) mastectomy is the most effective way to dramatically lower that risk. Reconstruction can be performed at the same time, meaning patients can wake from surgery with a reconstructed breast.
This is an intensely personal decision, and one that deserves careful, unhurried consultation. Mr. Blackburn takes time to explain every reconstructive option in full — implant-based or autologous — so that each patient can make an informed choice that is right for her individual circumstances, body type and lifestyle.
Timing, surgical technique and reconstructive choice have all evolved considerably over the past decade, and Mr. Blackburn keeps his practice aligned with the latest evidence in this rapidly developing field.
Mr. Blackburn served for over 10 years as the dedicated Reconstructive Plastic Surgeon for the Family History & Gene Carrier Clinic at the Royal Surrey County Hospital, Guildford — one of the leading regional centres for hereditary breast cancer in the South East. In this role he worked as part of a dedicated multidisciplinary team including clinical geneticists, breast surgeons, oncologists, a specialist gynaecologist, a psychologist, and specialist family history nurses — providing fully integrated care to guide high-risk women through the decision-making process and deliver their reconstructive surgery.
This decade of dedicated specialist experience gives Mr. Blackburn a particular depth of understanding of the specific concerns and priorities of patients considering preventative mastectomy — including the importance of preserving the nipple where oncologically safe, achieving natural symmetry, and minimising recovery time.
Banerjee, Joshi, Kokkonis, Saunders, Georgas, Hopper, Blackburn, Horsnell & Irvine (2022). 10 years of changing trends in reconstructive choices in patients presenting to the Guildford gene carrier clinic. European Journal of Surgical Oncology, 48, e226–e227.
View published paper →breast.london is a dedicated patient resource that explains autologous breast reconstruction in detail, covering the DIEP flap, TUG flap, L-shaped Upper Gracilis (LUG) flap and other own-tissue techniques, including timing, what to expect, and how to choose the right approach for you.
Visit breast.london →Facing a mastectomy or already looking to explore reconstruction options? Mr. Blackburn offers unhurried, compassionate consultations to help you understand every option available to you. Self-referrals and GP referrals are both welcome.
Book a Consultation