The outbreak of the coronavirus disease 2019 (COVID-19) pandemic caused global challenges, including the restriction of surgical options for women with breast cancer. Autologous reconstruction availability has still not returned to pre-COVID-19 levels. This study aimed to collect data about waiting lists for autologous breast reconstruction and is the first of its kind. A total of 31 units were approached and asked to complete a study specific questionnaire. In total, there are at least 2255 patients on a waiting list, which equates to a 2-year and 5-month backlog at the current level of provision, without the inclusion of new referrals. Alarmingly, 40 women reportedly developed breast cancer whilst on the waiting list. The impact of COVID-19 has been significant, revealing national inequity in reconstruction provision and long waiting lists. Recommendations include increasing theatre capacity, optimising plastic surgeons' job plans to prevent waiting lists from growing as well as training more surgeons in autologous reconstruction.
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