Have you had a mastectomy or are planning to have one due to a breast cancer diagnosis or because you are at a high risk of developing it? Are you wondering if you can or will ever look and feel the same again? Your doctors may have told you about your options to reconstruct your breast or breasts. Breast reconstruction typically takes place during or soon after a mastectomy (removal of the entire breast) and in some cases lumpectomy (removal of the lump without removing the entire breast) but it can also be done several months or years after. Breast reconstruction is another serious consideration when fighting breast cancer. The entire journey as a survivor is such an emotional roller coaster that first you would want to cure yourself and then decide whether to opt for reconstruction. Wanting to have breast reconstruction surgery is a very personal decision and here I’d like to help you delve into your feelings and understand more about the procedure.
Looking within
It is impossible to predict how you would actually feel after losing a breast or part of your breast. It is so unimaginable – your identity as a woman, your sexuality, how you feel in your clothes or in your own skin – so much is affected by this loss. It is absolutely normal to feel anxious, lost and clueless. However, now you have the ability to decide what happens next. When considering breast reconstruction surgery, ask yourself the following:
- How important is breast reconstruction for you?
- Are you comfortable with another surgery to rebuild your breast after your mastectomy or lumpectomy?
- Will a breast reconstruction and proportionate looking breasts make you feel whole again?
- Would you consider living with a breast form that you can take on and off rather than a permanent fix via surgery?
- Are you mentally prepared to learn more and dig deeper into all your options?
- Do you think you can make this decision now? Have your doctors told you enough? Or are you just not ready?
Being diagnosed with breast cancer itself may have been a terrifying phase. To then be bombarded with information on the specificities, the treatment options and the risks is just draining. Do your best to give yourself time and space to think. Try and think in the long-term even though breast reconstruction is always an option further down the line. Do what feels right to you.
The facts to be aware of
In a breast reconstruction surgery, a plastic surgeon rebuilds your breast using an implant, a flap of tissue from another place on your body, or both. While the procedure can reconstruct the shape of the breast, it cannot restore sensation to the breast or the nipple. You may feel a little over time, but it won’t be exactly the same as it was before surgery.
Breast reconstruction can be performed at different times depending on your condition:
- During your mastectomy – Immediate reconstruction – Your cancer surgeon and plastic surgeon work together during one operation and your breast is reconstructed immediately after the cancer surgeon removes the affected breast. This generally produces better cosmetic results than if performed later.
- After your mastectomy/lumpectomy and after chemotherapy/ radiation therapy – Delayed reconstruction – Radiation therapy and sometimes chemotherapy can cause breasts to change appearance and you may want a reconstruction after you have undergone these treatments. Patients may see volume loss, color and even texture changes. Surgeons may advise patients to wait after these treatments are completed which could mean a delay of 6 to 12 months after a mastectomy/lumpectomy.
- Staged approach – Delayed-immediate reconstruction– Depending on your situation your cancer surgeon may recommend a partial reconstruction during the mastectomy and a completion after chemotherapy and/or radiation therapy. New techniques have also emerged where a temporary expander implant is placed to preserve the breast shape and is later replaced with a more permanent reconstruction after radiation treatments have been completed.
It is also important to be aware of the fact that every woman’s case is unique. For example, if you originally had large breasts, the reconstructed breast may appear smaller, requiring a breast reduction on the other breast and a nipple reconstruction on the rebuilt breast later on. Consult your Plastic Surgeon to manage your own expectations so that you are prepared every step of the way.