If you’ve received a breast cancer diagnosis, it can be helpful to know what your options are after treatment. Breast cancer treatment usually involves the partial (lumpectomy) or total removal (mastectomy) of the affected breast. After these procedures, breast reconstruction using a variety of methods is an effective way to restore your breasts with the help of a board-certified reconstructive surgeon. Here’s what to know about breast reconstruction and how it can help.
What Is Breast Reconstruction?
Breast reconstruction is a series of surgical procedures aimed at restoring your breast after surgery for cancer or cancer prevention. It is performed by a plastic surgeon and comes in a variety of surgical forms.
The information below outlines the types of reconstruction, risks and benefits of each, and the pros and cons for each type of procedure to help you understand what might be best for you and what you should discuss with your surgeon.
Can I Have Surgery to Create a New Breast After My Mastectomy?
Most women are candidates for some form of breast reconstruction. Our goal as plastic surgeons is to recreate a breast mound that is similar to your native breast. There are multiple ways to do so, but the overall goal is for you to have as natural a breast as possible and be balanced and symmetric in your clothing.
Breast reconstruction is for three different categories of women:
- Those having removal of their breast due to cancer (mastectomy)
- Those having removal of a portion of their breast for cancer (lumpectomy or partial mastectomy)
- Those having removal of their breasts for preventive purposes (prophylactic mastectomy) usually due to a genetic mutation making them at higher risk for breast cancer (BRCA-1 and BRCA-2).
Reconstruction of your breast can often be done at the time of mastectomy, but other times reconstruction may have to be performed at a later time because of the need for other therapies such as chemotherapy or radiation therapy or due to patient preference.
Do I Have to Have Breast Reconstruction?
No. The reasons to have or not have reconstruction are different for every patient. Some women choose not to have additional surgery. For these women, there are options for prostheses to wear in a bra to provide the appearance of a breast. Other women need additional therapy that may prevent them from having reconstruction, while some women are unable to decide what type of reconstruction to have.
Remember: You have the choice to have reconstruction at any time in the future and should not feel pressured to make a decision.
Can I Have Breast Reconstruction During the Same Surgery as My Mastectomy? If Not, How Long Do I Need to Wait?
It’s often possible to have reconstruction at the time your breast tissue is removed, in a procedure called immediate reconstruction. In this case, the breast tissue is removed along with the circle around your nipple (the areola). This option often provides the benefit of saving some of your natural breast skin.
Otherwise, reconstruction can be done at a later date, in a procedure called delayed reconstruction. Often this option is selected in order to allow time for chemotherapy or radiation therapy or in the event that you choose not to have immediate reconstruction. Here, often the majority of your breast skin is removed at the time of mastectomy.
Advantages of Immediate Reconstruction:
- Never having to live without a breast
- Possibly a better cosmetic result
- Fewer surgeries and possibly lower cost
Disadvantages of Immediate Reconstruction
- Longer surgical time
- Often longer recovery
- Difficulty determining skin viability after mastectomy and possibly more skin loss
Advantages of Delayed Reconstruction
- Allows time for adjuvant therapy—chemotherapy and/or radiation therapy to treat cancer. This is often very important.
- More time to think about options for reconstruction
- Time to mentally deal with cancer diagnosis
Disadvantages of Delayed Reconstruction
- May compromise cosmetic outcome
- Period of time without a breast mound
- Sometimes more difficult for the surgeon
- Requires additional surgery, time in the hospital and recovery