BREAST RECONSTRUCTION AFTER MASTECTOMY
Almost any woman who has had a mastectomy can opt to have breast reconstruction. New techniques and better skills enable surgeons to achieve results that can be remarkably natural and pleasing.
For many women, a breast reconstruction is a milestone that symbolizes that they have completed the treatment, and are ready to get on with their lives. It is also an opportunity to regain their feminine silhouette and restore their self-image.
Today about three out of four women chose to have breast reconstruction after mastectomy. About half of them decide on implants. Most of the others prefer breast reconstruction with their own tissues, moved from other parts of their bodies.
Sadly, in some parts of the country, women are not offered the opportunity for breast reconstruction. Even if your physician doesn’t bring up the topic, or if you can’t stand the thought of additional surgery right now, don’t dismiss the possibility of rebuilding your breast. It can be done at the time of the mastectomy, or at a later date. Give it careful consideration. In the future, you might be glad you did.
Choosing a Plastic Surgeon
If you are considering breast reconstruction, even if it’s to be done at a later date, arrange a meeting with a plastic surgeon well before your mastectomy, to discuss the details of the procedure.
It is crucial that you select a surgeon who has extensive experience in reconstructive breast surgery, and is a board-certified specialist, because the cosmetic results will depend significantly on the surgeon’s skill. Your primary surgeon can refer you to one.
Be sure to ask the surgeon who will perform your reconstruction to show you photos, and perhaps arrange for you to interview some of the patients who had the same procedure that you are considering. General surgeons who are trained in oncoplastic surgery techniques should be able to achieve good results with implant procedures, but be sure to check out their training and performance.
There are many reconstruction options.
One more key point: it is important that your expectations be realistic. The new breast can look natural, and feel normal to someone touching it, but you will not have sensation in the nipple, and will have decreased or no sensation in the skin of the breast. Your satisfaction with the final result will depend as much on the surgeon’s skill and technique used, as on your healing pattern and your expectations.
Reconstruction can be done at any time: at the time of mastectomy—which is called immediate reconstruction—or at a later date—which is called delayed reconstruction. Most women chose the immediate reconstruction option.
There are two main methods for reconstruction. One uses synthetic implants to create the shape of a breast. The other relies on the patient’s own tissues, transplanted from another area of the body.
Very commonly, you may need a minor plastic procedure on the other breast, such as a breast lift, to achieve the best similarity possible to the reconstructed breast.
Reconstruction may be easier if you have a skin-sparing mastectomy, where much of the skin of the breast is left in place.
Once the breast is rebuilt, you can go on to have a reconstruction of the nipple and the areola, to achieve an even more natural look.