Deciding whether to have breast reconstruction after a mastectomy can be a difficult choice for some women. It’s important to understand all the facts before going ahead with a decision, do as much research as you can, talk to your doctor and if possible talk to someone who has already had the operation.
There is no need to rush into a decision, as surgery can be done years after a mastectomy. Your doctor will be able to advise you about immediate reconstruction or delayed reconstruction and will take into accounts factors such as the stage of your cancer, treatments you will be undergoing and your personal preferences.
Women choose to have breast reconstruction for many reasons; mainly it’s to feel what they perceive as ‘normal’ again. Improved self esteem and body image is something that cannot be underestimated and many women find it helps them to get their life back on track.
Be aware of your choices for breast reconstruction
Techniques for breast reconstruction have improved significantly over the years and there are many factors to take into consideration prior to the operation. Talk to your doctor about what is best for you, every case is different. Breast reconstruction can be done at the same time as the cancer surgery, however in some cases the reconstruction will wait either because the woman has chosen to do so or has been advised to follow this route.
There are pros and cons of each route – an immediate reconstruction may help you to cope better with the loss of your breast and of course you will have fewer operations and less anaesthetic. It may also help with the look of your new breast as the surgeon will be able to use the breast skin already there. You may also experience less scarring on the reconstructed breast. There will be disadvantages of having immediate reconstruction such as the way it affects your treatment after the operation if you were to need chemotherapy. Chemotherapy works best if it’s started within six weeks of your cancer surgery, therefore if there was a problem after the reconstruction your treatment may have to be delayed. In addition to this, if you are having radiotherapy after the operation it may damage the reconstruction.
In a lot of cases, women prefer to get over their mastectomy surgery and any treatments they have had to undergo in the first instance. As the treatment is already finished, it won’t affect the reconstruction, although you may have a larger scar on the new breast. Delaying the operation will also give you more time to consider your options for the surgery.
Breast reconstruction is a major type of surgery
It’s important to understand that breast reconstruction is a major type of surgery and in some cases may require more than one procedure. Some women find that they are not emotionally or medically prepared to undergo surgery and it’s at this point, a woman must consider delaying the operation. If you decide to have reconstruction directly after your mastectomy, ensure you discuss this with your surgeon prior to going ahead with the initial operation as it may affect the way the surgery is carried out.
The aim of the breast reconstruction surgery is to rebuild a breast similar in size and shape to your own breast and the nipple and areola (darker area around the nipple) can also be added in some cases, however this is usually done at a later date once the breast has healed. It’s important to understand that a reconstructed breast won’t be identical; some women notice a difference when undressed.
A mastectomy involves removing all the breast tissue and in most cases the skin covering the breast along with the nipple. There are various methods of reconstructing a new breast and you will need to discuss the best option for you with your surgeon. Deciding on what route to go down may depend on factors such as how much breast tissue has been removed, your size and shape, your personal preference and of course your surgeons recommendations. Methods include:
- Removal of the whole breast and skin, then inserting an implant under the skin or chest muscle to allow the remaining skin to stretch gradually
- Removal of just the breast tissue, leaving the skin, then inserting the implant
- Using your own living tissue taken from elsewhere in your body such as the chest wall, abdomen or back
- A combination of an implant and your own living tissue.
All surgeries carry risks and it’s important to understand them, so speak to your doctor in depth before going ahead. It’s not possible to rebuild the breast to exactly how it was before and the operation can cause pain, scarring, infection and a loss of sensation. However it’s vital to remain positive to aid a speedy recovery and most women are generally very happy with the results.