Deciding on breast reconstruction

Deciding whether to have breast reconstruction or when to have it is highly personal and will depend on your individual situation. Only you, along with your doctor and any family or friends you choose to involve, can decide what feels best and is right for you.

Once you’ve decided to move ahead with having reconstruction, you and your doctor need to decide which procedure is most suitable for you. You’ll also need to decide when to perform the reconstruction, whether immediately along with the mastectomy, or at a later time after all cancer treatments are done. You’ll also need to decide if you want the healthy breast altered to better match the reconstructed breast in size and shape. Finally you’ll need to decide whether you want your nipple and areola reconstructed and whether you want nipple tattooing in order to match the color.

These are a lot of decisions to make.

MAKING YOUR DECISIONS

There are a lot of things to think about when making your choices about breast reconstruction. In addition to medical reasons to choose one option over another, there are also your personal values and preferences.

Questions to ask:

Can you have breast reconstruction?

Will you need other cancer treatments that will delay reconstruction?

What reconstruction options are possible with your body size and shape?

How do you want to look in and out of your clothes?

How much time are you willing to spend recovering from surgery?

What physical activities do you do that could be affected by surgery to my stomach or back?

HOW WILL BREAST RECONSTRUCTION AFFECT YOUR LIFE?

Breast reconstruction may help you to feel better about your body: you may feel more “normal,” “balanced,” and feminine. It may also help you to be able to wear more kinds of clothes with convenience and comfort.

Some women are afraid that if the breast cancer returns, it will be harder to detect the tumor through a reconstructed breast than through a mastectomy scar. However, there’s no need to fear difficulties with cancer detection. Current evidence indicates that it is no more difficult to find and treat cancer through a reconstructed breast than it is through a mastectomy scar.

If you’re thinking about breast reconstruction and are interested in breastfeeding your children, you should know that you cannot breastfeed from a reconstructed breast. The parts of the breast that deliver milk are the most likely parts to develop cancer and are therefore removed during the mastectomy.

Having breast reconstruction may cause you some inconvenience during the period after the surgery. It’ll take time to recover, and there may be additional treatments or follow-up surgeries. Depending on which kind of breast reconstruction you choose, you may need up to six months or a year to fully return to your normal life.

Only you can decide whether the mental and physical benefits of having a new breast are worth the costs of having the surgery.

ADVANTAGES OF BREAST RECONSTRUCTION

You may feel more ``balanced,`` in terms of both breast weight and looks

Your body may feel more ``normal,`` in and out of your clothes.

You may be able to wear more kinds of clothes, possibly even low cut clothes like tank tops and swimsuits

You may feel more feminine and attractive

You may feel more feminine and attractive

DISADVANTAGES OF BREAST RECONSTRUCTION

Regardless of the type of reconstruction you have, you will need more surgery, with all of the inconvenience and potential problems that come with it

You may need more time to heal

You may need to take more time off from work or from your family responsibilities

There may be more scars

There may be extra problems after the surgery, such as infection, swelling, or delayed healing

You won't know how the new breast will look until after it's finished

In rare cases, there may be problems that come and go for years afterwards, like infections or breast implant complications

The new breast, no matter how good it is, will never exactly match your natural breast

If you think you might want to have breast reconstruction because you have had, or are about to have, breast surgery due to breast cancer, it’s a good idea to mention this before you have a mastectomy or lumpectomy. You don’t have to make a definite decision at this stage, but it will help the surgeon to plan your initial surgery.