Results

Expectations vary with each patient. The goal is to create a soft breast that has a good shape and is reasonably symmetrical with the opposite breast. This is easier to achieve for some patients than others. The results depend on the way the individual patient heals, the type of mastectomy, the reconstruction technique used and the patient’s existing tissue and opposite breast.

Plastic surgeons are constantly refining breast reconstruction techniques and timing to ensure that the results are pleasing. They can achieve some outstanding aesthetic results, but it’s important to have realistic expectations. Your new breast or breasts may not live up to your expectations of size, position, angle, or balance. They may not be as soft or feel as natural as you thought they would. It can be difficult for women to adjust to their reconstructed breast(s).

THINGS TO BE AWARE OF

Individual breast reconstruction surgeons use different techniques, which can have different results.

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There will be scars from the mastectomy and breast reconstruction surgeries.

A reconstructed breast(s) and nipple(s) will not have the same sensation and will not produce milk.

Reconstructed nipples will not change with changes in temperature.

One of the best ways to make sure you’re as satisfied as possible with your reconstructed breast is to ask your plastic surgeon lots of questions about what to expect. Ask to see photos of breast reconstructions your surgeon has performed.

SPECIFIC FACTORS THAT PLAY A ROLE YOUR SATISFACTION

Symmetry

Symmetry is a primary goal in breast reconstruction, but in some patients this is only possible by altering the opposite breast. Although some patients also find that a slight degree of asymmetry is acceptable, about 30%-40% will choose opposite-breast surgery in order to match the shape and volume of the reconstructed breast. This improves appearance and sense of balance and makes fitting clothes and dressing easier.

Size

The reconstructed breast will be somewhat larger than the other breast right after surgery due to swelling. As the reconstructed breast heals, the swelling will go down and the reconstructed breast should be closer in size to the other breast. If there’s still a noticeable size difference, your surgeon can remove some fat from the reconstructed breast.

Weight Gain

A breast that’s been reconstructed with an implant doesn’t gain and lose weight if you do. A breast that’s been reconstructed with flap techniques does. If you have implant reconstruction and gain weight after the surgery, you and your surgeon may want to exchange your original implant for a larger one to help restore balance to your breasts.

Sagging

It’s hard to match the natural drop of your original breast. A breast reconstructed with flap techniques may develop some sag with time and gravity, but a breast reconstructed with an implant rarely sags. Over time your other breast may start to sag while the reconstructed breast remains higher and firmer. This may be fine when you are wearing a bra or swimsuit, but it may bother you when you’re naked. If it does, it’s usually much easier for your surgeon to reduce and lift your other breast to match the reconstructed breast.

Breast Sensation

When you touch your reconstructed breast it’ll feel to your fingers a lot like your natural breast, but you probably won’t feel much actual sensation in your breast since most of the nerves are cut during mastectomy and reconstruction. This can be troubling for women whose breasts were an important erogenous zone. The nerves do have the potential to regrow, but it can take a long time. If the nerves start to regrow, you may feel tingling or other sensations in your breast. If any sensation is going to come back in your breast, it’ll likely start to happen after a year or two. If you have no sensation in your breast, you may get feeling back in the area next to your breast. Some women find that the armpit next to the reconstructed breast becomes tremendously sensitive to touch and is a new erogenous zone.

WHAT BREAST RECONSTRUCTION CAN AND CAN’T DO

What Breast Reconstruction Can Do:

Give you a breast contour

Provide improved symmetry to your breasts so that they look similar under clothing or a bathing suit

Help you avoid the need for an external prosthesis

What Breast Reconstruction May Do:

Improve your self-esteem and body image

Partially erase the physical reminders of your disease

Require additional surgery to correct reconstructive problems

What Breast Reconstruction Can't Do:

Make you look exactly the same as before

FEELINGS ABOUT RECONSTRUCTION

An audit published in early 2011 looked at how satisfied women were after mastectomy with and without reconstruction. They found that 9 out of 10 women who had reconstruction were satisfied with their surgery. The audit looked into how women felt in various situations including how confident they were socially. 85% of women who had reconstruction felt confident compared 77% who hadn’t had reconstruction. Women who had reconstruction were also more likely to feel confident and happy and sexually attractive.