Things to Take into Consideration

Take a moment to prioritize what’s important to you when considering your breasts after cancer. How you felt about your breasts before cancer, your treatment plan, and other considerations will influence how you wish to deal with reconstructive surgery.

Click here for a quick checklist of things to consider for Breast Reconstruction.

Timing Considerations

Based on different factors of your health, breast surgeons either suggest immediate reconstruction, or delayed reconstruction after you have healed from cancer surgery. You have the option to undergo reconstruction or alternative reconstruction procedure even many years later.

To begin reconstruction at the same time as your mastectomy or delay it for later on is a decision that requires you consider several factors. If radiation therapy is or was part of your treatment plan, you should ask about the best timing for reconstruction to reduce damage to the reconstructed breast (radiation reduces the elasticity of skin tissue and can impact reconstruction). Or, if you smoke most surgeons will require that you stop before reconstructive surgery.

Advantages to immediate reconstruction include potentially more chest tissue to support reconstruction because there is no surgical scarring or damage from radiation therapy (unless you had that earlier in your life), less surgery and exposure to general anesthesia, ability to recover from everything at the same time, and less dramatic physical changes after a mastectomy.

On the other hand, delayed reconstruction gives you more time to adjust emotionally to a cancer diagnosis and research your reconstruction options. In some cases, women prefer to have more time to recover from their mastectomy surgery before starting the reconstructive surgery process. For women who smoke, are overweight, or have diabetes, their health care team may ask them to wait on breast reconstruction to avoid surgical risks and complications. Your doctors may also advise you to wait for reconstruction, depending on the type of breast cancer that you have, as the added healing time may delay your ability to start systemic treatment.

Most women will not be able to predict how they’ll adjust to body image changes after a mastectomy until they experience those changes. It is comforting to know that you can still choose to alter your breasts at a later date. It is also helpful to know that many women who choose not to undergo reconstruction learn to be content with that decision too.

Changing Body Image

Reconstructed breasts do not have the same feeling and sensation as natural beasts. But, they can look very much like your natural breasts. In some cases, women like their breast size and shape better after reconstruction. It is important to realize that no surgery will make your breasts look, feel, or have the same sensations as before surgery, nor can it erase the distress caused by cancer.

Reconstruction can be a tool to help you feel whole again, and help you get back on track. On the other hand, for some, moving on has much more to do with personal courage and perseverance. Whatever the case is, it is still helpful to get a better idea of how you might look after reconstruction. It is a good idea to ask your plastic surgeon to show you pictures of the results of the different types of reconstruction that you are considering – or show you how mastectomy scars look without reconstruction.

Ask your plastic surgeon to connect you with at least one former patient who has had the same surgical procedure that you are considering. Most plastic surgeons will have picture books for you to look at, as well as former patients who would be willing to talk with you about reconstruction.

Because this is a big decision and some reconstructive surgeons prefer or specialize in certain procedures, you should seek a second or even third opinion with other plastic surgeons to ensure that you have heard all of the available options for you.

Some great websites and bulletin boards that share “After Reconstruction” images and real testimonials include:

  • - The American Society of Plastic Surgeons offers before/after photo gallery of breast reconstruction.
  • – Illustrates different breast reconstruction surgery types with a photo gallery of women and their stories about their reconstruction experience (search “photos”).
  • - Facing Our Risk of Cancer Empowered has a password-protected photo gallery of real women who share their experiences and a discussion board open to anyone.
  • - Your Breast Options offers comprehensive information about breast health, breast cancer awareness and breast reconstruction options, including testimonials (no images).
  • - Young Survival Coalition has ongoing dialogues by women about reconstruction, among other issues, in their open bulletin board. YSC also offers an important list of Questions and Answers about breast reconstruction on their site as well as access to the SurvivorLink program.

Click here for Back Pocket Questions to ask your healthcare team as you further consider your reconstruction options.