Breast reconstruction

Is it right for you?

Women who have a mastectomy or lumpectomy to treat breast cancer may want to rebuild the shape and look of their breast with reconstruction surgery.

Breast reconstruction is a very personal decision. If you're considering it, talk it over with your surgeon and a plastic surgeon—and do it before you have the mastectomy or lumpectomy. Even if you decide to postpone reconstructive surgery until later, this lets the surgical team plan the best treatment for you.

Are you aware of the benefits of reconstructive surgery?

If you answered "yes." OK. But just to recap, there are several reasons women may choose breast reconstruction surgery, including:

• To make their chest look balanced when wearing a bra or swimsuit—this can also help with posture and back pain.
• To permanently regain the shape of their breast.
• To avoid the inconvenience of inserting, removing and caring for an external prosthetic breast.
• To be happier with their bodies and how they feel about themselves.

If you answered "no." There are several reasons women may choose breast reconstruction surgery, including:

• To make their chest look balanced when wearing a bra or swimsuit—this can also help with posture and back pain.
• To permanently regain the shape of their breast.
• To avoid the inconvenience of inserting, removing and caring for an external prosthetic breast.
• To be happier with their bodies and how they feel about themselves.

Are you aware of the limitations of reconstruction surgery?

If you answered "yes." Good for you for learning the possible limitations. As you may know, the downsides to reconstructive surgery can include:

• Not all reconstructive surgery is a total success. The result might not meet your expectations.
• A reconstructed breast won't have the same sensation and feeling as a natural breast.
• If tissue from other areas of your body will be used as part of the reconstruction, those areas may look different after surgery, and you may lose sensation or function there.
• The surgeon might suggest reshaping the other breast to match the new one. This could mean additional surgery.
• Breast reconstruction sometimes can involve several surgeries over a long period of time.

If you answered "no." The downsides to reconstructive surgery can include:

• Not all reconstructive surgery is a total success. The result might not meet your expectations.
• A reconstructed breast won't have the same sensation and feeling as a natural breast.
• If tissue from other areas of your body will be used as part of the reconstruction, those areas may look different after surgery, and you may lose sensation or function there.
• The surgeon might suggest reshaping the other breast to match the new one. This could mean additional surgery.
• Breast reconstruction sometimes can involve several surgeries over a long period of time.

Healing can be affected by certain risk factors. Are you of normal weight, a nonsmoker, and without diabetes or blood circulation problems?

If you answered "yes." That's great. But be sure to discuss other risk factors that can affect healing—such as previous surgery, chemotherapy, radiation therapy and chronic health problems.

If you answered "no." Diabetes, circulatory problems, and being obese or too thin are some of the factors that can slow healing after surgery. Additional factors include previous surgery, chemotherapy, radiation therapy and other chronic health problems. Review these with your doctor. If you smoke, you may be required to quit for a while before surgery so your body is better able to heal.

Does your health plan cover reconstructive surgery?

If you answered "yes." If your health plan covers mastectomy, by law it must also cover breast reconstruction. You may have to provide a letter from your doctor and other documentation indicating that reconstruction is necessary. If you're having a lumpectomy—and not a mastectomy—check with your insurance plan to be sure any necessary reconstructive surgery will be covered.

If you answered "no." If you don't have insurance coverage, it's especially important to consider the costs of reconstruction surgery. You may prefer to use an external prosthesis—a wearable, synthetic breast form. Worn inside a bra or attached to the body, this is a flexible option for women who, for various reasons, do not have reconstructive surgery. But if reconstruction is important to you, work with your plastic surgeon to figure out the best option available.

Having reconstructive surgery will delay your return to normal activities. Is that OK?

If you answered "yes." In most cases, women who don't have reconstructive surgery are able to return to their daily life more quickly than those who choose reconstruction.

If you answered "no." In most cases, women who don't have reconstructive surgery are able to return to their daily life more quickly than those who choose reconstruction.

Have you sought a second opinion about surgery?

If you answered "yes." That was probably a good move on your part. It's common for people to get a second opinion before having surgery—and that includes women who are facing mastectomy, lumpectomy or reconstructive surgery. There's often no need to rush into surgery—even mastectomy surgery—before you know all your options.

If you answered "no." You may want to consider it. It's common for people to get a second opinion before having surgery—and that includes women who are facing mastectomy, lumpectomy or reconstructive surgery. There's often no need to rush into surgery—even mastectomy surgery—before you know all your options.

Results

Talk with your doctor about your results, and be sure to ask any questions that came up in this assessment. Together, you can decide what the right next step is for you.

Sources: American Cancer Society; Breastcancer.org