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Breast Reconstruction Surgery

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Breast reconstruction surgery restores the shape and size of one or both breasts after a lumpectomy or mastectomy. In most cases, breast reconstruction is done by a plastic surgeon. Making the choice to have breast reconstruction is a very personal decision, so take the time you need to figure out the best options for you and your unique situation. Reconstruction can be done months or years after breast cancer surgery.

Quick facts about breast reconstruction surgery:

Breast reconstruction can be done during or after both mastectomy and lumpectomy.

You also can have the surgeon recreate a nipple and areola on the reconstructed breast, if these were removed during surgery.

Although breast reconstruction recreates the breast, it doesn’t restore sensation to the breast or nipple, though some types of breast reconstruction may be combined with procedures that can help restore sensation.

In some cases, breast reconstruction surgery includes surgery on the other, unaffected breast, so the two breasts match in size and

Is breast reconstruction right for you?

If you’re thinking about having breast reconstruction or aren’t sure, it’s a good idea to talk to your breast cancer surgeon and a plastic surgeon who is experienced in breast reconstruction before you have mastectomy or lumpectomy surgery. You can talk to your doctors about the pros and cons of reconstruction, and your doctors can recommend the best options for you.

Here are some things you may want to consider when deciding whether breast reconstruction is right for you:

Do you want to reconstruct your breast?

Breast reconstruction isn’t right for everyone. After mastectomy, you may prefer to leave one or both sides of your chest flat rather than have the breast or breasts recreated – this is called “going flat.” You always have the option to wear a breast form (prosthesis) — an insert that you put in your bra or bathing suit. If you desire a permanent breast shape, whether you’re wearing clothes or not, reconstruction may be best for you.

Is it important to you that your breasts match in size and shape?

After a mastectomy or lumpectomy on one breast, some people want their breasts to have a balanced, symmetrical appearance. Although you may be able to see some differences between a reconstructed breast and your other breast when you’re naked, your breasts look similar when you’re wearing clothes.

Are you willing to have several surgeries to reconstruct your breasts over an extended period of time?

If you decide to have breast reconstruction surgery, most techniques involve more than one procedure to complete the reconstruction. The first reconstructive procedure may be done during breast cancer surgery. Then a second reconstructive surgery may be scheduled a few months later. It’s also possible that you need several surgeries throughout your lifetime to adjust the reconstructed breast. For example, changes in weight may affect the balance between a reconstructed breast and the opposite unaffected breast, or you may need to replace your breast implant or readjust its position. A plastic surgeon can outline the steps of any breast reconstruction so you know exactly what to expect.

Do you want to resume your regular activities as soon as possible?

Women who don’t have reconstruction are able to resume their daily activities much sooner than women who have reconstruction; different types of reconstruction have different effects on how soon you can return to your regular routine.

Are you an athlete or do you have a physically demanding job?

If so, full range of motion in both of your shoulders may be important to you. Some women find that implants, which are placed under or over the chest muscle, can limit their range of motion or be uncomfortable when reaching full range of motion. Certain flap reconstruction procedures cut through muscle in the back or lower abdomen, which can which can cause weakness or loss of function. A plastic surgeon can help you weigh the physical advantages and disadvantages of each type of reconstruction.

Do you have any other medical conditions that might affect your ability to heal after surgery?

If you have diabetes, circulatory problems, or a bleeding disorder, it may take you longer to heal from reconstruction surgery than someone who doesn’t have these conditions. Heavy smoking and drinking also can affect your ability to heal. All surgery leaves some scars, but the skin cells along your incision may die (a condition called necrosis) if your ability to heal is reduced. If you smoke, you may be required to quit smoking for a period of time before reconstruction surgery so your body is better able to heal.

When is breast reconstruction surgery done?

You can have breast reconstruction surgery at the same time as mastectomy or lumpectomy, which is called immediate reconstruction. (When reconstruction surgery is done at the same time as lumpectomy, it may be called oncoplastic lumpectomy.) Breast reconstruction can also take place months or years after mastectomy or lumpectomy — this is often called delayed breast reconstruction.

The timing of breast reconstruction depends on a number of factors, including whether radiation therapy after breast cancer surgery is recommended for you.

You can have breast reconstruction surgery at the same time as mastectomy or lumpectomy, which is called immediate reconstruction. (When reconstruction surgery is done at the same time as lumpectomy, it may be called oncoplastic lumpectomy.)

Breast reconstruction can also take place months or years after mastectomy or lumpectomy — this is often called delayed breast reconstruction.

The timing of breast reconstruction depends on a number of factors, including whether radiation therapy after breast cancer surgery is recommended for you.

Do you have any other medical conditions that might affect your ability to heal after surgery?

If you have diabetes, circulatory problems, or a bleeding disorder, it may take you longer to heal from reconstruction surgery than someone who doesn’t have these conditions. Heavy smoking and drinking also can affect your ability to heal. All surgery leaves some scars, but the skin cells along your incision may die (a condition called necrosis) if your ability to heal is reduced. If you smoke, you may be required to quit smoking for a period of time before reconstruction surgery so your body is better able to heal. - Source: breastcancer.org/Jamie DePolo

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