One the big decisions you face is what type of breast reconstruction will suit you and your lifestyle, your body and any treatment you will be having for breast cancer. Additional factors that might influence your decision is the availability of a procedure in your location or preferred hospital. Not all hospitals can accommodate all types of reconstruction, the same as all surgeons cannot always perform all the surgical techniques. Keep these things in mind while weighing the pros and cons and with your discussions when interviewing your potential surgeons.
There are two main techniques for reconstructing your breast:
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"Both approaches have advantages and disadvantages, says Frank J. DellaCroce, M.D., F.A.C.S., plastic surgeon and co-founder of the Center for Restorative Breast Surgery. “Just like we have vanilla and chocolate, there are two ‘flavors’ of reconstruction: implants and flaps. That’s it. Implant reconstruction is easier on the front end: an easier surgery, easier to recover from, easier to understand. Flaps are more difficult to perform, more time-consuming, and a longer recovery. But on the back end, things flip. Over time, implants are more prone to problems and often require additional procedures to correct these problems. Flaps perform better over time; a flap done well should not need more attention over the course of a lifetime. So it’s all a matter of what’s right for the woman and her individual situation.” |
Some things to consider when choosing your breast reconstruction type
There are many factors to consider when selecting the best type of procedure for you. It’s not only the medically safest and aesthetically pleasing type, but other the physical factors that might impact on your quality of life in the subsequent years. A great way to learn about what it is like to live with the various types is to get in touch with women who have undergone these procedures recently and also those who have been complete for a longer period.
Personal preference You may have a personal preference for either implants or tissue transfer. Some women like the look of the implant and the minimal impact on the rest of the body. While others prefer warm more natural looking breasts and are prepared to compromise the donor site to achieve their desired outcome. Other women feel very clearly that they do not want a foreign body inside theirs, but with most types of procedures some kind of material is placed for reasons of support or strength. |
Seven years ago I had my mastectomy and immediate recon together. I was 37 at the time. I had a lat dorsi with silicone and it looks good. I do feel that having the immediate recon helped me heal. I do understand that an immediate recon may not be for everyone. My scars have healed really well too. |
Age
Your physical age might be a factor to consider in terms of shock to your body and ability to bounce back post-surgery. Generally implant procedures have fewer revisions required and shorter surgeries so the process will be completed over a shorter period of time, but often there are additional complications of infection or contracture that require further attention. The stamina required for continued procedures might be a consideration for you.
Lifestyle
Your lifestyle might dictate the most appropriate type of reconstruction procedure for you. For example, if you enjoy going to the gym and doing sit-ups and core strength exercises then you might not want to compromise the muscles in your tummy, so a TRAM flap surgery would not suit you. Or if you have a job that involves climbing and lifting you might steer clear of the Latissimus Dorsi procedure. Talking these things over with your surgeon and with women who have had these procedures can give you a good insight into what to expect.
Medical history
Additional medical conditions might influence on the length of anesthetic that is safe for you. In turn this may impact on a safe length of surgery meaning a short implant procedure is more suitable than the longer tissue transfer procedures. In some cases the procedures can be completed in stages to decrease the length of time under anesthetic.
Family responsibilities
Generally the implant procedures are shorter length, and have a shorter recovery period. This might be a influencing factor for women with young children, or single mums or women caring elderly parents or other family commitments. Ladies with grown or independent children who can provide care or support in the home may feel comfortable choosing the longer procedure with the longer recovery.
Work
If you work outside the home you may be limited in the sick leave you are able to take or time you can be away from your job. The type of work you do might also influence the type of procedure you choose.
Friends and family
Surprisingly not everyone may at first support your need for breast reconstruction and some of the biggest opposition might come from those closest to you. People looking on sometimes have a very difficult time imagining what it would be like in your situation which makes it difficult for them to understand why you want to pursue this additional non-essential to breast cancer survival surgery. This might cause you to further reflect on your choices, however it should not be underestimated how important it might be to your overall physical and emotional recovery from your breast cancer journey. Your loved ones are showing their concern for your health and welfare, so encouraging them to see it from your point of view and how it will make you feel can be a powerful way to turn their opposition into support.
Your physical age might be a factor to consider in terms of shock to your body and ability to bounce back post-surgery. Generally implant procedures have fewer revisions required and shorter surgeries so the process will be completed over a shorter period of time, but often there are additional complications of infection or contracture that require further attention. The stamina required for continued procedures might be a consideration for you.
Lifestyle
Your lifestyle might dictate the most appropriate type of reconstruction procedure for you. For example, if you enjoy going to the gym and doing sit-ups and core strength exercises then you might not want to compromise the muscles in your tummy, so a TRAM flap surgery would not suit you. Or if you have a job that involves climbing and lifting you might steer clear of the Latissimus Dorsi procedure. Talking these things over with your surgeon and with women who have had these procedures can give you a good insight into what to expect.
Medical history
Additional medical conditions might influence on the length of anesthetic that is safe for you. In turn this may impact on a safe length of surgery meaning a short implant procedure is more suitable than the longer tissue transfer procedures. In some cases the procedures can be completed in stages to decrease the length of time under anesthetic.
Family responsibilities
Generally the implant procedures are shorter length, and have a shorter recovery period. This might be a influencing factor for women with young children, or single mums or women caring elderly parents or other family commitments. Ladies with grown or independent children who can provide care or support in the home may feel comfortable choosing the longer procedure with the longer recovery.
Work
If you work outside the home you may be limited in the sick leave you are able to take or time you can be away from your job. The type of work you do might also influence the type of procedure you choose.
Friends and family
Surprisingly not everyone may at first support your need for breast reconstruction and some of the biggest opposition might come from those closest to you. People looking on sometimes have a very difficult time imagining what it would be like in your situation which makes it difficult for them to understand why you want to pursue this additional non-essential to breast cancer survival surgery. This might cause you to further reflect on your choices, however it should not be underestimated how important it might be to your overall physical and emotional recovery from your breast cancer journey. Your loved ones are showing their concern for your health and welfare, so encouraging them to see it from your point of view and how it will make you feel can be a powerful way to turn their opposition into support.
What are the risks?
As with all surgery there are risks involved. Not all women will have all possible complications, however it is important to understand the potential risks to help you make an informed decision. You should discuss all possible risks with your surgeon prior to your final decision. Connecting with other women who have had breast reconstruction can also be a good source of information regarding risks, but it is important to understand that each person will tolerate the surgery and possible complications differently.
Some possible general risks include:
Specific risks for the type of reconstruction are included on the reconstruction type pages.
Some possible general risks include:
- Wound infection
- Seroma or build up of fluid around the reconstruction site
- Distortion with movement
- Pain and discomfort
- Unequal breasts if your weight changes
- Asymmetrical breasts
Specific risks for the type of reconstruction are included on the reconstruction type pages.