Breast reconstruction is no doubt one of the big challenges of your breast cancer journey, or if you are a woman seeking to minimise your high risk, it can be an equally big step.
Most women who have undergone reconstructive procedures are happy with their results and glad they pursued it. Lots of women get through with no problems at all, while other ladies unfortunately have some hiccups along the way, so it is good to get a realistic idea of what can be achieved and also how the stages might play out before you embark on this part of the journey
Most women who have undergone reconstructive procedures are happy with their results and glad they pursued it. Lots of women get through with no problems at all, while other ladies unfortunately have some hiccups along the way, so it is good to get a realistic idea of what can be achieved and also how the stages might play out before you embark on this part of the journey
There are a few key things that will help you to achieve the best outcome for you:
- Get informed - Do your research, learn as much as you can early in your breast cancer journey because decisions you make now can impact on your options later, become your own advocate.
- Work out what you want - Consider the relevant information, speak to surgeons and women who have experience, decide what is important to you.
- Define your goal - Breast reconstruction usually goes in 3 stages; stage 1 is your original reconstruction surgery (either immediate or delayed), stage 2 is any revision (this may be more than 1 surgery), stage 3 is what to do about nipples. You can stop after any stage if you are satisfied with that result. You can take a break if you want to. What can be helpful is if you have an idea of what you might be satisfied with so you know when you have reached your goal. But also remember you can move the goal posts, if you choose, when you choose.
Who decides?
Deciding which type of breast reconstruction is best for you is a conversation to have with your reconstructive breast surgeon or plastic surgeon. Some breast surgeons are very informed about the current procedures and can refer you to a reconstructive breast or plastic surgeon who specialises in your preferred procedure. A reconstructive breast or plastic surgeon is the most knowledgeable person to discuss the technique that will best suit you.
Surgeons are specialists in their field and while your breast surgeon may be very skilled at removing your cancer or breast tissue, they will not have the experience or knowledge of an oncoplastic breast surgeon or specialist plastic surgeon to fully inform you about breast reconstruction. You are fortunate if you have options to choose from, so it is a good idea to get more than one opinion. Reconstructive surgeons also specialise in their preferred procedures and each surgeon may recommend something different for you. |
"We believe that nearly every woman who has a mastectomy could have a reconstruction if she chose to. Giving women the choice, upfront, to have reconstruction if they want it, and as part of a package of treatment options, has led to almost half of the women we see wanting to take up the offer." Professor Andrew Spillane, President BreastSurgANZ |
What's important to you?
Each woman facing mastectomy is unique and your decision about whether to reconstruct your breasts or not is an intensely personal one. Most women can choose to undergo breast reconstruction immediately at the time of mastectomy, or at any time post mastectomy. Its important to understand though, that the decisions you make early on can impact on what reconstruction procedures you can have later.
Some women prefer to leave the decisions about breast reconstruction until they have managed their breast cancer while others feel the need to have an immediate reconstruction. There is nothing neat and timely about diagnosing breast cancer and choosing treatment and surgery options, but if you are well informed, you are more in control of what happens to your body.
Most women have the time to slow down and gather relevant information for their situation. With this information and the guidance of your health professionals you can begin to work through how you feel and what is important to you. If you cannot conceive of even a short time without breasts, and your diagnoses allows it, you may be able to choose an immediate reconstruction. This way you wake up from your surgery with something that resembles breasts.
If you feel more comfortable waiting until you recover from your breast cancer treatment, or the timing doesn't allow it, or you feel rushed and uncertain, then you can choose to delay breast reconstruction. You might be able to have an expander placed at the time of mastectomy to preserve your skin in preparation of a future procedure.
There are many many options to choose from and your specialist plastic surgeon is the best person to give you advice on what breast reconstruction method is best for you.
Some women prefer to leave the decisions about breast reconstruction until they have managed their breast cancer while others feel the need to have an immediate reconstruction. There is nothing neat and timely about diagnosing breast cancer and choosing treatment and surgery options, but if you are well informed, you are more in control of what happens to your body.
Most women have the time to slow down and gather relevant information for their situation. With this information and the guidance of your health professionals you can begin to work through how you feel and what is important to you. If you cannot conceive of even a short time without breasts, and your diagnoses allows it, you may be able to choose an immediate reconstruction. This way you wake up from your surgery with something that resembles breasts.
If you feel more comfortable waiting until you recover from your breast cancer treatment, or the timing doesn't allow it, or you feel rushed and uncertain, then you can choose to delay breast reconstruction. You might be able to have an expander placed at the time of mastectomy to preserve your skin in preparation of a future procedure.
There are many many options to choose from and your specialist plastic surgeon is the best person to give you advice on what breast reconstruction method is best for you.
Define your goal
The good thing about working this out is out is that you then have something to aim for. It gives you a point in time or a tangible thing to work towards, and this means that you will know when you are finished.
This is a long and emotional journey, so it can be a good idea to try to visualise the point at which you will be happy and complete. For many women this point is after her first reconstruction surgery and she is happy to look good in clothes and have a mound to fill out her bra. Other women might want to look good naked and want to have the shape refined and both breasts matching. Some women are pleased to have shape and volume but they see no need for nipples. Other women will not feel complete unless they have nipples reconstructed and finished off with the colour tattooed. Then other women are satisfied with a simple tattoo for colour or to seek out 3D tattooing for visual appeal.
The good thing about working this out is out is that you then have something to aim for. It gives you a point in time or a tangible thing to work towards, and this means that you will know when you are finished. A great way to define your goal is to chat with other women who have been through breast reconstruction. Look at their pictures, especially the final stages, to get a good idea of what you might be able to expect. Meeting women in a casual environment for a show and tell or chatting on the phone are other good ways to develop an understanding of a realistic outcome. Find ways to connect online, on the phone or face to face by clicking here. |
"When I looked in the mirror after nipple reconstruction I felt an enormous weight lift from my shoulders, I realised I had made it to the end and I now felt complete." |
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.
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 anaesthetic 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 anaesthetic.
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.
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.
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 anaesthetic 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 anaesthetic.
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.