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If you have surgery as part of your
breast cancer treatment, you may choose reconstruction to rebuild
the shape and look of your breast. Several types of breast
reconstruction are available. Learn about your options and what to
expect before and after surgery.
When does reconstruction happen?
Immediate reconstruction: You might be able to have breast
reconstruction at the same time as your breast cancer surgery.
Delayed reconstruction: Some people need to wait until later, or
choose to do so.
Some people choose to wait, especially if they dont want to make
decisions during treatment or dont want extra surgery right away.
But keep in mind that the results of your reconstruction may be
different depending on whether you have it right away or wait until
later. Your surgeon can help you understand your options and what to
expect.
Should I get breast reconstruction surgery?
Many people choose to have reconstruction surgery after breast
cancer, but it might not be right for everyone. People choose breast
reconstruction for many reasons. For example, you might have
reconstruction to:
Make your chest look balanced when you wear a bra or swimsuit
Help make your clothes fit better
Regain your breast shape without using an external breast form
(breast prosthesis)
Feel better about your body
Possible risks
As with any surgery, its also important to consider the potential
risks and side effects. Breast reconstruction may cause unique
problems for some people. Your surgeon will go over these risks with
you. Be sure to ask questions if you are unsure about anything.
You can learn more about the possible risks in What to Expect After
Breast Reconstruction Surgery on the American Cancer Society
website.
Healing after surgery
Many things can affect how you heal after breast reconstruction
surgery, such as past surgery, chemotherapy, radiation, smoking,
diabetes, or weight. Poor blood flow can cause part of the tissue to
die. This is called necrosis. It can slow down your healing and may
need more surgery.
Because of these risks, you may need to wait before having
reconstruction. Quitting smoking at least 2 months before surgery
can help healing. In some cases, reconstruction may not be
recommended.
What will my breasts look like after surgery?
Breast reconstruction often leaves scars, but these usually fade
over time. Newer methods have also reduced the amount of scarring.
When you wear a bra after reconstruction, your breasts should be
relatively alike in size and shape.
Its important to know that your reconstructed breast may not look
exactly how you expect. You can ask your surgeon to show you
examples of people whove had reconstruction. This can give you a
better idea of what to expect.
Keep in mind that your reconstructed breast will not be a perfect
match or substitute for your natural breast. A rebuilt breast will
not feel the same to the touch as a natural breast. You may also
have little or no feeling in the breast.
Talking with your plastic surgeon can help you understand what is
realistic.
You might also choose to have surgery on the other breast, so both
sides look more alike. This is called a symmetrizing procedure. It
may include lifting, reducing, or enlarging the other breast.
What other changes should I expect?
If tissue from your belly, back, thigh, or buttocks was used as part
of the reconstruction, those areas will also look different after
surgery.
Before you make your decision, talk with your surgeon about scars
and changes in the shape or contour of your body. Ask where these
scars and changes will be and how they will look and feel after they
heal.
Can a reconstructed breast hide cancer or make it come back?
Studies show that reconstruction does not make breast cancer come
back. If the cancer does come back, reconstructed breasts should not
cause problems finding the cancer or treating it.
Reconstruction rarely hides a return of breast cancer.
This is true for both reconstruction with an implant and
reconstruction with your own tissue (tissue flap).
You should not consider this a big risk when deciding to have
breast reconstruction.
Finding the right plastic surgeon
Your breast surgeon can help you find a plastic surgeon who should
be able to explain all your choices and answer your questions. Your
plastic surgeon and breast surgeon will work together to coordinate
your care.
If time allows, consider getting a second opinion before having
surgery. This can give you more information about your options and
help you feel more confident about your choice.
To find a board-certified plastic surgeon in your area, or to find out if
your surgeon is board certified, contact the
American Board of
Plastic Surgeons.
Questions to ask before breast reconstruction
Understanding your options
Can I have breast reconstruction?
When do you recommend I have it?
Will it interfere with chemotherapy or radiation therapy?
What types of reconstruction could I have?
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Am I a candidate for a direct
implant, or is a tissue expander a better option?
I am very active. Would it be better to have the implant or
expander placed above the muscle?
Am I a candidate to use my own
tissue (flap procedure)? If so, what type of flap?
If I need radiation, will that affect my reconstruction? What is
the timeline?
Am I a candidate for nipple-sparing mastectomy?
Am I a candidate for nerve-sparing mastectomy?
What are the risks and benefits of each option?
How many of these surgeries do you do each year?
Are there any new reconstruction options or clinical trials that I
should know about?
Is this covered by my insurance?
What to expect
What will my reconstructed breast look like?
Can you show me photos of typical results?
How will the breast feel to the touch? Will I have any feeling in
it?
Should I consider surgery on the other breast to help them look
alike?
Could I have the nipple reconstructed if I choose?
What kinds of changes to the breast can I expect over time?
Will I need more surgery in a few years because of possible
complications?
For tissue flap surgery
Will there be pain, scars, or other changes in the parts of my
body where the tissue is taken from?
Will I also need an implant to give the reconstructed breast a
better shape?
For implant surgery
How long will my implant last?
Will the implant be smooth or textured? Saline or silicone?
Will I need extra imaging tests depending on the type of implant I
get?
Recovering from surgery
How long will I be in the hospital after surgery?
How long would it take me to recover?
How much discomfort or pain will I feel?
What possible problems should I know about?
If I have diabetes, will it affect my healing?
If Im still smoking, will it affect my healing?
What should I do if my arm swells?
Will I need blood transfusions?
How will I care for my surgical scars (incisions)?
Will I have a drain to let fluid out of the wound?
How much help will I need at home?
Will I do exercises after surgery? When can I start them?
When can I go back to my usual activities like driving and
working?
Understanding costs and insurance coverage
Under the Womens Health and Cancer Rights Act (WHCRA) and other
federal laws, most health insurance plans that cover the cost of a
mastectomy must also cover breast reconstruction. In the past, some
health plans have denied coverage despite these laws. Your surgeon
may be able to help you if your insurance plan wants to deny
coverage.
Ask your insurance company if they
will pay for your reconstruction surgery. See if there are any
limits on what types of reconstruction they cover, and find out if
you have to pay any part of the bill yourself.
Health insurance often pays for most or all of the cost of
reconstruction after a mastectomy.
This is not always the case for reconstruction after
breast-conserving surgery, such as lumpectomy or partial mastectomy.
Help and support from someone whos been there
Support and guidance are available to help you understand your
reconstruction options and cope with the changes you're going
through. Talking with your healthcare team is a good place to start.
If youd like to connect with someone who had a similar type of
reconstruction, you can download the
ACS CARES app.
Through ACS CARES, you can choose to be matched with a breast cancer
survivor who is trained to support others. They will share their
experience, offer advice, and suggest helpful resources as you
consider or go through reconstruction.
Taken from the American Cancer Society website
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