Any diagnosis to cancer is over whelming – there are tremendous implications for one’s health, family, and quality of life. But when women hear they have breast cancer and that they will lose one or both of their breasts, the emotional tool is extreme. In addition to the worries about health and family are added concerns about how you will look and feel, and how others will react to you. Because many women identify their femininity with their breasts, the idea of losing one or both breasts may make you feel less of a woman which is to some extent very true. In spite of all above facts reconstruction does not appeal to all women, many find a sense of comfort knowing that breast reconstruction is an option available to them after mastectomy surgery. Some women appreciate being able to return to a physical appearance similar to that before the breast cancer surgery. Women describe a sense of emotional healing, restoration of self-confidence, femininity, joy and peace of mind after breast reconstruction.
Some women choose breast reconstruction because they feel it allows them to return to as “normal” an appearance and lifestyle as possible. Some women find the mastectomy scar constantly reminds them of the breast cancer. Other women prefer not to wear an external prosthesis (artificial breast) for a variety of reasons. Reconstruction of a breast is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast.
Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all. Not all women will have mastectomies. Some will choose lumpectomy and irradiation. Nor will all women having mastectomies want the additional procedures involved in breast reconstruction.
Despite the growing acceptance of reconstruction among mastectomy patients and members of the medical community, the general public is still largely unaware of the physical and psychological transformation that is possible through reconstructive breast surgery. The education of all women about the spectrum of therapeutic alternatives available to them is necessary so that they can more effectively influence their own destinies and play an active role in their own health care.
A plastic surgeon is a part of the “Breast Management Team” and should be visited before having breast cancer surgery to review the possible breast reconstruction options that would apply to individual diagnosis, general health and personal desires. Great strides have been made in the field of breast reconstruction in recent years, resulting in more aesthetic breast shape and appearance. It is important for you to realize that your reconstructed breast will not look or feel exactly like your natural breast. While it is not for everyone, many women who have undergone breast reconstruction experience a faster and more complete emotional recovery from the loss of their breast.
The decision to have breast reconstruction depends on your own individual case, medical condition, general health, lifestyle, emotional state, and most of all breast size and shape. You may consider consulting your family, friends, and breast cancer support groups to help you in making this decision. Your general surgeon, plastic surgeon, and oncologist should work together to plan your mastectomy and reconstruction procedure to give you the best possible result. But bear in mind, post-mastectomy breast reconstruction is not a simple procedure. There are often many options to consider as you and your doctor explore what’s best for you.
Your surgeon will decide whether your health and medical condition makes you an appropriate candidate for breast implant reconstruction. Women with small or medium sized breasts are the best candidates for breast reconstruction. Breast reconstruction can be accomplished by the use of a prosthesis (a breast implant, either silicone gel or saline-filled), your own tissues (a tissue flap), or a combination of the two. Women with larger breasts may require reconstruction with a combination of a tissue flap and an implant. Your surgeon may recommend breast implantation of the opposite, uninvolved breast in order to make them more alike (maximize symmetry) or he/she may suggest breast reduction (reduction mammoplasty) or a breast lift (mastopexy) to improve symmetry.
- Mastopexy involves removing a strip of skin from under the breast or around the nipple and using it to lift and tighten the skin over the breast.
- Reduction mammoplasty involves removal of breast tissue and skin. If it is important to you not to alter the unaffected breast, you should discuss this with your plastic surgeon, as it may affect the breast reconstruction methods considered for your case.