Know your options for breast reconstruction


Women diagnosed with breast cancer face a daunting list of decisions about treatment and recovery. An important choice is whether or not to rebuild the shape and look of the breast after a mastectomy.
There's no right or wrong decision about breast reconstruction. What's important is to understand your options and consider your expectations for physical and emotional healing after your initial surgery.
Here are six things to know about breast reconstruction.

  1. It's right for some, not for others. Breast reconstruction is a deeply personal decision. Your needs, wants and expectations are different from other women. So is your cancer. That's why it's important to understand options that fit your situation and consider what's right for you.

  2. You are in control. If you face a mastectomy to remove breast cancer, you may not want to have more surgery right away. Your doctor can approach your surgery with reconstruction at a later time in mind. After you recover, you can revisit your options.

  3. Reconstruction can take place right away or later. Many women have breast reconstruction at the same time as a mastectomy. This approach is called immediate reconstruction. It can get you on the road quickly toward physical and mental healing.

    Delayed reconstruction gives you a chance to recover from cancer treatment. When you feel up to it, you can move forward with your choice for breast reconstruction.

    It's important to remember that the insurance company that pays for a mastectomy must pay for reconstruction, according to the Women’s Health and Cancer Rights Act of 1998. They must also pay for breast reconstruction and any additional surgeries to the opposite breast needed to provide symmetry.

  4. Breasts can be rebuilt two ways. You may have a choice between implants or using your own body tissue to reconstruct the breast.

    Implant reconstruction uses an artificial shell filled with either saline or silicone to give you the shape and look of a breast. Flap reconstruction uses a flap of tissue from another part of the body, such as the belly, back, thighs or buttocks.

  5. You may need one or more surgeries. Several factors affect your options for reconstructive surgery. Talk with your breast surgeon and plastic surgeon to understand what fits best for you.

    Single-stage surgery means doctors place an implant immediately after removal of the breast tissue. The procedure allows for minor adjustments later that do not require additional surgeries.

    Multi-stage reconstruction offers a safe option for patients at higher risk for complications with wound healing or infections. During a mastectomy, surgeons place tissue expanders, which are like temporary deflated balloons. The expander is inflated gradually over several weeks to allow the skin to stretch. During a second surgery, doctors place the final implant. This approach gives more time for gradual, gentle healing after the mastectomy.

  6. Prosthetics give you an alternative to reconstruction. You may decide reconstruction surgery isn't right for you. Fitted breast prosthetics and bras can re-create a breast shape and give you a balanced look. They are available in many shapes, sizes and materials.

If you are considering breast reconstruction after a mastectomy, talk with your breast surgeon, oncologist and a plastic surgeon about your options. They can plan the treatment that best meets your needs, whether you decide to have reconstructive surgery right away or wait until you have recovered from cancer treatment.
Breast specialists at Goshen Retreat Women's Health Center work closely with the Goshen Center for Cancer Care oncology team and plastic surgeons at The Centre, P.C. to coordinate breast reconstruction for women.
Laura Morris, MD, and Fiona Denham, MD, are board certified and fellowship trained breast surgical oncologists at Goshen Retreat Women’s Health Center. Dr. Morris helped found the Retreat in 2003, and she currently serves as medical director.
The Retreat is dedicated to treating patients with benign and malignant diseases of the breast as well as management of high-risk patients. It is an accredited breast center by the National Accreditation Program for Breast Centers (NAPBC).