What Are My Options for Breast Reconstruction?

Women who have undergone surgery to treat breast cancer, such as a mastectomy, have the option to rebuild the removed breast or breasts. A number of factors influence the decision to undergo breast reconstruction, including which type of reconstruction you want.

Types of Breast Reconstruction Procedures

There are multiple reconstructive surgery options out there, and in some cases, more than one operation will be necessary. Speak to your doctor at length before making these decisions, and try to be as fully informed as possible. Two primary operations that can be done during breast reconstruction include:

Breast implants: These are silicone or saline inserts
Tissue flap procedures: These use your own body tissues to reconstruct the breast

In some final stages of reconstruction, nipple and areola reconstruction procedures might be done to help the breast appear more like the original breast. In some cases, a combination of implants and the flap procedure is utilized to get the best possible results.

Immediate vs. Delayed Reconstruction

Another important choice when considering reconstruction will be one between immediate reconstruction (done at the same time as the surgery to treat cancer) or delayed reconstruction performed at a later time.

Immediate reconstruction can be a benefit because it can help preserve breast skin, which can produce better-looking results. Women also don’t have to spend any time without the shape of a breast. While immediate reconstruction can begin right away, there might be multiple steps required to get the final shape.

Delayed reconstruction is a better choice for some women, including in the following situations:

You don’t want to think about it while coping with cancer treatment: Cancer treatment is often very difficult, and some women wait until after surgery to decide on reconstruction.
You have other health issues: Your surgeon may suggest waiting on reconstruction, particularly if you smoke or have other health issues. If you do decide on reconstruction, it’s best to quit smoking at least 2 months in advance to allow better healing.
You have advanced cancer that has spread to the skin: If this is the case, you may not be a candidate for immediate breast reconstruction.

Factors in Choosing

If you’ve decided to move forward with breast reconstruction, there are still choices to be made. Here are some factors you and your doctor will consider while making this decision:

Your overall health (including any potential healing issues, such as smoking or health conditions)
Size and location of breast cancer
Breast size
Extent of surgery
Whether treatments beyond surgery are needed
The amount of tissue available for reconstruction
Whether reconstruction is needed on one or both breasts
Your desire to match the look of the other breast
Your insurance coverage and related costs
How quickly you want to be able to recover
Your willingness to have more than one surgery during reconstruction, if necessary
The effects different kinds of surgery might have on other parts of the body

You’ll speak with your doctor about medical history, and you’ll have a chance to speak to him or her about your preferences and voice any concerns as you formulate the proper plan for breast reconstruction surgery.