10 Things to Consider before Undergoing Breast Reconstruction Surgery
There is an overwhelming amount of information on the internet about breast cancer related topics. When you are newly diagnosis with breast cancer, trying to digest this high volume of information can feel like trying to drink from a fire hydrant. The checklist below provides a good starting point for things to consider when deciding your treatment plan.
- Research. It is common to want to rush the process along when you are given the shocking news of a breast cancer diagnosis. While this is very understandable, it is also very important for you to take enough time to understand all of your options. A discussion with your doctors will provide you with answers and reputable resources to reference.
- Talk to your doctor. With the emerging popularity of social media, patients frequently get information from online support groups and other patient forums. Although having the support of others going through breast cancer is amazing and can be very helpful, it is also very important to remember that every patient’s situation is unique and you are only able to see part of the picture online. Questions specific to your care should be addressed directly with your doctor and their team for the most accurate information
- Make the best decision for you. Breast reconstruction surgery is a personal decision, and several factors play into it. It can be helpful to bring your spouse, family, or support system with you to your consultation so they also understand your options and expectations. It is helpful to weigh the options with your support system, but ultimately you must make the best decision for YOU in your current situation.
- Plan ahead. After any type of surgery there is an obligatory recovery period. The length of your recovery varies depending on the type of work you need to resume. Be sure to discuss the details of your expected recovery and post-op restrictions with your surgeon so you can plan accordingly with your support system and your employer.
- Can I pick my breast size? The size of your breast reconstruction is dependent on your pre-operative body habitus. Part of your consultation with your reconstructive surgeon will involve discussing what your ideal breast size is (bigger, smaller, or in line with your current size). After examining you, your surgeon will be able to discuss your expected breast size and the likelihood of meeting your expectations. Your surgeon may show you photos of patients with a similar body habitus to help you get a better idea of what you will look like.
- Know your timeline. Our goal at Breast Reconstruction Associates is to complete your reconstruction in as few surgeries as possible. Ask your surgeon how many surgeries they anticipate for you, and what the expected timing of each of surgery will be. Timing of reconstruction may have to be adjusted to prioritize the cancer treatment specific to your care.
- What will I look like? Looking at photos of other patients who have had the surgery can go a long way in allaying your fears. At Breast Reconstruction Associates, we often look at photos together with patients to give them an accurate visual of the scars patterns they will have.
- Ask questions. Nothing is off the table – make a list of all the questions you have and go over all of them with your doctor.
- What about your nipples? Even with a mastectomy, some patients have the option of keeping their nipples; this is called a nipple sparing mastectomy. Depending on the location of your tumor, and the position (ptosis) of your nipples, your breast surgeon and plastic surgeon will assess and determine if you are a candidate for a nipple sparing mastectomy. If you are not able to keep your nipples, there are other great options to complete your reconstruction like nipple reconstruction or 3D nipple areola tattoos.
- What is the goal of reconstruction? It is important to discuss realistic expectations with your plastic surgeon, and to understand the difference in reconstructive surgery and cosmetic surgery. The goal of reconstruction is to restore what cancer took away from you; to rebuild your breasts and be able to fit clothing evenly without the need to use a prosthesis. While it is a life-changing experience, it is often emotional during the transition. It takes time and perspective to accept and love your new reconstructed self. Don’t be embarrassed or afraid to discuss your emotions through your healing process.
In summary, take some time to learn about your options before moving forward. For more information, visit Breast Reconstruction Associates.
FAQs
Breast implants used in reconstruction are not lifetime devices. Most implants last between 10-20 years, though some may last longer. You may eventually need revision surgery due to implant rupture, capsular contracture (scar tissue hardening), or changes in appearance over time. It’s important to understand that breast reconstruction is often a journey requiring multiple procedures over your lifetime, and your surgeon should discuss a long-term maintenance plan with you during your consultation.
Implant-based reconstruction uses saline or silicone implants to rebuild the breast and typically requires fewer initial surgeries with shorter recovery times. Autologous or flap reconstruction uses your own tissue (usually from the abdomen, back, or buttocks) to create a new breast. While flap surgery involves longer operative time and recovery, it can feel and age more naturally, doesn’t require future replacements, and may provide the added benefit of body contouring. Each approach has distinct advantages and limitations that should be discussed with your surgical team to determine which is best for your body and lifestyle.
Breast reconstruction does not interfere with cancer surveillance, though reconstructed breast tissue can make mammography more complex. Your oncology team should be informed about your reconstruction method so they can adjust imaging protocols accordingly. Implant-based reconstruction may require specialized imaging techniques, while flap-based reconstruction typically allows for standard screening. Regular communication between your plastic surgeon and oncologist ensures that your reconstruction doesn’t compromise your ability to monitor for cancer recurrence.
While many insurance plans cover medically necessary breast reconstruction under the Women’s Health and Cancer Rights Act, out-of-pocket costs can vary significantly. These may include co-payments, deductibles, anesthesia fees, facility costs, and expenses for procedures not covered by insurance such as nipple tattooing or revisions for aesthetic refinement. Additionally, if you choose to reconstruct the opposite breast for symmetry, that procedure may be classified as cosmetic and require out-of-pocket payment. It’s essential to discuss the complete financial picture with your surgeon’s billing department before proceeding.
Most breast reconstruction results in some permanent loss of sensation in the breast and nipple area, though some sensation may gradually return over months to years. Breastfeeding after reconstruction depends on your specific surgery type and extent of nerve involvement. Flap reconstruction typically preserves a better chance of breastfeeding, while implant-based reconstruction may limit milk production if breast tissue was significantly removed. If future breastfeeding is important to you, discuss this explicitly with both your breast surgeon and plastic surgeon during planning.
The emotional aspects of breast reconstruction are just as important as the physical recovery. Many patients experience grief over their cancer diagnosis, body image changes, or if reconstruction doesn’t meet initial expectations. Consider connecting with a therapist who specializes in cancer survivorship or body image issues before surgery. Support groups specifically for reconstruction patients, rather than general cancer support, can provide insights from others at similar stages of their journey. Your surgeon’s office may be able to connect you with mental health resources or patient advocates.
Immediate reconstruction occurs at the time of mastectomy, while delayed reconstruction happens weeks, months, or even years later. Immediate reconstruction can be psychologically beneficial and requires fewer anesthesia exposures, but may limit surgical options if extensive radiation is needed. Delayed reconstruction allows time for complete cancer treatment planning, may offer more surgical choices, and gives you time to adjust emotionally before committing to surgery. Your breast cancer stage, need for radiation therapy, and personal preferences should all factor into this decision, which should be made collaboratively with your entire medical team.