What You Need to Know if You Choose Breast Reconstruction


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No surprises: Ask a lot of questions before deciding about reconstruction.
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If you want to have reconstructive breast surgery after your mastectomy (and the procedure is appropriate given your health profile), you'll either get an implant or so-called autologous reconstruction, using your own tissue—or some combination of these methods.

A few key things to consider when choosing between the two are your comfort, your appearance, and how quickly you want this over with. Implants feel less natural than human tissue, but the surgery involved in taking tissue from your abdomen or back can be hard on some women because it takes a long time and is relatively invasive.

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You will probably go under the knife more than once
Also keep in mind that reconstructive surgery usually involves more than just one procedure, even if you have so-called immediate reconstruction—right after your mastectomy.

"We rarely do the [reconstruction of the] areola and nipple at the same time," says R. Bruce Shack, MD, professor and chairman of the department of plastic surgery at Vanderbilt University Medical Center in Nashville. "Because the breast mound may shift a little bit, I like to delay that until the very last thing. Frequently we do it at the same time that we adjust the other breast. More than half the time an adjustment of the opposite breast is necessary to get symmetry."

Find out what to expect
Looking at "before" and "after" photos of your plastic surgeon's previous reconstruction patients is a good way to know what to expect. "If surgeons are honest they'll show you an average result—not just their very best results. Any incision we make is going to heal with scars," cautions Dr. Shack, who's found it more helpful to connect former patients with new ones to talk through every aspect of reconstruction. "It's the total experience that the patient wants to know about."
Lead writer: Lorie Parch
Last Updated: May 05, 2008

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