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confidence and self-image after
mastectomy.
The decision to have breast
reconstruction is a personal one,
to be decided by you and your
loved ones. It is paramount to
understand that not all patients
are candidates for all types of
reconstruction. The type of
reconstruction you undergo will be
decided by you and your surgeon,
depending on your particular
needs, anatomy, and previous
treatments.
Many women wonder what a
reconstructed breast looks and
feels like. For instance, ‘Will it look
the same as my previous breast?
Will it match my other breast?
Does the nipple have feeling?’
Unfortunately, while there are
many techniques of breast and
nipple reconstruction, none of
them will be able to give you back
the exact same breast you were
born with. It is important to realize
that after a mastectomy, the only
tissue remaining on the chest
wall is muscle and a thin layer of
skin. Your plastic surgeon will be
creating an entirely new breast
from these tissues. The breast often
feels and looks different from the
original breast and procedures to
make it
look more similar to the opposite
side may be required as you will
read below.
In addition, most women find
the skin of the chest wall has less
sensation after a mastectomy.
Nerves that were removed during
the mastectomy cannot be
replaced and the loss of feeling
is unfortunately permanent.
However despite these limitations,
most women who undergo breast
reconstruction derive immense
benefits from the procedure.
These include feelings of regained
wholeness and femininity, as
well as practical benefits such as
eliminating the need for wearing a
cumbersome breast prosthesis and
achieving spinal balance.
There are 3 main
steps in any breast
reconstruction:
1
The creation of a new
breast mound
2
Touch-ups of the
reconstruction, and
possible modification of
the opposite breast (lift,
reduction) in patients
having a mastectomy of
one side (optional)
3
The creation of a new
nipple and areola
(optional)
Types of breast
reconstruction:
There are three main types
of breast reconstruction.
The first type of
reconstruction uses
an implant filled
with silicone
gel to recreate
the breast
mound. A
second option is
to build a breast
mound using
tissue “borrowed”
from another
part of your body.
The last type of
reconstruction combines the use of
both “borrowed” tissue from your
back as well as an implant.
Your plastic surgeon will discuss
these methods with you and
counsel you as to which option
is best suited for you based on
your physical and treatment
characteristics.
Who can have
reconstruction?
Most women who are having or
have had a complete or partial
mastectomy (removal of all or
some of the breast tissue and
nipple) are candidates for breast
reconstruction. If you have had,
or will need radiation therapy to
the breast, it may influence the
type of reconstruction, and when
you can have it. Some patients
will need chemotherapy after their
mastectomy, and this too can affect
the timing of your reconstruction.
When to begin
reconstruction?
Reconstruction can be either
immediate (at the same time as
the mastectomy) or delayed (at a
later time). This decision may be
dictated by the characteristic and
stage of the breast cancer, and will
be made together with your breast
surgeon. In many cases, immediate
reconstruction is a reasonable and
safe option.
Don’t feel Guilty:
I see many women who feel guilty
or ashamed about wanting breast
reconstruction. (In the sentence
that follows please change double
quotations to single) Many patients
will come in for a consultation
to discuss breast reconstruction,
and they may say, ‘I’m not vain,’ or
‘my husband says he doesn’t care
if I have breasts,’ or ‘I feel guilty
for wanting reconstruction, after
putting my family through so much
already.’ Breast reconstruction is
not something that women should
be ashamed of for wanting or feel
guilty for having. It is not vanity. It
is about recovery and healing.
H
35
Oct/Nov 2014