If you want to have breast reconstruction it is best to discuss
this with your doctor as soon as you realise you need a mastectomy,
although, breast reconstruction can be done months to years
after a mastectomy or immediately after mastectomy as part
of the same operation.
There are two main types, one in which muscle, flesh and/or
skin are taken from another part of your body (the
back, stomach or other breast) and one using
implants. The surgeon will often recommend which is best
for you based on your breast size and personal preferences.
You may also be given a choice where either may suit. There
is high level information on each on this site and references
are provided to other site and information sources. It is
useful to do the research on this and look at photos and videos,
both in relation to the type of operation and to your choice
of surgeon.
Depending what you prefer, your nipple and aureola may or
may not be added to the reconstructed breast. Reconstruction
of the nipple is often deferred until after the breast reconstruction
to allow for better placement of the nipple.
Women undertake breast reconstruction
for a number of reasons including:
- Maintenance of self-esteem and confidence
- Body image reinforcement
- Sexual adequacy
- Appearance for professional reasons
- To avoid the inconvenience of a mammary prosthesis
which may be uncomfortable in hot weather, especially
if the woman plays active sports and swims
In Australia more younger women opt for breast reconstruction,
but it is equally available to women of all ages who
desire it for any of the above reasons.
Ideally your GP or surgeon will initiate a discussion
about reconstruction, but all mastectomy patients should
feel free to request this option.
It is a legitimate request, not a matter of vanity.
|
Questions most women ask |
| Question |
Comment |
| What are the different
types of reconstruction available and how are they done? |
Several options are
available for breast reconstruction:
- Using either the stomach or back muscle
- Using Breast Implants (sometimes with tissue expanders)
|
| Can I have a nipple
reconstruction? How are the nipples created? |
See Nipple
reconstruction |
| What sort
of implants can be used? |
Saline or
silicone, or a combination of both. |
| Will my breasts look
the same? |
Your surgeon will
try to closely match your own breast, but usually it
will not match exactly. If you are not happy with the
result, you may be able to improve it by having an operation
on your other breast. Or the implant may be replaced
with one that is larger, smaller or positioned differently.
When you are naked you may notice differences in terms
of fullness and droopiness, with your reconstructed
breast often being less droopy. Your surgeon will try
to make sure these differences are not too great. |
| Will they feel the
same? |
Your reconstructed breast
will feel soft to touch but slightly firmer than your
own breast |
| What will the scars
look like? |
It depends on what type
of reconstruction you have. Take a look at the sections
following. |
| Will I have any feeling
or sensation in my breasts after reconstruction? |
Most women have very little
feeling in their reconstructed breast. Occasionally there
may be sensation in the skin, but often not. If you have
a nipple reconstructed, it won't have any sensation. You
may experience phantom nipple sensations, but these disappear
with time. |
| Is breast reconstruction
covered by Medicare? |
Yes, but only partly. |
| Are there any costs
involved? What are they? |
Surgical, anaesthetist,
assistants, hospital and implant costs. These will depend
on one's health insurance. |
| Do I still need to
have breast screening? Will breast reconstruction interfere
with breast screening? |
Research has shown that
this is not the case. |
| How will I feel afterwards? |
You are likely to experience
some degree of discomfort following your breast reconstruction,
as you would after any operation. Some women experience
more pain than others, and they may need painkilling injections
for a day or so after the operation. However, many women
have less pain than they expected. |
Ask the surgeon |
| Question |
Comment |
| Is it possible for
me to have a breast reconstruction? |
Breast reconstruction
is possible for most women who have had all or part of
their breast removed. Providing you are well enough, you
can have a breast reconstruction at any age. |
| Which approach would
you recommend for me and why? |
The choice will depend
on for example, the size of your breast and whether you
are having one breast or both reconstructed. It will also
depend on whether or not you have had previous radiotherapy.
|
| Can I pick the reconstruction
size? |
Yes, this should be possible.
If it is not possible, ask why. |
| Can I see any pictures
of before and after reconstruction? |
Yes, your surgeon should
be able to show you these. |
| Are there any costs
involved? What are they? |
Surgical, anaesthetist,
assistants, hospital and implant costs. These will depend
on one's health insurance. |
| Can mammography damage
a breast implant? |
Yes, but this would be
very unusual. |
| If I do get breast
cancer, could it be concealed by the scar tissue or breast
reconstruction? |
Generally this will not
be the case, but do ask. |
| How long will I have
to wait before having the operation? Can I have it while
I am having the mastectomy? |
Sometimes breast reconstruction
may be performed at the same time as surgery for breast
cancer. Later adjustments are often necessary. In this
case. Some doctors still recommend a delay, particularly
if you are advised to have chemotherapy or radiotherapy.
There may be a waiting list. |
Discuss the following with the surgeon in deciding what will
work best for you.
There are reports that the incidence of complications following
surgery is higher in:
