Even more than most forms of plastic surgery, breast reconstruction after cancer is an individualized procedure. The extent of cancer, type of treatment, previous surgeries, body type, and personal goals will all affect the type of reconstructive surgery that is best for you – or even if you choose to have reconstruction at all.
To understand what the reconstruction process will entail, it’s best to sit down with one or more plastic surgeons – with expertise in the field – and ask the following questions.
Will reconstruction be covered by my insurance?
Breast reconstruction is unique amongst medical procedures in that the federal government (The Women’s Health and Cancer Act (WHCRA) 1998) mandated insurance coverage for breast reconstruction and all other procedures related to it. This includes any surgeries that need to be performed on the opposite breast to improve symmetry such as breast reduction, breast augmentation and breast lifting.
When will the reconstruction take place?
Most commonly breast reconstruction is performed at the same time as a mastectomy; however, these surgeries are sometimes performed on different occasions for a variety of reasons. There may be medical reasons for waiting, such as ongoing radiation treatment. Or, it may be overwhelming to you to have the reconstruction process begin while you are still so close to a cancer diagnosis.
Either way, it is important not to rush things. Choose a surgeon who offers a methodical approach to achieve the best long-term results over one who wants to rush you through the process.
Will the reconstruction be complete after a single surgery?
The number of surgeries you need depends on the extent of your mastectomy and how much tissue, muscle and skin were removed. For some women a single procedure may be possible, but more frequently, successful reconstruction requires multiple steps. The initial surgery is typically the longest and requires the most recovery time. Secondary procedures are usually short, outpatient procedures to fine tune your final result.
Talk to your surgeon about the number of surgeries you will need for optimal results before you decide to proceed.
How is it done?
Again, this will depend on a number of factors. The extent of tissue removed during mastectomy, what kind of therapy you need after surgery (particularly radiation) as well as your body type and goals.
In some cases an expander is used to stretch the skin and increase the available space for a proper-sized implant. Other types of reconstruction involve using tissue from other parts of the body to recreate breasts.
Each approach will have different recovery requirements and deliver different aesthetic results. Understanding the surgery itself is important, but understanding how it will affect your day-to-day life in the following weeks and years is also valuable.
Your surgeon should be able to talk you through all of your options and the risks and benefits of each.
How will it affect future risk and detection of cancer?
After a breast cancer diagnosis, you need peace-of-mind that reconstruction won’t interfere with detection of further cancer or increase the risk of recurrence. The American Cancer Society states that this is normally not an issue. However, this is an important discussion to have with your surgeon as you move forward with your recovery and reconstruction.
Are there other options?
Not everyone wants to have breast reconstruction after a mastectomy, and certainly it is not required. Perhaps you don’t like the idea of more surgery. Maybe you don’t want to prolong your recovery from cancer surgery any more than necessary. The number of women who choose breast reconstruction after mastectomy is growing, but still around 37 percent decide surgery isn’t right for them. Most importantly you should be provided with information about breast reconstruction and an opportunity to speak with plastic surgeon who specializes in breast reconstruction prior to undergoing your mastectomy. Unfortunately this is not always the case.
Ask your surgeon about skipping or delaying reconstruction. He or she should be able to discuss choices such as wearing an external breast prosthesis form inside your bra, or even going flat. There is no wrong choice. Make the choice that you are most comfortable with once you understand all the options.
Are you qualified to perform breast reconstruction after cancer?
Breast reconstruction is a complicated surgery with many options and variables that affect the appropriateness of each option. The results of which will affect you for a lifetime. You should be given the opportunity to consult with a reconstructive surgeon prior to having your mastectomy. Should you decide to do so choose a surgeon with the training and experience who will take the time to discuss the pros and cons of all the various reconstructive options and is best suited to perform the type of reconstruction you will have.
Dr. Slack, for example, not only completed a plastic surgery fellowship, he followed it with an additional surgical fellowship in Cosmetic and Reconstructive Surgery of the Breast at Georgetown University. He continuously fulfills the rigorous requirements for membership in the American Society of Plastic Surgeons.
If you have been diagnosed with breast cancer, you need an experienced plastic surgeon to answer your questions honestly and provide the information to make the best decision possible. Dr. Slack would like to be that surgeon. Please get in touch to schedule your consultation.