Timing Your Breast Reconstruction After Mastectomy

Breast reconstruction isn’t for everyone. Tig Notaro, for example.

After her double mastectomy without reconstruction, the dry-witted comedian embraced her new body and performed topless (for a full 20 minutes!) in her 2015 HBO special Boyish Girl Interrupted. If you aren’t as willing to accept a new life without breasts, reconstruction may be an easy choice for you. Even if you aren’t 100 percent sure whether you will want a breast reconstruction, do your due diligence now because timing matters if you want to achieve optimal results.

Here’s what the American Cancer Society has to say about that:

“If you are thinking about having reconstructive surgery, it is best to talk about it with your surgeon and a plastic surgeon experienced in breast reconstruction before you have surgery to remove the tumor or breast. This lets the surgical teams plan the best treatment for you, even if you decide to wait and have reconstructive surgery later.”

Breast reconstruction is most often performed at the same time as mastectomy (immediate reconstruction), but it can also be done years later (delayed reconstruction). In other words, though you shouldn’t wait to get informed, you don’t have to decide whether to have the surgery right away. With everything you have to think about before a mastectomy, it can be overwhelming to have to make a decision about reconstruction too. Your doctors may also recommend you wait if you are continuing with radiation treatment.

Here are some other reasons to delay reconstruction.

You are a smoker

Cigarettes and other tobacco products contain hundreds of toxic chemicals, including nicotine, hydrogen cyanide, and carbon monoxide. They leave your body with an overall shortage of oxygen and make it harder to heal. Smokers are more likely to suffer from complications, like an infection or blood clot, during or after surgery.

While claims have been made that e-cigarettes are a healthier alternative, this does not make them safe. Toxic metals like lead, chromium, manganese and nickel have been detected in their vapor. Read more about vaping and plastic surgery in this post.

Most plastic surgeons will require that you quit smoking at least four weeks before surgery.

You have other health problems

Cancer may not be the only health problem you are dealing with. Conditions such as obesity, diabetes, heart disease, stroke, high blood pressure, sleep apnea, or other breathing problems can impair your body’s ability to withstand the stresses of another surgery.

Your plastic surgeon will likely require that conditions like these be managed and well under control before undergoing breast reconstruction.

You haven’t found the right plastic surgeon

Your oncologist or surgeon will likely be able to refer you to a qualified plastic surgeon before your mastectomy. Take the opportunity to meet with them as soon as possible. You want to do your homework to make sure the surgeon is right for you. Your plastic surgeon should be board certified and have hospital privileges at a reputable facility you have access to.

Breast reconstruction is complicated and no two surgeries will be the same. You will need someone (like Dr. Slack) who has specific training and experience in breast reconstruction surgery and is able to discuss the options available to you.

Whether and when to have breast reconstruction after mastectomy is a very personal decision. One that you need to make with your healthcare team, including a plastic surgeon. Maybe, like Tig and many other women, you will decide to go flat, or maybe reconstruction is a no brainer for you. As long as you are informed, there is no wrong choice. You do you—shirt off, or on, or somewhere in between.

If you have any questions or want to learn more about breast reconstruction, contact our office today