What is Breast Reconstruction Surgery?

For women who have survived breast cancer and subsequent mastectomy, one of the most difficult traumas is getting adjusted to their new appearance. Breast reconstruction surgery is a procedure to make a new breast following a mastectomy, and can help women regain their confidence and feel better about themselves.

What is a Mastectomy?

A mastectomy is surgical removal of the breast, including all of the breast tissue and most, if not all, of the skin covering it. A partial mastectomy, or conservative surgery, is when only part of the breast is removed. Breast reconstruction surgery is possible when either all or part of the breast has been removed. Women in good health of any age can undergo this procedure.

Who Has Breast Reconstruction Surgery?

Not all women opt for this surgery, the choice is up to you. Some women feel comfortable wearing special bras, or having a prosthesis placed inside their bra to make them look full-chested. If you do opt to have this type of plastic surgery, you can either do it when you have the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). The choice is a personal one and no one choice is better than the other. Each one has its own pros and cons (see below).

Is it Available on the NHS?

Yes, if you have had or will have a mastectomy as a treatment for cancer, you are entitled to free breast reconstruction surgery. If you choose to go with a private surgeon, however, you will have to pay for it yourself.

What Does Breast Reconstruction Surgery Involve?

This depends. Two types are available, either an implant or one using living tissue from other parts of your body. Depending on your cancer surgery, you may need a new nipple created, or you may need surgery on your other breast to make the two match each other better. This may involve subsequent operations.

Please note that surgeons who perform mastectomies are not always the best medical professionals to reconstruct breast tissue. You may need to look for a specialist surgeon with lots of experience in the field before embarking on an operation of this type. For more information, contact the British Association of Aesthetic Plastic Surgeons (BAAPS) or the British Association of Plastic and Reconstructive and Aesthetic Surgeons (BAPRAS).

Breast reconstruction surgery is a serious operation that will require full anaesthesia and a hospital stay of several nights at least. You will be asked to follow a simple after-care regime that will involve massaging the breasts, looking out for infection, and wearing soft support bras with no under-wiring.

Pros and Cons of Immediate Reconstruction

Advantages:

• You will wake up with a new breast following your mastectomy, and may find it easier to cope.
• The surgeon may be able to use the skin already there, so your new breast may appear better.
• You will have fewer operations.
• Most women have less scarring.

Disadvantages:

• Complications can delay any chemotherapy you may subsequently need.
• Radiotherapy can damage the reconstruction. And if you plan to have radiotherapy after, you will not be able to have an implant.
• You may not have adequate time to decide what exactly you want, nor enough time to get a good surgeon to do the reconstruction.

Advantages and Disadvantages of Delayed Reconstruction

Advantages:

• Time will be on your side, giving you ample opportunity to get a qualified surgeon.
• Your treatment for breast cancer will be over, everything else will be cosmetic.

Disadvantages:

• You may find it difficult to cope at first with the loss of your breast.
• You could have more scarring.

What Will My New Breast Be Like?

Like any form of plastic surgery, people who are the happiest with the outcome are those who enter with realistic expectations. Your new breast will not feel nor have the same sensations as the old one, visible incisions lines will always be present, and you may also have scars at the donor site, if you use living tissue. Despite this, the vast majority of women who have breast reconstructive surgery following cancer or other conditions are usually more than satisfied with the end result.