Ten Tips for Choosing a Breast Reconstruction Procedure

Throughout more than thirty years as a board-certified plastic surgeon, I have developed a passion for helping breast cancer survivors and other mastectomy patients to reclaim their lives and their confidence with breast reconstruction. But I also recognize how overwhelming this process can be, because within the category of breast reconstruction procedures, they need to choose between a wide number of surgical options, and this is a decision which will affect them for many years to come. For instance, patients may choose one of several types of breast implants, or they may choose from a number of techniques that utilize their own tissue (like fat and muscle from the abdomen or another area) to reconstruct the breast. If you’re considering your options for breast reconstruction, below are some tips that can help in your decision-making process.

• Keep your future cancer treatments in mind. Radiation can cause changes to both the scar around an implant and to the tissue if you choose autologous breast reconstruction (any of the techniques that use your own tissue), so knowing whether you’ll be undergoing future radiation will be helpful in discussing your options during your plastic surgery consultation.
• Weigh the pros and cons of immediate and delayed reconstruction. Immediate reconstruction is performed during the same surgery as your mastectomy, while delayed reconstruction can be performed at any time after you’ve healed from your mastectomy. This will have an effect on which reconstructive options are available to you and on your recovery time.
• Think about the long-term effects of your procedure. For instance, if you want your breasts to age with your body and to look especially natural throughout the years, autologous reconstruction may be the right choice, but if you want to limit the degree to which your breasts will sag as you age, you may prefer implants. Be sure to also understand the scarring that each procedure will entail and also the loss of sensation on the chest with any type of mastectomy.
• Consider how each option will impact the rest of your body. The TRAM flap, for example, is a breast reconstruction method which uses tissue from your abdominal area. This means you will have a scar on your lower abdomen, but you’ll also receive a tummy tuck-like effect.
• Recognize that your breast skin will impact your choices. If your mastectomy removes a large amount of the skin from your breast area, an implant reconstruction may require the use of a tissue expander, which lengthens the overall process, and an autologous reconstruction may require more skin to be transferred from your abdomen or other area.
• If you’re having a mastectomy or lumpectomy on only one breast, ask how symmetrical the results will be. In general, autologous breast reconstruction is more likely to give your breasts better symmetry when only one breast needs to be reconstructed, and your breasts will likely age in a more symmetrical way as well.
• Decide how long of a recovery you can accept. Though every patient’s recovery is different, a reconstruction with breast implants tends to require less recovery time than an autologous reconstruction.
• Discuss all your medical conditions and current medications with your surgeon. Being upfront and telling your surgeon all of your existing conditions can help them know how safe each choice is for you. For instance, an autologous reconstruction may not be the best option for those who smoke or who have a higher risk of complications because of the length of the operation.
• Consider your surgeon’s experience with each procedure. Autologous procedures like the TRAM flap are largely dependent on the surgeon’s expertise, so they may be a better choice for patients of Dr. Elliott, who actually contributed to the development of the TRAM flap, as opposed to patients of a less experienced surgeon.
• Be sure to discuss the entire process and your expectations. Many breast reconstructions require multiple procedures to achieve the best results in a safe and healthy way, so make sure you understand what will be involved and what you can expect over the coming months.

Whether you’ve just recently been diagnosed with breast cancer or you have a mastectomy or lumpectomy years ago and have been considering reconstruction ever since, making a decision about breast reconstruction is an important and personal decision which you should make with the help of a trusted and experienced plastic surgeon. To start discussing your options, schedule a consultation with Dr. Franklyn Elliott. Or, for more tips and helpful plastic surgery information, follow Dr. Elliott on Facebook, Twitter, and Google+.