When my Oncologist told me I must have a mastectomy, I freaked! I didn’t personalize my identity through my breasts. But, to have one taken away was one of the most helpless feeling I felt ever! I thought that immediate reconstruction was my best option to feel normal again.

Immediate reconstruction takes place during the mastectomy surgery. Your plastic surgeon will work in tandem with your mastectomy surgeon. You also have the option to choose reconstruction surgery later, or no reconstruction. There are two options for reconstruction: Implant or Flap.

In using implant reconstruction, your plastic surgeon’s goal is to restore the breast mound appearance so that the mounds are symmetrical. An expander is used as a placeholder. The surgeon will input the expander behind the muscle in your chest wall during the same operation after your breast surgeon’s mastectomy procedure. Drain care is essential to a successful rehab. Please read my blog on surgical drains. The expander will be filled with saline at an office visit. Over time the fillings create a pocket for your implant. When the expander is at the required level of liquid, it is surgically removed. After rehab time, your nipple tattoo will be drawn onto the new breast. This procedure is suggested for women who are thin or small. Recovery time is between 12-14 days.

With Flap Reconstruction surgery, your plastic surgeon’s goal is the same. She will remove tissue from your body. The tissue is usually taken from the belly. Tissue can be used from the back, buttocks, or the inner thigh. Fat tissue can also be used to reconstruct the breast. In that surgery, liposuction is used to extract fat tissue from your buttocks, thighs, or abdomen. The Flap tissue is moved through your body to maintain its blood supply. It is then positioned in the mastectomy area to create a breast mound. This is a more complex surgery than the implant surgery. Drain care is important. Stitching for the drains will be removed in 5-10 days. Due to the larger incisions, this surgery takes longer to heal and may require a longer hospital stay. Average recovery times are 3-6 weeks. After rehabbing, your nipple tattoo will be scheduled, then drawn onto the new breast.

In October 2018, the JAMA Network, affiliated with the American Cancer Society, provided a study titled, Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. It found that, “At 2 years after reconstruction, patients who underwent autologous reconstruction (Flap surgery) reported significantly greater satisfaction and breast-related quality of life compared with patients who underwent implant-based technique.”

This is one of the many steps in coping with your “New Normal.”

You might not have applied, but Welcome to the Breast Cancer Club!

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