Reconstruction or No Reconstruction After Breast Cancer Surgery

For anyone facing a mastectomy, one of the main issues to be decided is whether to undergo reconstruction. In my case, it was never a matter of whether or not I would have reconstruction; it was a given based upon the recommendation of the cancer surgeon. I was very grateful that the decision was made immediately at the time of our discussing my second cancer surgery.

This afforded me the opportunity to meet with the cosmetic surgeon who would be present at the cancer surgery and would be placing the expanders during the same surgery thus eliminating a separate surgery later on. The next course of action had already been put in place and that made everything as one flowing, continuous process.

“Only you can decide what is best for you. Your decision must be your own as you will have to live with it forever.”Barbara Jacoby

Since then, the most important thing that I have learned is that if you are considering reconstruction, you need to get the cosmetic surgeon involved as soon as possible. For me, this allowed for a finish to the surgery that was as clean and neat as possible with the least amount of scarring. I saw the way that the scarring was after my lumpectomy when the cancer surgeon was the only one involved.

That scar was rugged and very irregular. But after the double mastectomy with the cosmetic surgeon doing the closing, the majority of the scarring looks like a pink thread that is just about completely invisible except for the area under the armpits where the expanders were removed and the implants were inserted. That was a far more beautiful outcome than even I could have imagined.

However, the thing that needs to be kept in mind is that each of us is so different from one another and what is the perfect solution for one person may not even be a viable option for another. I am grateful that I had the implants done but there are so many other choices available now that I wouldn’t know where to begin with how to decide.

I have spoken to women who have had reconstruction done in other ways and are very pleased with their outcomes but others who are definitely not satisfied. There are women who were considering reconstruction but eventually decided against it for so many personal reasons. And there are those who were so scared of the outcome and all of the things that could go wrong that they never even gave it a second thought. And there are those for whom reconstruction was never an option, either by choice or not being able to have reconstruction for other reasons.

If you decide that reconstruction is in your future, do talk to your doctors as soon as possible. What you think that you want and how you want your reconstruction to happen is just as important to figure out as any other part of your post-cancer journey.

When and if you will be having chemo and/or radiation may make a difference. The type of reconstruction will definitely need to be considered. The timelines need to be scheduled just as carefully as anything else. And remember that another whole aspect of reconstruction needs to be decided if it is to include areola and nipple reconstruction.

Only you can decide what is best for you. Your decision must be your own as you will have to live with it forever. Many look at mastectomies as amputations and whether you choose to use a prosthetic afterward to replace the missing part is completely a matter of what works best for you.

The choice should always be made sooner rather than later if you are comfortable with making that decision. But, since this decision is not a life-threating one as are your decisions about your cancer, don’t add the stress of making this decision to everything else if you just are unsure about what you want to do. It just isn’t worth it and more than likely the decision will come to you when you least expect it.