From the very instant they get a breast cancer diagnosis, many patients feel that their lives are a whirlwind. There are appointments to be made, treatment to research, medicines to take and doctors to meet. On top of this, there is the possibility of mastectomy and breast reconstruction. What I want my patients to know is that they are not alone if they’re feeling overwhelmed and can take a deep breath, because when it comes to reconstruction options, you cannot make a wrong choice.
Your Health Is the First Priority
First and foremost, your health is absolutely the most important thing. The days, weeks and months following a breast cancer diagnosis can be an extremely tumultuous time and the last thing you need is to feel extra unnecessary pressure. Talk to your oncologist. Talk to your plastic surgeon. Your medical team will help give you options for cancer removal and reconstruction – if that’s the route you choose – that will best fit your health needs.
No two breast cancer patients are the same. A breast reconstruction method that works well for one patient may not even be a suitable option for another. That’s why I want my patients to know that they have options when considering breast reconstruction after a mastectomy or lumpectomy. Here’s a short rundown of what your plastic surgeon might recommend:
Lumpectomy with oncoplastic surgery – If the cancer hasn’t spread too far and it’s possible to remove the mass and still preserve the surrounding tissue, a lumpectomy and oncoplastic surgery may be a good route for some patients. This surgery, which is still relatively new in the world of reconstruction, allows us to reduce the size of the breasts and reshape them where volume was lost during the removal of the tumor. It works especially well in women with large breasts.
DIEP flap/TRAM flap – The DIEP (deep inferior epigastric perforator) flap and TRAM (transverse rectus abdominus) flap procedures are microsurgical techniques in breast reconstruction that utilize the body’s own tissue to reconstruct the breast. The DIEP flap procedure utilizes skin, fat and blood vessels surgically removed from the wall of the lower abdomen and relocates them to a patient’s chest. The result is a natural looking and feeling breast following a mastectomy. The TRAM flap utilizes the blood vessels, skin and fat of your own body, but also uses the entire muscle in your lower abdomen instead.
Implants – The most well-known breast reconstruction method is probably the use of implants to restore volume and shape to a breast. Both silicone and saline implants are safe and approved by the Food and Drug Administration.
Something else to know is that while you have choices, there is absolutely no hurry to make one.
You Have Time to Make the Decision
Some patients decide in the beginning that they don’t want to have reconstructive breast surgery following a mastectomy and then 10 years later change their minds. I have good news – this is totally OK and it happens all the time. The bottom line is that there is no time limit on breast reconstruction. In fact, there are typically two modes of thinking: Having reconstruction at the same time as the mastectomy, or having it later – sometimes long after the surgery from the first has healed.
Electing to have reconstruction at the same time means there’s only one recovery period. Electing to have the reconstruction afterward means that you have a second recovery time, but some patients feel they need this time – whether to make the right decision on reconstruction or give themselves enough time to mentally and physically recover from the breast cancer diagnosis. There is no wrong time to have breast reconstruction – the choice is entirely yours and your medical team will help give you the information you need to make informed decisions.
Dr. Jamal Bullocks is a board-certified Plastic Surgery specialist whose clinical interests include reconstructive breast surgery, cosmetic surgery for men and women and body contouring after weight loss.