To choose, or not to choose – details to consider
If you choose reconstruction, there are several details to consider. Reconstruction can be performed at the same time as your mastectomy (immediate reconstruction), or it can be performed at any time in the future following your mastectomy (delayed reconstruction). After any type of breast reconstruction, plans may be made to reconstruct a nipple and areola complex in the future. This may be performed at any time after a few months from your final reconstructive procedure. The breast reconstruction procedures that are offered today include both implant-based and autologous (your own tissue) flap reconstructions, including DIEP, SIEA, TAP, and other free-tissue transfer breast reconstructive procedures. Be aware of all of your options, and again, become involved in the decision of which reconstructive procedure will be the best fit for you.
Women may choose not to undergo surgical reconstruction. For medical or psychological reasons, some women choose to delay their reconstruction. If you choose not to undergo immediate reconstruction, this does not preclude you from undergoing reconstruction at a later date. Some women have had breast reconstruction surgery months to years after their mastectomy. Often times, the same reconstructive options are available to you, and your surgeon will help to determine this for you when you feel ready to proceed with your reconstruction.
During this time, you may consider wearing an external breast prosthesis garment fit to match your remaining breast, or wear prostheses for both breasts. However, a reconstructed breast offers several advantages over breast prostheses. You will not be limited in your clothing options or the activities in which you participate. Psychologically, women reiterate the fact that they feel more confident, attractive, and feminine with a reconstructed breast than without one. The fear of the prosthesis becoming visible or displaced is gone. There is no constant reminder of the previous surgery on your breast or the cancer when placing the prosthesis on and taking it off. Lastly, there is a wholeness that is achieved, as the reconstructed breast becomes part of your own body.
Overall, every woman should be informed of her breast reconstruction options following breast surgery at the time of her diagnosis. Taking into account your cancer type, tumor size, nodal involvement, the need for pre/postoperative chemotherapy or radiation therapy, your overall medical health and comorbidities, along with your own personal preferences, should lead to a meaningful discussion about which reconstructive procedure, if any, you should have. There are several reconstructive options to consider, and not one procedure is right for each person. However, your breast surgeon should discuss the breast reconstruction option and your plastic & reconstructive surgeon should inform you about the pros and cons of every procedure available and assist you in deciding which procedure is most suitable for you.
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