Mastectomy And Restoring Breast Appearance - Living With Breast Cancer And Its Treatments: Breast Cancer

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Mastectomy and restoring breast appearance

If you are planning to have a mastectomy or if you have already had one, breast-reconstruction surgery can restore the size and shape of your breast. If you are thinking about breast reconstruction, you have several choices. You can choose to have the procedure at the same time as the mastectomy operation, or you may wait and go back for reconstructive surgery later. You will also need to decide which type of breast reconstruction is best for you. Your plastic surgeon will help you evaluate your choices. These include:

• a saline (salt water) or silicone implant immediately placed under the chest wall muscle

• a tissue expander inserted as preparation for an artificial implant

• a muscle flap procedure, which uses skin, muscle, and fat from another part of the body to reconstruct the breast.

Your size and shape, as well as your activity level, will influence your decision. For example, the choices for a woman who is tall and thin may be different from those for someone with more body fat. A thinner woman has less tissue available from her lower abdomen for a TRAM muscle flap procedure and may be better off choosing an implant or a latissimus flap from her back. Advances in reconstructive surgery mean that almost any woman can have breast reconstruction, regardless of age, the type of breast surgery she had, or when she had her mastectomy. Breast reconstruction can produce a breast shape that will help you feel and look normal and attractive in your clothes. In the nude, however, reconstructed breasts are seldom perfect copies of the remaining breast. Regardless of the reconstruction procedure you choose, you will not have a new nipple at first; this will be created when you return about three to six months later for an outpatient procedure.

A new breast, particularly one with an artificial implant, tends to sit higher and more forward than your other breast - it won't have the same natural droop. Some women choose to have their remaining breast reduced or reshaped to match the reconstructed one.

Before making a decision, gather as much information as possible about each choice and its risks and benefits, including its long-term outcome. A good route is to talk to one or two plastic surgeons and to "Reach to Recovery," an organization of volunteers who have been through this decision process themselves.

Alternative to reconstruction: A breast form

Some women who have a mastectomy decide not to have breast reconstruction. To gain breast symmetry when wearing a bra or bathing suit, these women may choose to wear a prosthesis, a breast form made from materials that have the weight and feel of a breast. Not every woman feels it is necessary to use a prosthesis after surgery, and others choose to wear one only in certain public situations. Still others wear one most of the time.

Breast forms are made from many different materials and are available in many different shapes and sizes, weights, and consistencies; they vary from very soft to relatively firm to match the other breast.

Breast forms are sold in the lingerie departments of large department stores, in specialty lingerie shops, and in surgical supply stores, usually listed in the phone book under "brassieres" or "surgical appliances."

Created by the Faculty of the Harvard Medical School

Copyright Harvard Medical School, Harvard University, 2007

Last updated:	April 23, 2007