Diagnosis

Acupuncture Allergies Alzheimer's Disease Androgen Anxiety Disorders Asthma Atherosclerosis Attention Deficit Hyperactivity Disorder Bacterial Vaginosis Biofeedback Bipolar Disorder Birth Control Pills Blood Donation and Transfusion Breast Augmentation and Reduction Breast Cancer Breastfeeding Breast Reconstruction Caregiving Cervical Cancer Chiropractic Chlamydia Cholesterol Chronic Fatigue Syndrome Clinical Trials Colon Cancer Contraception Depression Diabetes Dry Eye Syndrome Eating Disorders Endometriosis Epilepsy Estrogen Fibroids Fibromyalgia Fitness Flu/Colds Gastroesophageal Reflux Disease (GERD) Genetic Testing Genital Herpes Glaucoma Gonorrhea Health Insurance Heart Disease Hepatitis High Blood Pressure HIV/AIDS Homeopathy Human Papillomavirus Hypnosis Hysterectomy Incontinence Infertility Irritable Bowel Syndrome Legal Health Tools Liposuction Lung Cancer Lupus Macular Degeneration Medication Safety Menopause Menstrual Disorders Metabolic Syndrome Migraine Multiple Sclerosis Naturopathy Nonsurgical Aesthetic Procedures Nutrition Obesity Ocular Allergies Oral Health Osteoarthritis Osteopathic Medicine Osteoporosis Ovarian Cancer Overactive Bladder Pain Management Pelvic Organ Prolapse Pelvic Pain Peripheral Arterial Disease Polycystic Ovary Syndrome Pregnancy Premenstrual Syndrome Preparing for Surgery Progesterone Rheumatoid Arthritis Schizophrenia Scleroderma Sexual Dysfunction Sinusitis Sjogren's Syndrome Skin Cancer Skin Health Sleep Disorders Smoking Stress Stroke Substance Abuse Tai Chi Teen Health Thyroid Disorders Trichomoniasis Urinary Tract Conditions Urinary Tract Infection Uterine Cancer Varicose Veins Violence Against Women Vulvodynia Weight Management Yeast Infections Yoga

Regardless of why you had a mastectomy, the decision to undergo breast reconstructive surgery, use a breast prosthesis under your clothes or make no changes after mastectomy can be complex and difficult.

In making the decision, ask yourself the following questions:

• How do I feel about my breasts?

• How important are my breasts to my self image?

• How does my partner feel about my breasts?

• What will it be like living without one or both breasts after surgery?

• Will I be able to exercise with prosthesis?

• Am I willing to undergo the surgery and recovery that is required?

• Will the fact that I may not have much sensation in the reconstructed breast bother me and/or my partner?

It's also a good idea to talk with other women who have had mastectomies about their choices. Breast cancer support groups or even your doctor's office can put you in touch with other women.

No matter what you think you might do about breast reconstruction, it's important to involve a plastic surgeon early on as a part of your health care team, even before the mastectomy. To find a plastic surgeon in your area, click here

The plastic surgeon can work with your breast surgeon to ensure that the mastectomy is performed in such a way as to provide the best possible outcome for later breast reconstruction. Plus, your general surgeon, oncologist and plastic surgeon should make a joint decision with you on whether immediate breast reconstructive surgery is appropriate given your medical history. Keep in mind that even if you are sure you don't want breast reconstructive surgery, you can always change your mind later—even years later—as long as you remain in good health.

Ask your breast surgeon about a skin-sparing mastectomy, particularly if you're planning breast reconstructive surgery at some point. In this procedure, the surgeon takes only as much skin as necessary to remove the cancer and prevent its spread, leaving as much skin as possible to provide a pouch, or covering, for future breast reconstruction. This procedure provides a better cosmetic result after breast reconstructive surgery because it enables the plastic surgeon to match the color and shape of the original breast. Your surgeon won't do a skin-sparing mastectomy, however, if the tumor affects the skin, as with inflammatory breast cancer.

In some instances, your breast surgeon may also be able to preserve the nipple and areola (the dark skin surrounding the nipple).

Immediate vs. Delayed Breast Reconstructive Surgery

One of the first topics to discuss with your surgeon, even before your mastectomy, is whether you are a candidate for immediate breast reconstructive surgery. Immediate breast reconstructive surgery occurs while you are still under anesthesia from the mastectomy, so you never wake up without a breast.

Otherwise, you undergo delayed breast reconstructive surgery, which occurs after you have recovered from the mastectomy. Delayed breast reconstructive surgery is possible even years after a mastectomy, so if you don't want to have breast reconstructive surgery now, it remains a possibility down the road.

Studies find that immediate breast reconstructive surgery after mastectomy is perfectly safe and doesn't delay the start of chemotherapy or affect its outcome. However, it may increase the risk of post surgical complications compared to mastectomy alone.

Studies also find that women who have immediate breast reconstructive surgery feel better emotionally and are happy with their decision.

Specifically, studies find women who have undergone immediate breast reconstructive surgery have better self images and are less likely to be depressed than women who chose to delay breast reconstruction, according to research published in the European Journal of Surgical Oncology.

Immediate breast reconstruction may be less expensive because there's just one operation, one anesthesia and one hospital stay required. And, of course, it's less disruptive to your life, since you're only recovering from surgery once.

Additionally, some studies find that it's easier to make the new breast look more like the old breast with immediate breast reconstructive surgery, because the skin flaps left from the mastectomy are still flexible; as time passes, they stiffen and retract into the chest wall.

However, studies find no differences in complication rates after immediate vs. delayed breast reconstructive surgery and no increased risk of cancer recurrence or problems with postoperative administration of chemotherapy or radiotherapy.

Immediate breast reconstructive surgery is not an option for every woman. If you have an advanced stage of cancer requiring radiation and/or high-dose radiation, many doctors prefer to wait. Also, if you need radiation, most surgeons prefer to perform breast reconstructive surgery after treatment to avoid complications. Additionally, your own health and health habits play a role in your ability to have immediate breast reconstructive surgery. These include your weight, whether or not you smoke, if you have other diseases like diabetes or heart disease and your psychological state and willingness to invest the time required for healing.

For some women, the stress and trauma of having breast cancer is all they can handle; they prefer to wait for breast reconstructive surgery, even if they are eligible for immediate breast reconstruction. The most important thing is to do what feels right for you—both physically and emotionally.