Mastectomies may be performed to decrease the risk of breast cancer or as part of treatment when breast cancer is present. Although you may be overwhelmed with the thought of having a mastectomy and possible cancer treatments, before you have your mastectomy is the ideal time to consider your breast reconstruction options.
Ultimately, the timing of breast reconstruction is dependent upon the reasons for your mastectomy and a consensus between you and your care team. If you are having a prophylactic mastectomy, it is possible for you to have the mastectomy and reconstruction during the same surgery. This is ideal if you plan to have reconstruction in the future and want to minimize recovery time.
When breast cancer is present, your choices for timing will be more limited. In most cases, your oncologist and reconstructive surgeon will want you to wait until after your mastectomy and any cancer treatments to consider reconstruction. The time you need to wait will vary and depends on whether your mastectomy is curative or part of the overall treatment approach. Additionally, how you heal after the mastectomy and cancer treatments is also important. If you have a type of breast cancer with a high recurrence rate, you may want to wait several years before having reconstruction.
Use Of Tissue Expanders
To help preserve as much skin and space in the breast area as possible, you should consider speaking with your care team about the placement of tissue expanders. It is possible to place tissue expander immediately after having a mastectomy, even if you are going to have cancer treatments. Since the mastectomy and possible radiation treatments can cause scarring and other changes to the residual skin and soft tissues, tissue expanders can increase the likelihood you will have enough skin available to perform a reconstruction in the future. If you prefer having tissue expanders placed before cancer treatments, you should also discuss the impact, if any, on the effectiveness of radiation therapy.
Type Of Implant
Some women are able to have their breasts fully reconstructed with donated tissue from elsewhere on their body, whereas other women may need breast implants or a combination of the two procedures. If you have excess fat around the mid-section, this is an ideal location to use for donor tissue. Some women who are thin and do not have enough tissue to use as an implant may consider gaining a few extra pounds purely for the purpose of creating donor tissue.
The alternative to using your own tissue is a saline or silicone implant. No matter which type of implant you choose, they are not permanent. You must factor in the long-term maintenance and impact of implants on identifying and treating breast cancer if it were to reoccur. In general, implants may last up to 20 years before they need to be replaced. Each type of implant has its own advantages and disadvantages. When choosing, you may need to decide if ease of maintenance or a natural feel and appearance is more important.
Making the decision to have reconstructive surgery after a mastectomy is not easy. There are several variables you need to consider for your overall health and to achieve satisfactory results. Contact a reconstructive surgeon for more information.
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