Breast reconstruction has benefited many women both emotionally and physically.  In order to determine whether this choice is for you after a mastectomy, you must first explore the various options.  This booklet is designed as a guide to the most common reconstructive operations along with their benefits, limitations, pitfalls and overall objectives.  As an introduction to the reconstructive process, it is not meant to be all-inclusive; rather, a starting point.

Losing a breast to cancer is an emotional event both in dealing with the loss of a body part and the threat of what the future may bring.  There is no proof needed to show that you are psychologically harmed by the mastectomy.  Nor should you have to consider or demonstrate that your chances of survival are excellent.  Women of all ages seek out and have breast reconstruction, as this is a valuable alternative for the young and the elderly.  Finding a flattened chest objectionable, or the use of an external breast prosthesis uncomfortable, is reason enough to consider having breast reconstruction.

The breast as a symbol of femininity has been written about, drawn and sculptured throughout time.  It stands to reason that the loss of a breast may be viewed as a mutilating event.  Frequently, women find that the flattened chest wall on the side of the mastectomy may be a constant reminder that their lives have been disrupted by cancer.  For many, breast reconstruction is a sign that the treatment has started or has been completed. 

There are other psychological benefits of having breast reconstruction.  Depression, a common feeling after a cancer diagnosis, and the anger and mourning that accompany the loss of a breast are significantly relieved.  By helping to allay these emotions, reconstructive surgery can often enable you to get on with other important aspects of life, such as your family or career.  Consider the philosophy that you need to feel good about yourself inside to look good outside.

Besides the mood-elevating effect, there are also practical and social advantages to reconstruction.  You may find that the external breast prosthesis worn inside your bra after a mastectomy can be cumbersome and an annoyance when wearing certain clothes, such as low-cut dresses, tops or your swim suit.  Some women feel reconstruction restores their femininity and self confidence in social or sexual relationships.

Understanding what the diagnosis of cancer means to you is the first step in helping yourself.  Your surgeon will discuss the various alternatives for treating the breast cancer.  If total removal of the breast has been chosen, then meeting with a plastic surgeon for an in-depth discussion of the reconstructive process is in order.

The consultation will include an evaluation of both breasts as well as highlighting the benefits, limitations, risks, length of hospital stay, recovery time and major potential complications of the various reconstructive procedures that are best for you.  Pictures of the average result and length and site of the scars may be shown.  Women who obtain the most benefit psychologically from breast reconstruction are those who have realistic expectations of how the finished breast will look and feel.

You are an active participant in the decision making process.  After consulting with your surgeons, and with full consideration of the process, you may decide you are still unsure and thus, wish to forgo the breast reconstruction at this time or perhaps plan for it in the future.  Just knowing that breast reconstruction is available has prompted earlier breast examination for breast lumps as women are less fearful that they will lose a breast and not be able to have it reconstructed.  Early detection benefits the patient by bringing smaller masses or tumors to the attention of the surgeon, and hopefully allows for their removal before there is time for it to spread. There is no easy answer to the burning question of whether you should or should not have your breast surgically restored.  It is entirely an individual choice--one made for yourself and no one else.  Finding your way through the maze of uncertainties surrounding your eventual decision may be eased by seeking as much information as possible and speaking to women who have been in similar situations.  Communicating with your family and loved ones will help in this transition period.  They, too, feel distraught and need your help as much as you need theirs.  Keeping all of your frustrations and anxieties within does not help the problem.

It may also help to talk through your feelings about your mastectomy with trained counselors before you decide to have a breast reconstruction.  Some hospitals have breast care nurses who would be happy to discuss your concerns.  The Norma F. Pfriem Breast Care Center can give you details of counselors in your own area.