Breast cancer puts women on a difficult journey. One that often leads to surgery. But the journey doesn’t end there. After a lumpectomy or mastectomy, women face another tough question:
How do I feel like myself again after breast cancer?
Once tissue is removed, the breasts never look or feel exactly the same again. The cancer is gone and you’re on the road to recovery, but the damage to your confidence and self-image can remain. If you don’t feel like yourself after breast cancer surgery, you have options:
- Get reconstructive surgery. Breast reconstruction allows you to permanently regain your breast shape or balance things out if you only had surgery on one breast.
- Wear a prosthesis. A breast form gives you the look of breasts under your clothes. It’s worn inside the bra or attached to the body to mimic the look, movement, feel and weight of natural breast tissue.
- Go flat. Many women who have mastectomies decide against prostheses or reconstructive surgery and choose to adjust to life without breasts.
Your choice is a personal one. And you don’t have to make it right away. You can decide to go flat in the time after your surgery and opt for a prosthesis or reconstruction down the road. But it’s best to speak with a plastic surgeon about reconstruction before you have breast cancer surgery so you can explore all your options.
What breast reconstruction options do I have?
The first thing that comes to mind is probably a breast implant. Breast implants are used in reconstructive surgeries just as they are in augmentation. However, implants aren’t your only option, you can get reconstructive surgery using your own body tissue.
At The Iowa Clinic, we offer two primary approaches:
Implant Reconstruction
Implant reconstruction uses silicone or saline implants to replace breast tissue lost during a mastectomy. The implant can be inserted either through the same incision used during the mastectomy or through a new incision beneath the breast. Depending on your specific needs, the implant can be positioned either above or below the chest muscle. Some patients prefer this approach for the ability to select the size, shape and type — silicone or saline — of their implants in order to achieve their desired results.
Flap Reconstruction
Flap reconstruction involves rebuilding the breast with tissue taken from another part of your body. The exact procedure depends on where the tissue is harvested, with several options available.
The most commonly performed flap surgery is the DIEP flap (deep inferior epigastric perforator). In this method, tissue is removed from the abdomen, similar to a tummy tuck, and transferred to the chest to form the new breast. Surgeons carefully connect the abdominal blood vessels to those in the chest using microsurgery, ensuring the tissue stays healthy.
One of the key benefits of the DIEP flap is that it avoids removing muscle, which often results in less post-surgery discomfort and a quicker recovery. An added bonus of this technique is the contouring effect it has on the abdominal area, leaving behind a flatter midsection.
Do I have to make a decision before breast cancer surgery?
No, there isn’t a deadline for a decision as big as this. You can get breast reconstruction done years after a mastectomy or lumpectomy. But it helps to talk to a plastic surgeon about your options beforehand because you may want to have reconstructive surgery at the same time as your breast cancer surgery.
If you prefer reconstruction but are nervous about another surgery, immediate reconstruction may be your choice. After the surgical oncologist removes your breast, a plastic surgeon reconstructs it with an implant or tissue. You get out of breast cancer surgery without cancerous tissue and with a rebuilt breast. Prophylactic mastectomy patients — those getting breast tissue removed to reduce a high risk of cancer – always get immediate reconstruction.
Not everyone has that option, however. You may need additional treatment like chemotherapy or radiation therapy. These treatments can cause your breasts to lose volume or change in appearance. Diabetes, circulatory problems and other health conditions are also cause for delayed surgery. So you may have to wait months for breast reconstruction.
You can also opt for reconstructive surgery any time after that. It might even be covered by insurance. Medicare covers breast reconstruction, and the Women’s Health and Cancer Rights Act of 1998 requires group health plans covering mastectomy to also pay for reconstructive procedures.
Your decision to pursue breast reconstruction is deeply personal. The Iowa Clinic plastic surgeons will help you explore your options, weighing the benefits and risks of each procedure. Together, we’ll create a plan that aligns with your goals and helps you feel like yourself again.