Health and Fitness

Breast Reconstruction after a Mastectomy

Women who have already undergone a mastectomy or expect to face one in the future will still be faced with some challenging decisions, even after the procedure. One of them will be whether or not to pursue breast reconstruction surgery. While foregoing this option is something many women do choose, other women feel that having the procedure done is in their best interests. It can be a boost to their self-esteem, especially after battling a long and depressing illness. Even women who feel convinced that they do want breast reconstruction may not know exactly what is involved.

How do I know if breast reconstruction is right for me?

When considering breast reconstruction surgery, following a mastectomy, there’s more to consider than just your desire to get your former shape back. There are many factors that you should weigh, before making your decision. Certainly, you want to consider whether it is important to have a permanent breast shape or whether wearing a prosthetic breast may be an acceptable option. Some women find that a prosthesis is too inconvenient as a long term solution, because it requires having to frequently put it on or remove it.

Of course, if you’re still young enough or active enough that you often wear swimwear to the beach or sportswear to the fitness center, having matching breasts will also be a concern. Certainly, a reconstructed breast will look slightly different from the remaining natural breast, when nude, it will be much more difficult to notice a difference when dressed in active wear or outfits with a plunging neckline. Conversely, a prosthesis will appear uneven and may cause embarrassment by shifting, while you’re engaged in physical activity.

Another consideration is the time commitment involved in breast reconstruction. In most cases, you will have to submit to multiple surgeries to get your desired results. This is especially true if your remaining natural breast is of a large size. The reconstruction may result in a smaller size, which might mean having a reduction done on the healthy breast. In addition to the costs involved with this type of reconstruction, some women are put off by the additional downtime this will cost. Women who do not opt for breast reconstruction return to their normal activities much sooner than those who elect to have the procedure done. For this reason, it’s important to consider whether you’re willing to postpone your normal lifestyle long enough to follow the proper healing and recovery process involved with breast reconstruction.

One other point to consider and one which you should discuss with your plastic surgeon is how the implant will affect your range of motion. If you live an active lifestyle or work in a profession that requires you to twist, reach, and bend frequently, this may be an important point to consider. Depending on the type of reconstruction, your range of motion may be limited.

Will I be satisfied with my reconstructed breast?

In most cases, you will have to be patient and continue consulting your surgeon, even after the reconstruction is complete. This is because the reconstructed breast may seem larger than the natural breast, due to swelling. You’ll have to wait for the swelling to subside, before the reconstructed breast size will be more reliable. Once the recovery phase is complete, both breasts should be of relatively equal size. If there’s still a noticeable difference, your surgeon may have to reduce the fat in the reconstructed breast.

Additionally, a reconstructed breast will be unaffected by weight gain or loss. This means it will remain the same size, as you lose weight, even though your natural breast will also lose weight. If you do lose weight, you may have to revisit your surgeon to have your reconstructed breast size adjusted. In cases where the breast has been reconstructed using the flap procedure, it will gain and lose weight along with the rest of your body. For this reason, you may prefer this method over other reconstructive options.

You may also notice a difference in sagging. Your natural breast will typically sag more than the reconstructed breast. Although the reconstructed breast will drop some over time and as a result of gravity, it will generally keep a firmer and bouncier shape. Again, this is something you will likely only notice when naked, so it shouldn’t pose a problem in social or work situations.

Whether or not you do opt for breast reconstruction, a mastectomy, like the reconstructive surgery, results in a numbing of the nerves in the breast. For this reason, the breast will be less sensitive than it may have been in the past. In some instances, the nerves may revive over time, giving back your sensations in the breast. Patients shouldn’t expect this for at least 1 to 2 years, following reconstructive surgery, if it happens at all.

How will breast reconstruction affect screening?

In cases where you have had a double mastectomy, you typically won’t need to submit to screenings unless a problem arises. Your doctor may request that you come in for a screening to establish a baseline, but, otherwise, you may not need to continue with regular screenings.

The flap reconstruction surgery can result in a hard lump in the breast, but, in most cases, it turns out to be a benign fat necrosis. Fat cells calcify and harden, just after surgery, and this is usually what the patient will feel while doing a self-exam. When the lumps are hardened fat cells, they will either remain the same size, or may get smaller over time. If you do observe lumps in a reconstructed breast, your doctor can determine if they are benign fat cells through a physical exam.

If you still have one healthy breast, you should still continue to get your annual mammograms. An MRI might be an alternative option, but a yearly exam is still advised. Additionally, you should continue to conduct self breast exams on a regular basis.

If you’re facing the possibility of breast reconstruction, the offices of Douglas S. Steinbrech, M.D., F.A.C.S. are able to answer all of your concerns. As experienced surgeons, they can provide a thorough assessment of your situation, whether you need reconstruction or breast reduction. Dr. Steinbrech is certified by the American Society of Plastic and Reconstructive Surgeons and he’s a diplomate of the American Board of Plastic Surgery. To learn more about the practice, visit the office’s website at