Breast Reconstruction: Why or Why Not?

The latest clinical research shows that breast reconstruction after mastectomy has many benefits, but the fact remains that only about 20% of women who lose their breasts to mastectomy choose to undergo breast reconstruction. Why aren”t more women choosing reconstruction?

I”d like to explain the benefits of breast reconstruction, and address a number of misconceptions that in my experience cause many women to discount the potential benefits of this procedure.

Common Misconceptions

As a Seattle breast reconstruction surgeon, I see many women opt out of reconstruction because:

  • Their mastectomy surgeon neglected to discuss the option at all, and/or failed to mention that the cost is generally covered by insurance
  • The patient thinks she is too old for surgery
  • The patient initially delayed reconstruction, and thinks that after years without breasts, reconstruction would have minimal benefits
  • They dislike the idea of breast enhancement using implants

Over the years, I”ve seen better awareness of the benefits of reconstruction among mastectomy surgeons like the ones I work with. Some are even developing enhanced techniques to preserve more of the original breast curve by using more vertical mastectomy incisions.

While some patients have other health concerns that make them less eligible for surgery, in my experience most women who forego reconstruction because of age, time since mastectomy, or aversion to implants do not have accurate information about the procedure.

Seattle Breast Reconstruction: Options and Impact

There are actually two main options for breast reconstruction:

  • Expander and Implant (typically more appropriate for larger-breasted women): The surgeon uses a tissue expander to stretch the chest skin gradually before replacing the expander with a breast implant.
  • Flap Method: The surgeon reconstructs the breast mound using your own tissues from your abdomen or back.

While immediate reconstruction patients tend to experience greater benefits to their mood, both immediate- and delayed-reconstruction patients generally see significant positive effects on their:

  • Self esteem and mood; specifically, incidence of depression and anxiety can be reduced
  • Body image and how feminine a woman feels
  • Sexuality, including both how attractive a woman feels and her degree of sexual satisfaction

Self-image is complex, so these benefits will be different for each woman. However, in general, women who choose not to undergo reconstruction tend to experience higher levels of depression and anxiety than women who do. Many patients find breast loss hampers personal relationships and everyday activities like clothes shopping.

In the end, many of my patients see their reconstructive plastic surgery in Seattle as part of the healing and recovery process. Better self-confidence and feelings of normalcy can accomplish a great deal to help a patient regain a sense of physical and emotional wholeness, and alleviate some of the fears that persistent after a cancer diagnosis. Many psychologists see breast reconstruction as “positive coping” because it requires a patient to initiate a decision about her body and assume control of her own wellbeing.

One Response to Breast Reconstruction: Why or Why Not?

  • Robert Heck says:

    Great Article. I really like the detail in your “common misconceptions.” I always find it rewarding to help restore self esteem and self confidence in patience.

    Thank you for the information.

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