Losing an intimate part of the body, such as a breast, can cause feelings of grief and sadness in many women. If having a mastectomy, one decision to consider is whether to have breast reconstruction surgery. There are many options available for reconstruction, which can seem overwhelming, so it is often a good idea to make sure you know all your options.
What is breast reconstruction?
Breast reconstruction is surgery to rebuild your breast shape after a mastectomy. It may involve an implant, a flap of your own tissue (autologous graft: TRAM, DIEP or other flap) or both (Latissimus Dorsi).
What does it involve?
Reconstruction typically involves three stages: initial surgery, often a revision (which may be more than one operation) and finally reconstruction of the nipples. It involves resilience and preparation but the final results can be life-changing.
When should I have breast reconstruction?
You can choose to have reconstruction straight away, to delay this or not to have it at all. Currently only 1 in 10 Australian women who have had a mastectomy will have a reconstruction.
If you initially decide not to have reconstruction, you can always change your mind. There is no time limit to delayed reconstruction; it can be performed many years later and if you are fit for surgery there is no age limit.
For those that do decide to have reconstruction, there are still many factors to consider. Some women will be offered an immediate breast reconstruction while others will be advised to wait until after chemotherapy and radiation are completed.
Breast reconstruction is possible for most women, although this can be impaired for those who smoke, do not have a healthy BMI or who have medical conditions. Your surgeon will discuss these with you to work towards the best results.
Make sure you research and prepare yourself for what to expect both before and after surgery. From a visual perspective, surgeons may have photos of their work for you to look at or you can access the Breast Surgery Gallery at Royal Perth Hospital.
You may also want to use the links below or speak to your breast care nurse to find more information about:
• the difference between a Reconstructive Plastic and an Onco-Plastic Breast Surgeon
• how to choose a surgeon
• another woman’s experience with latest techniques
• expert opinion on reconstruction before or after radiotherapy
• why so few Australian women have reconstruction
• questions to ask your surgeon
• how to prepare physically, practically and psychologically for reconstruction
• arrange to meet or chat online with other women who have had a reconstruction
There is more to your planning than just what your reconstruction will look like:
• Organise someone to help with housework, childcare, shopping
• You will not be able to drive for a few weeks
• Rearrange your home so everything is in reach
• Try not to get frustrated if housework standards drop for while
Private vs. public system for reconstruction
Breast reconstruction after breast cancer is available through the public hospital system as well as the private health system as it is considered a medical procedure, not cosmetic surgery. However there are some key differences to note between the two.
• More control over timing of surgery, better able to plan
• Out of pocket costs vary but can run to over $12,000, so it’s best to request a quote
• You can choose your surgeon
• Harder to plan long-term as often waiting for a date
• Costs are covered by Medicare
• You will be allocated a surgeon