The type and timing of breast reconstruction after mastectomy will depend on many factors from your overall health to the types of future cancer treatments you might require. In any event, breast reconstruction can help to restore your shape and natural appearance. Determining whether or not it is right for you is something you should spend a great deal of time contemplating.

What is Breast Reconstructive Surgery?

Breast reconstructive surgery is any plastic surgery whose goal is to restore or reshape the breasts after a mastectomy. There are many different types and techniques used, each depending on various factors with the individual patient. Some methods are better for some patients than others, depending on the amount of breast tissue lost. In some circumstances, a breast reconstruction after mastectomy may not be possible, though this is rare.

Types of Breast Reconstruction Techniques

Breast reconstruction technology and techniques have come a long way since their inception decades ago. Techniques are available now that leave less scarring and provide more natural results than the previous standard of care. Below is an overview of the different techniques, but you should discuss which breast reconstruction method is right for you with your doctor:

- Expander Implants: This method uses a special temporary expander where the breast should be in order to stretch the skin and create a pocket for a permanent implant. It is a two-part process since there must be a second surgery to place the final implants.

- Direct to Implant: This type of breast reconstructive surgery is like the above, except it skips the expander step and eliminates the need for a second surgery.

- Latissimus Dors Flap: This is a breast reconstruction after mastectomy technique that takes tissue from the back in order to recreate the breasts. It may be used in conjunction with expanders and implants.

- TRAM Flap: This is a relatively new procedure that allows the surgeon to take abdominal muscle, skin, and tissue to reconstruct the breast. The transfer is done under the skin so there is less scarring and the patient receives a bit of a tummy tuck in the process.

- DIEP, TUG, and Other Flaps: Similar in technique to the TRAM flap, these types of surgery take donor tissue from other areas of the body such as the inner thighs, buttocks, and more rarely, the outer thigh. DIEP flaps use tissue and fat from the abdomen but not muscle.

Should I Have a Breast Reconstruction After Mastectomy?

Dealing with breast cancer and a mastectomy can be so overwhelming that planning breast reconstructive surgery may be more than you can handle at the time. On the other hand, some women find that they would prefer to get all of their surgeries out of the way as quickly as possible. Only you and your doctor can decide if breast reconstruction after mastectomy is right for you, but here are a few things to consider:

- Prosthetic devices are available for use under clothing for women who want to appear as they did pre-mastectomy while clothed, but do not want breast reconstructive surgery.

- Not all patients are good candidates for breast reconstruction. General health, the need for future radiation, and being a smoker can disqualify you from the surgery.

- You must be willing to follow your doctor's post-operative instructions. This includes no lifting and no housework that requires repetitive movements of the arms until fully healed.

- Don't expect your new breasts to look and feel exactly like your old ones. Sensations will be different and you will look different when nude. Have realistic expectations.

Finally, you should decide whether you want immediate or delayed breast reconstructive surgery. Immediate surgery is directly after your mastectomy, so there is less surgery. There is a higher chance of developing necrosis, however. Delayed breast reconstruction offers time for radiation treatments but requires more surgery in the future. Talk to your doctor to decide which option is right for you.