By Dr. Mary-Helen Mahoney, MD, FRCSC
Breast reconstruction involves a surgical procedure to rebuild part or all of a breast that has been removed. Here are answers to some of the most frequently asked questions about breast reconstruction.
Who can have breast reconstruction?
Almost all women can consider having breast reconstruction. The timing of breast reconstruction may be influenced by a number of factors, including the type of breast disease or cancer, and the need for chemotherapy or radiation therapy.
How is a breast reconstructed?
There are two main types of breast reconstruction. One option is to use a breast implant, and another option is to use your own tissue. Tissue can be taken from different places in the body, but the most common sites are the lower part of the abdomen (DIEP or TRAM flap) or the back. Not all types of breast reconstruction are possible for everyone.
What happens to my other breast?
Your surgeon will try to create a new breast that matches your natural breast as much
as possible. Often, your surgeon will discuss the option of having surgery on your remaining breast to improve the symmetry. This may mean making the other breast slightly smaller or larger, or performing a breast lift to move the nipple.
What happens to my nipple?
When the breast is removed, it is sometimes possible to preserve the nipple, which is called a nipple-sparing mastectomy. If it is not possible to save your nipple, then the nipple and colour of the areola can be reconstructed and tattooed.
Can I use my tummy for breast reconstruction if I have had liposuction or a tummy tuck?
Sometimes it is possible that the abdomen can be used to create a breast even if
you have had liposuction in the area. Your surgeon may order special imaging investigations to see if this type of surgery is possible after liposuction. Unfortunately, the lower abdomen cannot be used for breast reconstruction if you have had a tummy tuck. In fact, when we use this area of the abdomen for breast reconstruction, you essentially get a tummy tuck at the same time!
Is breast reconstruction painful?
Pain following breast reconstruction is variable. Most pain improves over the first one to two weeks. Your doctor will make sure your pain is appropriately managed. When your own tissue is used, pain may persist longer because there are two surgical areas that need to heal.
What is the recovery like?
The recovery time for breast reconstruction depends on how the breast is reconstructed.
If your own tissue is used, the recovery is usually longer—you spend a few days in hospital, and recovery is about six to eight weeks. After implant reconstruction, you often go home the same day, and recovery is usually two to four weeks. Return to exercise is usually around four weeks for light exercise, but can be longer if your own tissue is used for reconstruction.
Do I have to pay for breast reconstruction?
Breast reconstruction is covered by provincial health care plans, such as OHIP.
After breast reconstruction, do I still need to have mammograms?
Women who have breast reconstruction after a mastectomy generally do not need routine mammograms or other imaging. There is not enough breast tissue remaining in the breast after a mastectomy to perform a mammogram.
Do I have to have breast reconstruction?
The choice to have breast reconstruction is a very personal one. There are many benefits to breast reconstruction, including increased confidence and body image. Your surgeon will discuss options that are most appropriate for you, but ultimately you decide if breast reconstruction is right for you.