Breast Reconstruction: Q&A
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Nervous About Breast Reconstruction with Mastectomy
My oncologist has recommended I have a mastectomy - I was diagnosed with breast cancer - and I'm going to have the surgery. He told me I could have reconstructive surgery on the breast at the same time--but I'm nervous about that. It just seems that the breast should be given time to heal and make sure that everything is ok first--but my doctor doesn't seem to think that's an issue. Is it ok to have reconstruction at the same time as mastectomy--or are there advantages to waiting?
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38 Doctor Answers |
Asked by
NancyM
in Rutherford, NJ
+5
Immediate breast reconstruction is usually preferred
There are many factors to consider when deciding whether or not to have immediate breast reconstruction. Immediate breast reconstruction is when the reconstruction is done at the time of mastectomy; in other words, there is no delay.
The reconstruction can be done using your own tissue or using a tissue expander. If you have a tissue expander, a 2nd procedure is needed to remove the expander and put in the implant. Many patients also have reconstruction of the nipple. Even though you...
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+4
Many variables to answer that question
Immediate breast reconstruction is an option for the majority of women getting a mastectomy. Keep in mind though, that breast reconstruction (even when considered immediate), often requires multiple steps to get it as symmetrical and aesthetically pleasing as possible. Delayed reconstruction is an option, but the skin envelope often contracts, which may require bringing in tissue in the form of an abdominal or latissimus flap. Good Luck!
+4
Discuss Breast Reconstruction issues with your surgeon
Your unique situation would clearly require a consultation.
Breast reconstruction involves a variety of techniques and methods which are too detailed to discuss in this format. Important information to acquire during a consultation involves a long history to document:
family history,
future risk,
methods/approaches/incisions for cancer removal (biopsy, lumpectomy, partial/total mastectomy),
management of the opposite breast (enlargement, reduction, or lift), previous surgical procedures...
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+3
Breast reconstruction
This is a tough question to answer in such a small space. I often spend 30 minutes to 1 hour with new patients regarding this very question. First, you want to know what type of tumor it is, how big, whether they suspect lymph node involvement, what type of post-op therapy you will need. All these are important questions.
If you are an appropriate candidate to have an immediate reconstruction, then I would strongly recommend it. It is much easier to reconstruct the breast when you know what...
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+3
Different options in breast reconstruction
Breast reconstruction can be immediate (at the same time as the mastectomy) or delayed (after a few weeks to months). The decision as to which one is better for a particular patient depends on a lot of factors one of them is surgeon preference.
In my practice I now rarely perform immediate reconstructions because I have a strong feeling that the wound has to settle down first, the disease has to be cured and the patient ready to embark on a long journey which is the reconstruction, starting...
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+3
Immediate breast reconstruction has advantages
Debbie,
Breast reconstruction is a personal decision and should be discussed thoroughly with your plastic surgeon. He/she can help you decide the timing and which procedure is best for you.
All things being equal, I feel immediate breast reconstruction has several advantages vs. delayed including one less surgery, combined recovery with mastectomy, greater psychological benefit and tissue which is more supple, allowing for a better cosmetic result.
Whether you use an expander/implant or your...
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+2
Mastectomy and immediate breast reconstruction yields the most aesthetic results
If you are diagnosed with breast cancer and a mastectomy (removal of all of the breast tissue) is recommended, you will always be a candidate for breast reconstruction. Breast reconstruction is in fact your right, by law!
Immediate breast reconstruction refers to reconstruction of the breast form at the same time. The advantage of this is that you will only need to undergo one major surgery, and the shape of the breast is maintained. Immediate reconstruction often...
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+2
Immediate breast reconstruction preferred
When an option, immediate breast reconstruction is generally preferred over delayed reconstruction. You are already under anesthesia, so it spares you from one additional surgery, and since everything is open already, the surgery can be quicker as well. If your surgeon feels like you are a good candidate for it, then I generally recommend it.
+2
Timing of breast reconstruction
There are advantages to both ways, and certain times when waiting is the only answer. A reconstruction performed during the same surgery as the mastectomy is known as an "immediate breast reconstruction" whereas having it later is known as a "delayed breast reconstruction." A diagnosis of breast cancer is a very emotional and intense event in ones life. Having to make a decision about reconstruction during this hectic time often seems overwhelming. One of the main goals...
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+2
Timing of Immediate vs. Delayed Breast Reconstruction
The decision to perform immediate vs. delayed reconstruction depends on one important factor: whether or not you will have postoperative radiation therapy.
If you are considering a implant reconstruction, the rate of capsular contracture after radiation may be much higher than without radiation. Autologous reconstruction fares better with radiation overall.
If radiation is planned, some surgeons prefer to irradiate the breast and then have the option to perform autologous reconstruction...
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