The Pros and Cons of Primary Reconstruction Following Mastectomy

When a woman is diagnosed with breast cancer, she faces many decisions about her health and her treatment. If treatment includes a mastectomy – the surgical removal of one or both breasts to either treat breast cancer or reduce her risk of getting it – one of those decisions will be whether to follow it up with reconstructive surgery.

Reconstructive surgery is rebuilding the shape and the look of the breast. This can be done at the same time as the mastectomy, or at a later time. Whether or not to have reconstruction immediately following mastectomy (also known as primary reconstruction), is a big decision that depends on a variety of factors:

  1. Body Image

Many breast cancer patients choose reconstruction for both cosmetic and personal reasons. Reconstruction can make the chest look more balanced and enable women to feel more comfortable and confident in their clothing. Some women feel more confident looking at breasts they can call their own rather than the lack of a breast due to a mastectomy without reconstruction. Some women also feel that having breasts that look and feel like their own enhances their sexual relationship with their partner. After going through diagnosis, treatment, and mastectomy, breast reconstruction can help improve a woman’s confidence and help her feel like her normal self again.

With primary reconstruction, an additional procedure to correct any defects or improve symmetry is often necessary. Remember to communicate with your surgeon, and if your breasts don’t look and feel exactly the way you envisioned, your surgeon will be happy to work with you to help you achieve the results you desire and deserve.

  1. Avoiding Additional Surgery

Natural breast reconstruction uses tissue harvested from other parts of the body, such as the stomach, thighs or buttocks, and uses it to reconstruct the breasts (also known as autologous or flap reconstruction). Having primary reconstruction, breast reconstruction done at the same time as the mastectomy, eliminates the patient’s need for an additional major surgery and allows a woman to come out of surgery with a breast present.

However, after undergoing a mastectomy, many women opt out of reconstruction – either delayed or immediate – because they do not desire to undergo another operation or simply do not want implants. Women should know that choosing to not undergo reconstruction is always an option as well.

Reconstructive surgery that is done using the patient’s own tissue – such as the DIEP (deep inferior epigastric perforator) flap and the GAP (gluteal artery perforator) flap – typically involves a longer recovery than with implant reconstruction, and scars on both the breasts and donor site are to be expected. Be sure to consider your schedule for the two months or so following your reconstruction, as recovery following DIEP/GAP procedures is typically 6-8 weeks. If your schedule requires that you are able to resume normal activities quickly, take this into consideration before proceeding with mastectomy with primary reconstruction using the DIEP/GAP flap. 

  1. Eligibility

In addition, not all mastectomy patients are eligible for reconstructive surgery due to age, prognosis, medical history, etc.

To make the best decision for you about mastectomy and reconstruction, be sure to create a personalized plan with your doctor to ensure that the outcome you desire aligns with the best choices for your overall health. It’s also a good idea to speak with other patients who have undergone the same surgery to better understand the experience from another’s perspective.

Remember – your doctor may recommend that you do both procedures immediately (primary reconstruction), wait until later for reconstruction (secondary reconstruction), or do part of it at the time of the mastectomy and part of it after you complete chemotherapy/radiation. Do your research, weigh all your options, and then make the right decision for you.

To learn more about natural breast reconstruction and find out if it might be the right choice for you, contact The Center for Natural Breast Reconstruction at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

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