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Deciding Factors Before Undergoing Breast Reconstruction

| July 9, 2020 August 2, 2023 | |

deciding factors before breast reconstruction - dr. ergun kocak
Reconstructive surgery answers a patient’s more subtle need or desire to regain what cancer took away. It is often the final step in the fight against breast cancer, following mastectomy or lumpectomy and various other therapies. If you find yourself – as thousands of women – contemplating the pros and cons of breast reconstruction, there are certain factors you may need to consider.

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should i have breast reconstruction or not - dr ergun kocak
Here are some questions you can ask yourself if you are considering breast reconstruction (You may click the image to enlarge it). If you want to learn more about the procedure, you may visit our landing page or schedule a consultation with one of our plastic surgeons.
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Asking The Right Questions

Each individual’s unique lifestyles and conditions can greatly affect the steps taken during reconstruction and subsequent recovery. Even before consulting with your surgeon, you should ask yourself the following questions:

1. Is having a permanent breast shape important to you?

The most common forms of breast reconstruction use implants, tissue flaps, or fat grafting.

Breast implants and tissue flaps last for years, if not permanently; breast remade with fat grafts may require additional injections every few years to maintain their size and shape.

2. Is it important that both your breasts appear balanced in a swimsuit if you undergo a mastectomy on just one breast?

The goal of breast reconstruction is to rebuild your breasts to be as close to your old ones as possible while maintaining your body’s form and proportions. Tiny adjustments may be required to achieve this, so you must be clear about your desired outcome with your doctor.

3. Do your needs require several breast reconstruction surgeries over a long period of time?

This generally applies to women who have late-stage cancer and need additional surgeries to remove any tumors entirely. However, this may also be a consideration for BRCA-positive survivors, as they have a higher chance than usual of breast cancer relapse. Getting rid of new tumors requires removing an already-present implant, and therefore another surgery to reconstruct the breast again.

4. Is remaining physically active after surgery important to you?

Undergoing a few radiotherapy sessions before reconstruction may be required to get rid of any remaining cancer cells. Also, full recovery from breast reconstruction can take several months. Make sure to schedule time away from work accordingly. You and your surgeon will devise a schedule that fits all your needs.

5. How expensive is breast reconstruction surgery?

All procedures related to breast cancer, including mastectomy and breast reconstruction, must be covered by all health insurance providers as stated under the Women’s Health and Cancer Rights Act of 1998.

6. Are you an athlete, or do you have a physically demanding job?

Answering ‘yes’ may mean your body has more muscle and less fat built up around the chest area, which must be taken into account by your surgeon. A well-built or slim figure may not be compatible with certain types of reconstruction techniques.

7. Did undergoing a lumpectomy affect the original shape of your breasts?

Inform your surgeon if your breast shape changed dramatically after lumpectomy. They can take steps to customize your reconstruction to address any aesthetic and balance issues.

8. Do you have any other medical conditions that might affect your ability to heal?

It would be best if you were open about your medical history during the consultation. Doing so will allow your physician to mitigate any possible risk without compromising your health and your results.

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Consultation with a Surgeon is Still a Priority

With all the above questions in mind, you are now ready for your consultation. A board-certified plastic surgeon has the necessary expertise and experience to answer any question and allay the fears you may have.

A self-evaluation at the start of it will go a long way towards a smoother and better experience. Being diagnosed with breast cancer can be a difficult period of your life, but we will be there to support you from beginning to end!

About the Author

Dr. Ergun Kocak, MD, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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*Our blog entries are written in order to further educate our patients and raise awareness towards topics related to plastic surgery. Any solutions offered on this blog are intended to help possible patients develop educated decisions before undergoing a consultation with our doctors.

2 thoughts on “Deciding Factors Before Undergoing Breast Reconstruction”

  • Charles Kemp

    I think it would be really helpful to have a reconstructive surgeon help out after you have had a mastectomy or lumpectomy. I know that it would help the person out because it wouldn’t feel like the person was missing anything. It also would be helpful to have normal tissue where the cancer was like you said.

    • Kathy Petrozelli

      When I was diagnosed with breast cancer at age 48, I was so beside myself that the first question I asked was obvious. I received my diagnosis via the telephone on my way to a girl scout meeting. I had many decisions to make. It is all about choices sometimes and boy did I have plenty of choices to chose from. Genetic testing revealed that I was positive for the BRCA2 gene. Because of this I started with a total hysterectomy.
      My next plan was to have a lumpectomy and radiation. I found out that I had this gene on my way into the OR when the surgeon asked me if I wanted to cancel my surgery. I emphatically said NO but guess I really didn’t understand the impact that this gene had at the time and my emotions at the time were all over the map. In following up with the surgeon, maybe at the third visit, he said to me you really need a mastectomy and if you don’t have it done and the cancer comes back, you’ll have to go somewhere else. I am thankful he said this to me because he led me straight to some very wonderful doctors after much sole searching. My boss at the time was responsible for helping me pick my doctors when he gave me a newspaper article about them written by one of their patients. I couldn’t have asked for anything more when it came to education and skill by my new doctors. They were all on the same page when it came to my care and I am so thankful that I came under their care. They made me feel important, not just like another number.
      I took my whole situation to heart and started to think about things and so I now know that I made the right choices for me. I consulted many doctors who all told me that they couldn’t make the choice for me and that these things were a matter of personal choice. I was looking for some guidance so I could came up with the right answers but in the end I fully understand the personal choice thing. What is right for me may not be right for another patient and so forth and so on.
      A little history. My mother had both breast and ovarian cancer. She was diagnosed with the breast cancer in 1980 and the ovarian cancer in 1988. She passed away eight weeks before my baby was born in 1994. My father also had prostate cancer. So who threw me the gene? My doctor said Mom, but who really knows? I could be wrong about this, but I don’t think it is equally as important as to where it came from as I have dealt with it. Anyway, I think perhaps Dad threw it since he, my grandfather and everyone of my uncles had prostate cancer with the exception of an adopted uncle. I have counseled my daughter about taking the proper care of herself since this is apparently a family issue. Recently my brother tested for the gene and he was “negative”. This was after his prostate cancer diagnosis. So gene or not, what I learned is that we all have to be aware that these family issues exist and we all need to receive our proper screenings. I will always credit my mammogram with saving my life since it picked up a very aggressive tumor at 0.6 cm big. My brother’s doctors are in the same place that my doctors are. He too likes the comfort that he feels there.
      After months and months of struggling to come up with the answers, I decided to have the mastectomy; a decision that I didn’t make lightly. By the time I got to the breast surgeon’s office I had my mind made up. Once the decision was made I felt the pressure was off, but was it really? There were additional decisions to be made at the time regarding reconstruction. Did I want to remain flat, get implants or something else. This was the only time I was glad that I had enough fat on my body. Ha. I was not really cool on implants because I had heard that silicone implants could rupture and cause problems. My doctor at the time told me that I could experience a problem in year 1, 10 or 17. I was 48 years old and was not looking for additional surgeries once I was reconstructed into my 60s. After meeting with my plastic surgeon I decided upon a Diep flap which meant that they would reconstruct my breast using my belly fat. I had several appointments with my doctor to make sure that I really knew what I was doing I guess. It was at the appointment that the risks were explained to me that I waivered a little and the doctor had to real me back in some. This was a very big important decision for me and for my family. My daughter who was in the 8th grade at the time was very upset by me having cancer and she was worried about the decisions that I made and she was crying a lot about it. I found myself running back and forth to school several times because she was crying at school and the teachers really didn’t know how to console her. So yeah, my decisions affected the whole family and my husband was upset mainly because I had breast cancer. I was told later that he also cried because I had cancer.
      Eleven years out and I made the right decisions for me and my family. I am going to be celebrating my 60th birthday in a half of year and I have experienced zero negative issues. I haven’t had to deal with bad implants or any problems associated with them. My plastic surgeon was so exceptional that no one can tell that I had Diep surgery unless I tell them. I have not one visible scar. He has everything tucked underneath where it cannot be seen. In the end, I am very happy with the decisions I made for me and my family. Hopefully, I won’t experience any more problems in the future. I pray on it, but no one really knows where the journey of life is going to bring us. I would tell you that given my situation, I would do Diep Flap all over again because it all turned out so well for me.