Since October is breast cancer awareness month, I want to answer a common question I get, which is, “What are my breast reconstruction options?”

Breast reconstruction is a really important part of a breast cancer journey for many women who want to rebuild their physical appearance. Most women either choose to have an implant-based breast reconstruction or a flap (autologous) reconstruction that uses their own soft tissue, typically from the abdomen or another part of the body. Some women decide they don’t want reconstruction at all and find that decision to also be an important part of the healing process. 


Implant reconstruction

The biggest advantage of an implant-based reconstruction approach is that it’s less invasive, which means it’s a shorter surgery than flap and often an easier recovery. You can also get a very predictable result in the right kind of patient.

If you’re choosing to have your breast reconstruction with implants, you may be a candidate for a tissue expander before your final implant is placed. A tissue expander basically serves to fill out the space where the implants might go, and that helps patients achieve a little bit of a larger and more natural look.


Flap reconstruction

The advantages of a flap reconstruction, are that you avoid having a foreign body inside of you, and you also have some reduction in fullness in the area that’s being treated. So for example, you could get a slimmer abdomen and fuller breasts at the same time.


Going flat

After cancer, many women end up not having any kind of breast reconstruction. This is typically called “going flat.” I would still suggest consulting with a plastic surgeon about this decision. A plastic surgeon can ensure that the chest wall is smooth and looks the way you want it to.


Lumpectomy options

Many women who have breast cancer have a lumpectomy as part of their treatment protocol instead of a full mastectomy. If you’re in that bucket of women, there are several possible approaches to help you with your reconstruction. Those include fat transfer to the area, sometimes an implant-based reconstruction, and sometimes even a symmetrizing procedure on the opposite breast.


How to decide

Every woman who has breast cancer has a little bit of a different story and requires a little bit of a different and specific treatment plan. For many women, breast reconstruction is possible immediately after a mastectomy, but for other women, it may be more prudent to wait a little bit.

I would suggest speaking to your plastic surgeon and your surgical oncologist about the treatment program that’s best for you.


During October, RealSelf is talking about breast reconstruction—from explaining all the different options to highlighting inspiring stories from our community. To learn more, go to Reconstruct Your Narrative.