Considering Breast Reconstruction? I’m Glad I Did It, and Here’s Why

PJ Hamel Health Guide
  • Are you having difficulty making up your mind about whether to have your surgeon build you a new breast, post-mastectomy? Perhaps my experience will help you come to a decision.


    A dozen years ago, after being scheduled for a mastectomy to remove my right breast, I was asked if I wanted to consider breast reconstruction.  


    “Um, what’s involved?”, I asked. 


    The words the surgeon had uttered were clear enough: breast; reconstruction. But what did it mean, exactly?


    After looking through a photo album the plastic surgeon had compiled of her work – all of it autologous (body tissue) reconstruction, not implants – I got the big picture.

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    Thankfully, she’d left me alone to peruse the photos: a series of women’s torsos, arms outstretched, the better to display their new breasts.


    “Wow,” I remember thinking. “If these are the good ones, I’d hate to see what the failures look like.” 


    The reconstructed breasts weren’t exactly Marilyn Monroe-like in their perfection: drooping a bit, perhaps pointing slightly to one side, large nipples (or no nipples).


    But then I realized: these reconstructed breasts matched both the woman’s missing breast, and her remaining breast. The surgeon wasn’t out to create a work of art; simply to provide a matched set, something that would look good in a bra, or swinging free in a halter top.


    I pictured my own breasts: not bad. A bit small, but nicely shaped. Did I want to have a pair, or just a single?


    I’ll take a pair, please.


    And thus I made the first important decision: did I WANT breast reconstruction? 


    Yes, I did. I’m a long-time jock; an aging jock now, but still working out at the gym six days a week. As such, there was always a good chance I’d be dressing or undressing in front of other women. Would I be happier doing so without the flat, scarred spot on my chest marking a missing breast? 


    Yes, I would. And it wasn’t vanity influencing my decision so much as a desire to blend in; to be “normal.” To look (and hopefully) feel like I did before cancer turned my world upside down.


    Did I consider my husband’s desires in all of this? How would he feel?


    Well, as many good husbands do, he said he didn’t care; the decision was up to me. The inference was he’d love me no matter what. 


    Still, I assumed – like most men – he’d prefer to see two breasts on his wife, rather than one. So yes, his feelings did play into the decision, though frankly not as much as did my own. My body – my decision.


    Once I got past the “Yes, I DO want reconstruction” step, I was asked to consider the cost. Not financial, thankfully; it’s a federal law, if you have health insurance that pays for your mastectomy, it also has to pay for your reconstruction. I had good health insurance through my employer; I’d already met my yearly deductible as the result of a failed lumpectomy.


    But money wasn’t all that was involved here. There was also time out of work to consider; and the time and pain of recovering from a 7- to 9-hour surgery.


    Time off work? They told me it would be 3 to 6 weeks for the TRAM flap reconstruction I was considering. Knowing I’m a fast healer, I figured on 3 weeks out of work. 


    And how about that painful recovery? Pain I can do; any woman who’s been through childbirth can safely say she can “take it.” So I wasn’t afraid of a couple of weeks of potential discomfort.


    The surgeon asked me for one last decision: did I want to have the surgery at the same time as the mastectomy, or put it off until (weeks, months, years) later?


    To me, this was a no-brainer – get it over with all at once, I thought. Recover and be done with the whole thing.

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    Which is exactly what I did. 


    Now I admit, the 24 hours following surgery were some of the most miserable I’ve ever spent, close (but not quite reaching) the level of labor pain.


    But after that? There was the awkwardness of rubber drains snaking out of my trunk and flapping around my midsection; the pull and itch of sutures. But pain? Not so much.


    And the three weeks I took off work was plenty; I was raring to go and back at my desk in just 2 ½ weeks.


    In retrospect, I was extremely fortunate. I was an ideal candidate for autologous breast reconstruction: in good physical shape, but not overly thin; I had sufficient belly fat to build a new breast. I was a non-smoker, meaning my new breast would have a good blood supply. And, I hadn’t yet gone through either chemo or radiation (both of which would come later); so I was healthy as could be going into the surgery (except for that darned cancer!)


    The surgery itself went perfectly. I have two scars: one thin white line across my lower belly, hip to hip; and a palm-sized circle around my new nipple. Both scars are easily hidden by clothing, even a swimsuit. 


    And once the swelling disappeared, I had a new breast whose appearance closely matched the old one: both shape, and “hang.” Unlike a silicone or saline implant, it felt and moved like a natural breast – not surprising, since it was in fact natural: my own body. 


    Admittedly, the nipple isn’t perfect; despite a later tattoo I had to color the areola, it’s kind of… well, odd looking. And as for feeling – well, the doctor said the breast would be numb, and it is; you simply can’t do that kind of surgery without nerve damage. 


    All in all, though, am I glad I had breast reconstruction? I sure am. And one of the best parts of the whole thing doesn’t even involve my breast. At age 60, unlike so many of my girlfriends, I don’t have any belly fat. It’s all up top – in my new breast. 


    A perpetual tummy tuck? Now that’s the kind of long-term side effect I love!


    Remember, please – I’m describing my own experience. If you choose reconstruction, your results might be quite different. If you’re a candidate, your best bet for a successful breast reconstruction is to choose a plastic surgeon who does a lot of them. Practice makes, if not perfect, at least very satisfactory – when it comes to a new breast.


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    Read the story of HealthCentral expert Phyllis Johnson, who decided not to have breast reconstruction.

Published On: April 18, 2014