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Breast Reconstruction FAQs

By PJ Hamel

Published April 2007 

Q. I’ve had a lumpectomy, and they didn’t get clean margins. So I’m going to have another lumpectomy, and then… I don’t know, maybe a mastectomy. Either way, I’ve been advised to look into reconstruction. That sounds pretty major, and I don’t know if I want to do it…

A. Breast reconstruction, either after a lumpectomy or a mastectomy, can indeed be major surgery. There’s a lot to consider as you make this decision:

- Can I take time off from work?

- Will insurance pay for it?

- What are the physical risks?

- Can it fail?

- What will it look like, and feel like?

Lots of questions. In my opinion, the most important thing to consider is this: How will I feel about the way I look if I don’t have reconstruction, vs. if I do?

Outwardly, reconstruction is all about looks–which doesn’t mean it’s all based on vanity. Any guilty thoughts you have about making this decision purely for “vanity’s sake,” get rid of them right now. Reconstruction (or no reconstruction) is really about feeling normal and healthy, even though you’ve lost your breast (or part of it). It’s about being able to take your life back because you feel good about yourself, both emotionally and physically. It’s about looking in the mirror, and not wanting to look away because you see a wrecked, disfigured body, a body that makes you feel sad and ashamed.

Which is not to say reconstruction is a necessity! Many women have a bilateral mastectomy with no reconstruction, don’t wear a prosthesis (something that slips into your bra to look like a breast), and are just fine with how they look. I know one woman who, instead of reconstruction, had a beautiful, intricate tattoo done; now, flowers and vines encircle her trunk, where her breast used to be. She loves it. AND THAT’S THE POINT. Whatever you do (or don’t), this is about how YOU feel, no one else. If you don’t want reconstruction, fine. If you do, go for it. But don’t let anyone’s advice or comments make you feel guilty, one way or another. What could be more personal than your own body geography?

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