Q. What might prevent a successful result with breast reconstruction?
A. Well… lots of things, actually. To begin with, you may not even be a candidate for body tissue reconstruction; since your blood vessels play such an important role in the outcome, generally you’re not eligible if you have diabetes, connective tissue or vascular disease, or if you’re a smoker.
The new breast might not exactly match the old one; you may want to have the surgeon go back in and do some tweaks, to one or both breasts. Remember, this is relatively new surgery, and requires a top-notch surgeon. With that in mind, understand that there may not be a surgeon in your area who can perform this surgery, particularly a free flap; it’s incredibly specialized.
The new breast tissue may die, in which case it has to be removed and you’re back to where you started, post-mastectomy. You may have complications in the area the tissue was taken from: a weakened abdomen or shoulders, enough to affect some of the physical activities you enjoy (tennis, perhaps, or Pilates or yoga). If you have a TRAM flap, you may be more prone to a future hernia. Cosmetically, you’ll have some pretty major scars in the area the tissue was taken from.
WOW, you’re probably thinking–I might go through all this, and not be happy with the result? Truthfully–yes. But surgeons are getting more and more skilled all the time. Ask your surgeon to show you his or her photo album; they generally keep a record of the surgeries they’ve done, with before and after pictures. Ask to see both the successful, and not-so-successful results, so you have an idea of the range of results you might expect.
In the end, I believe there are many more women pleased with their results, than displeased. So, just as with any other part of your cancer treatment–think positive!
One final word of advice: well, two. First, be sure to check with your insurance company before you begin any of this. It’s incredibly expensive surgery, and you want to make sure it’s covered. And second, ask to be referred for physical therapy once you’re sufficiently recovered. You’ll regain the use of your arm and shoulder much more quickly, and also hopefully avoid some potential complications, which might include minor loss of range of motion; a more serious and painful condition, called “frozen shoulder;” or lymphedema.
Good luck as you embark on this journey. Hopefully you’ll be as pleased with your reconstruction as I am with mine!