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Life After Mastectomy: Adjusting to Reconstruction

By Jeannette Vagnozzi

As soon as my doctor recommended a bilateral mastectomy after diagnosing me with breast cancer, she quickly followed with a discussion about reconstruction, as if to soften the blow. Somewhere in the back of my mind, the idea of being rebuilt at age 40 seemed like the first potentially positive trade-off to the whole ordeal. Still, it turned out that deciding how to reconstruct was as difficult a decision as deciding whether to reconstruct. There are a number of options: saline and silicone implants, using tissue and muscle from the stomach or other areas of the body, or combination of methods.

After weighing my risks and consulting with my doctors, I opted for saline implants. During my mastectomy, tissue expanders were inserted under the muscle in my chest. Over a period of time, they slowly expanded to create pockets for the implants. The expanders were uncomfortable, hard, and oddly shaped. I was concerned that it was a sign of things to come and considered having them removed and foregoing the implants altogether. After some reassurance from my doctor, I went ahead with the process as planned, and finally the silicone implants were inserted.

If you are considering breast reconstruction with implants, I hope you’ll find some of these lessons I learned helpful:

• My most important lesson: unlike augmented breasts, which are an enhanced alternative to natural breasts, reconstructed breasts are an alternative to no breasts. Put simply, you cannot expect a reconstructed breast to ever feel or look exactly like your own natural breast.

• Reconstruction takes time - I have spent more time on reconstruction than on treatment. Reality tv tries to convince us that healing takes place between commercial breaks, but in real life, reconstruction will not happen in sixty minutes. To have a good cosmetic effect, patience is absolutely required, and a follow-up procedure or scar revision may be necessary to get the desired effect.

• You will have to adjust to the feel of the implants. The expanders will feel hard, but the implants will be better. Still, implants will feel like, well, implants. It may make sleeping, getting a massage, or visiting the chiropractor uncomfortable for a while. I cannot lie comfortably on my stomach or even on my side due to some sensitivity at the incisions and the scar tissue around the area.

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