Weighing the Options on Breast Reconstruction After Cancer Surgery
As if a breast cancer diagnosis and treatment weren’t traumatic enough, many women who undergo breast removal surgery (mastectomy) also experience a sense of disfigurement -- that a part of them is gone.
“For many women, their femininity is part of their personal identity, and losing a breast can affect them emotionally. By restoring that aspect of their body and identity, day-to-day living can be easier – they feel whole again,” said David Yan, M.D ., a board-certified plastic surgeon with Gulf Coast Medical Group in Venice.
Dr. Yan performs surgery at Venice Regional Bayfront Health. His practice includes all aspects of surgical and non-surgical treatments in cosmetic and reconstructive surgery. Most patients he sees for breast reconstruction have lost one or both breasts to cancer.
“Each patient is different, so it’s important to present all of the options so the woman can make an educated choice,” Dr. Yan said. “I see many patients who haven’t been given enough information on their choices. We want to empower women to assess the options and feel confident in their decision.”
There are two categories of reconstruction: using an implant or using the patient’s tissue. Most breast reconstruction in the United States is based on an implant. The surgeon inserts a tissue expander to stretch the skin, and then about three months later, will insert the implant. Another option is to go straight to an implant.
Some people don’t want an implant because they remember that silicone implants at one time were thought to be unsafe, although that was later found to be false. Still, if the patient doesn’t want an implant, the surgeon can perform a more complicated and time-consuming surgery using skin and fat harvested from another area of the patient’s body to re-create a breast.
Whether the reconstruction occurs immediately following the cancer surgery or is delayed, it is generally covered by health insurance. The Women’s Health and Cancer Rights Act is a federal law that was passed in 1998 to help ensure that women can be covered for reconstruction after a mastectomy. This also includes procedures on the unaffected breast to achieve symmetry. Patients should always check with their insurance carrier on their coverage.
As with any surgery, there are risks of infection and other complications. Dr. Yan advises patients to understand fully the risks associated with any surgery they consider.
The American Cancer Society also provides a local support group for breast reconstruction patients to help them deal with the practical and emotional aspects following cancer surgery.
“My message to women in this situation is that you have options. There isn’t just one way to do it. Look for someone who has the ability to provide you with a range of options,” Dr. Yan said. “Consulting with patients on breast reconstruction requires a sensitive, interpersonal approach individualized to each patient. We want to help them feel normal and whole.”