If you decide to proceed with a mastectomy, your surgeon will discuss breast reconstruction with you. You do not have to have a breast reconstruction, and some women opt to be flat chested. You may wish to have wear a breast prosthesis, which gives the appearance of a natural breast under clothing.
Breast reconstruction is the process of re-creating a breast, either with an implant, your own tissue (autologous), or a combination of both. It is a very personal subject. There are many things to consider when choosing a breast reconstruction, and your surgeon and breast care nurse will spend as much time as you require discussing suitable options with you.
Immediate vs Delayed
A breast reconstruction that is carried out at the same time as your cancer surgery is termed an "immediate reconstruction". During this type of reconstruction your native breast skin is preserved, whilst the breast volume is re-created with an implant, your own tissue, or both. You may be advised against this due to the type or stage of your breast cancer. Many women choose not to undergo an immediate breast reconstruction, and opt for a "delayed reconstruction". Sometimes having to deal with reconstruction options as well as a breast cancer can be too much to process, therefore having a delayed reconstruction can reduce this stress.
Implant vs Autologous
Implant based breast reconstruction is the commonest form of breast reconstruction practiced in the UK. Implants can be fixed volume or variable volume. The implant is often used in combination with a biological mesh which acts as an internal bra to support the implant. The mesh may originate from pig or cow skin. Synthetic meshes are also available.
Autologous breast reconstructions utilise your own tissues to re-create the breast volume. Tissue may be transferred from other parts of your body, such as your back or tummy, which will leave scars at these donor sites. They are more complex operations relative to implant based reconstructions, but a more natural feeling breast is created. The autologous reconstruction will age naturally and is much less likely to require revisional surgery.