Breast Reconstruction Results, Should we Compare Photos?

Breast reconstruction results, should we compare photos? This is a perplexing question in the world of plastic surgery for those affected by breast cancer. However, I see this question asked several times a week. I want to share my thoughts and why I feel it continues to be a topic I think breast cancer patients should give careful consideration to.

When I lost my breast to breast cancer and began searching for a microsurgeon to perform my DIEP flap, I used their public website as a resource. It was full of information I needed to prepare for and understand the surgery I was about to have, DIEP flap, using my own tissue to rebuild my breasts.

Seven months before my DIEP flap breast reconstruction, I had a skin sparing, nipple sparing mastectomy after a second breast cancer diagnosis. Those seven months were psychologically difficult for me. Twelve years previous to my breast reconstruction, I had six weeks of daily radiation to my left breast. The combination of those two treatments for my breast cancer left me mangled, hesitant to enjoy public events, feeling shameful and emotionally bruised. Stepping out of the shower after my double mastectomy never became easier.

Before and After Photos

When I looked at results, or as they are often referred as, “before and after” photos, I found some plastic surgeons had photos, others did not. For me, my diagnosis of “acquired absence of breasts” meant I was without two body parts for months. Try to understand my amazement when I saw photos on a select group of plastic surgeons’ sites of women who had radiation fibrosis like I did or only one breast when I had none. Then to see the after photos  with a brand-new breast, my eyes often teared up in wonder and awe at the possibility of having my breasts back.

My experience is one of many. The body I presented to my plastic surgeon was unique in its form, skin laxity, age, the number of pregnancies I had stretching out the abdominal tissue, the amount of tummy tissue I had for my DIEP flap, coloration and pigmentation, fibrosis and scarring from prior radiation, and more importantly, absolutely no photos to show my surgeon what my breasts looked like before my mastectomy.

I regrettably did not take any before my double mastectomy. Our conversation focused on the “after” and what he hoped to achieve for me. Fast forward to my post DIEP flap results, I was beyond happy, in fact quite amazed at my new breasts. But we are each unique in our perception of outcomes after breast reconstruction.

Breast Reconstruction Results Vary Based on Many Factors

This list describes the various scenarios plastic surgeons might encounter when patients come to them for consult for breast reconstruction.

• Immediate Breast Reconstruction for prophylactic reasons.
• Delayed reconstruction with an expander placed at the time of mastectomy.
• Explant of an existing implant to a tissue flap conversion breast reconstruction.
• A delayed DIEP flap after a double  skin sparing, nipple sparing mastectomy with no expander.
• A delayed DIEP flap with a single mastectomy and possible lift or reduction needed in contralateral breast.

There are just a few examples. This list can be as exhaustive and unique as each of our own situations and what canvas we bring to our plastic surgery consult.

Should we Compare Photos?

Yes and no. Yes, if you set realistic expectations based on your own personal experience and consider the various scenarios I have listed in this blog. No, if you can use in your own words what you would like your aesthetic outcomes to be for your breast reconstruction and have complete faith in your plastic surgeon to do their best to accomplish your desired goals.

Size, projection, form, and function should all be words you use in a shared decision-making conversation with your plastic surgeon. Ask how many revision surgeries it will take to achieve these goals. It is very important you ask how many revisions will be covered by insurance.

I hope this helps you understand why I encourage you to give careful consideration when requesting before and after photos from other patients. What are your thoughts about the question, Breast reconstruction results, should we compare photos?

Disclaimer

References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website.  The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.