Patients who chose breast reconstruction often feel they are taking control despite the risks and complications associated with the surgery. I hear comments from patients after having breast reconstruction who have encountered complications including, seromas, wound healing issues, hernias, multiple surgeries, and yet, are very happy with their decision to reconstruct their breasts. Many feel it gave them control. Why? It gave them the opportunity to rebuild a body part lost after being diagnosed with breast cancer or deciding on prophylactic surgery due to a genetic mutation.
An article in the New York Times reported on complications after various types of breast reconstruction surgeries including both implants and numerous forms of autologous (using your own tissue) reconstruction. A multicenter cohort study referenced in the article in JAMA stated:
Reconstruction may be associated with a high risk for complications, but successful reconstruction may still be achieved in most patients. Women electing to undergo reconstruction after mastectomy should demonstrate a firm understanding of the risks and benefits during the consent process.
JAMA Surgery
The New York Times piece was written by the same author who has written several articles on choices women make to either reconstruct their breasts or not reconstruct after being affected by breast cancer. The author’s articles have included photos of women who have chosen to remain flat; articles included photos of breast-less women. I have yet to read about the inclusion of all patients, men included, in her stories. I am sensitive to this because men are included in my outreach. They have mastectomies and can choose to reconstruct after breast cancer. Her job is as a health reporter. My job is to educate on options for breast reconstruction so you can be empowered to make an informed decision, the decision to reconstruct or not, despite known risks and complications. I have walked this walk.
What are the Elements of Taking Control?
Positive outcomes in breast reconstruction occur when patients choose highly skilled plastic surgeons who successfully perform the type of surgery they opt for despite the known risks and complications. A plastic surgeon who engages in a shared decision-making model will discuss the risks and complications. This sets up a trust relationship with the patient allowing them to ask their surgeon about fears they have before even deciding on breast reconstruction. A compassionate, confident, plastic surgeon will allow a patient to take time to make the decision best suited for them, even if it is opting out of reconstruction in the end.
I speak to patients, present company included, who have gone through physical therapy to restore range of motion and minimize scarring after breast reconstruction. I speak with patients who experience wound healing issues and with great candor talk about how their reconstructive surgeon saw them through these complications to resolution. I speak with patients who despite the known risks and complications, would choose to have breast reconstruction again because of the support they had from their plastic surgeon.
It is important to choose your plastic surgeon wisely. Ask about the risks and complications of the surgery. Discuss with them what they will do if these complications arise and what support and means of communication they have in place to correct the problems as soon as the patient notices them. If your questions about all the risks and complications are not answered to your satisfaction, it’s time for a second opinion. I got a second opinion and it resulted in 100% satisfaction with my choice to move forward with breast reconstruction.
Choose your breast reconstruction surgeon wisely. Be in control of your decision and be your own best advocate.
We do not choose to have breast cancer or to carry a gene mutation. We can, however, choose to have breast reconstruction. It gave me a sense of control over the devastation of being diagnosed twice with breast cancer. I chose breast reconstruction, taking control despite the risks and complications. It is a personal choice and others may choose not to reconstruct. But for me, it gave me control and gave me resolution after feeling overwhelmed each time I looked in the mirror after mastectomy, reminding me of the disease that took my breasts away.
