A breast cancer diagnosis has many facets, both emotional and physical. Along with your doctor and family, you’ll be making several treatment decisions. If you need to have an entire breast or both breasts removed, you most likely have the opportunity to reconstruct your breasts with plastic surgery. Many women have a choice in reconstruction in terms of when to start, how it’s performed, and with what types of implants. Starting with finding an expert in reconstructive breast surgery, here are 10 important things to understand about breast reconstruction.

1.  Find an Experienced Plastic Surgeon

Breast reconstruction is a major operation. Your surgeon is starting mostly from scratch to build a new breast, instead of making an existing breast bigger. Breast reconstruction typically takes at least two surgeries and several office procedures over the course of several months. Whether or not you’ve made the decision to have reconstruction, now is the time to find a good surgeon to speak with about your particular options and to answer your questions. 

You’ll want a plastic surgeon board certified by the American Board of Plastic Surgery and experienced in breast reconstruction. Start with recommendations from your oncologist, but you can also find a board-certified plastic surgeon at www.healthgrades.com.  

2.  It’s Good to Talk About Reconstruction Early

Talk with the plastic surgeon about reconstruction well before your mastectomy. Your surgeon may be able to start the reconstruction process during your mastectomy. This would cut down on the total number of procedures necessary. And even if you don’t want to have reconstruction right away, planning ahead will help you receive the best treatment.

3.  Start Time for Reconstruction Depends on You and Your Body

You don’t need to start the breast reconstruction process at a certain time. You can and should start reconstruction only when you’re physically and emotionally ready. In many cases, you can begin the process at the same time as your mastectomy. Or you can start it months or even years later if you would rather focus solely on your cancer treatment and recovery. Your doctor can discuss your timing options with you.

4.  There Are Two Types of Implants 

The two types of implants used in breast reconstruction are saline and silicone gel. Saline-filled implants use sterile saltwater inside of them. Silicone-gel filled implants are made of a type of rubber. Saline-filled implants are the more common implant type, but many people think that silicone implants feel more like a natural breast. Your surgeon can talk with you about the safety and benefits of both types of implants.

5.   You Have Alternatives to Implants

Many breast reconstructions use saline or silicone breast implants. However, in many cases, surgeons can create your new breast using your own skin, fat, muscle, and blood vessels. These come from other parts of your body, such as your abdomen, back and thighs. This technique is called a tissue flap. In some cases, surgeons use a combination of tissue flap and artificial implants to create the particular size and shape of breast that you want.

6.   There Are Several Types of Tissue Flap Reconstruction Procedures

The latissimus dorsi flap uses tissue from your upper back to reconstruct your breast. In a TRAM (transverse rectus abdominis muscle) procedure, the surgeon uses tissue from your lower abdomen. Other less common procedures move tissue from your thighs or buttocks to your chest. Your surgeon can discuss your options and their pros and cons with you. 

7.   You May Be Able to Keep Your Own Nipples or Areola

During a mastectomy, your surgeon may be able to remove your breast but leave your nipple and/or areola. This is called a nipple-sparing mastectomy or areola-sparing mastectomy. It depends on the stage and location of your breast cancer. Although your nipple or areola is saved, they may not have much sensation because they no longer have nerves. You may still enjoy having the look of your own nipple or areola.