Reconstructive breast surgery: moving on.

When Toni Frenzke was diagnosed with breast cancer in 2011 at the age of 37, fighting the cancer was foremost on her mind, how she’d look after the treatment was the least of her worries.

“I had that mindset of ‘I don’t care,’” says Frenzke. “If you have to take them off and I’ll be flat-chested the rest of my life, I don’t care.”

But while Frenzke was absorbed with the “now” of her diagnosis, her doctor was also thinking about the future. Breast cancer is “not going to define you,” she told Frenzke before laying out Frenzke’s breast reconstruction options.

Had Frenzke seen another doctor, she might not have gotten any information on reconstruction -- 7 out of 10 women who undergo a mastectomy aren’t told it's even a possibility, according to the American Society of Plastic Surgeons. And fewer than one in five women go on to have breast reconstruction after a mastectomy.

Frenzke got hers a little more than a year later -- after she was done with her six rounds of chemotherapy and 28 radiation treatments. She wore plastic expanders -- that act as "placeholders" for the pending implants -- until she got the implants. “[They] are painful, absolutely,” says Frenzke. “They’re so wide that they come around under your armpits. My husband said it felt like he was hugging a brick.” But they were worth it. The implants helped her move on from her year-plus journey from diagnosis to implants.



How is breast reconstructive surgery done?

Whether it's done right away or revisited in the future, there are three ways to construct the breasts:

1. The most popular method utilizes the same silicone implants used in breast augmentation. After the breast is removed during a mastectomy, the surgeon inserts an expander, a high-tech water balloon that slowly fills over several months (via external port) to encourage the skin and muscle to grow where the breast was. Once the skin expands to the desired size, the expander is replaced with a silicone implant and reconstruction is complete.

2. Instead of an implant, a woman can choose a “flap” procedure that uses skin, fat and sometimes muscle from another part of the body -- usually the stomach or back and sometimes the butt -- to create a new breast. It's done in one surgery but the recovery time is longer because two parts of the body are healing. To qualify for this procedure, you have to have the excess fat to work with, so the skinnier you are, the less likely this will be the option for you.

3. A combination of these methods uses skin from your back to create the breast shape and an implant to create the volume.





What will they look like?

Whichever implant you select, there’s going to be scarring.

“The trade-off for mastectomy and reconstruction is there are scars to the breast,” says Dr. De La Cruz. “We try to keep them hidden. And depending on size and shape of breast there may or may not be different (scar) patterns.” Plastic surgeons can create the look of a nipple, using tattoos to create areolas. But reconstruction is not about getting back the breasts that were lost.

“The goal of reconstruction for most patients is functional and psychological,” says De La Cruz. “They can wear a shirt, they don’t need a prosthesis, they can fill out their bra and feel good in clothing. Psychologically, they've restored what was taken from them. They feel whole again. Those are the goals we hope to achieve.”

Frenzke was after the same goal. “People thought because I was going in for plastic surgery that I would come out looking Barbie-ish.” But she actually chose to go down a cup size. “This was not a cosmetic procedure,” she says. “This was about returning to normal.”



How will they feel?

Will the new boobs feel similar to the old ones? Not at all, says Merit Gest, 43. She opted to have a double mastectomy three years ago after discovering she carried the "breast cancer gene" (BRCA). Though her new breasts look great, she says they have about as much sensitivity as her elbow. “There’s no sensation anymore,” she says. “They’re hard. They’re not as hard as the expanders and they do soften up over time, but you have to sleep differently and they take some getting used to.”



How do I decide whether to get reconstructive surgery or not?

It depends. Women are attached to their breasts, says Susan Glaser, clinical social worker at the Evelyn H. Lauder Breast Center at Memorial Sloan-Kettering Cancer Center in New York City. Some women "have a strong sexual connection to their breasts," says Glaser. "Those that have had children and breast fed certainly have a connection." And older women have been with their breasts longer. But not every woman wants breast reconstruction. “You see young women opting not to have reconstruction,” says Glaser. “So it goes both ways.”

There are emotional, physical and even financial issues that go into making the decision. Molly MacDonald, founder of The Pink Fund (which provides financial assistance to women undergoing breast cancer treatment) opted for a prosthetic instead of reconstruction after one of her breasts was removed. The 43-year-old couldn’t afford the additional insurance co-pays for another surgery at the time. Later, when she did consulted with a plastic surgeon about reconstruction, she learned that to achieve a balanced look her unaffected breast would have to be lifted, and there was a chance of nerve damage and infection. “I decided against it,” says MacDonald. “The risk of infection really concerned me.”

Cambria Russell, 38, made the same decision for different reasons. After finishing treatment for stage 3 breast cancer, she had no interest in more surgery or doctor’s visits. “I wanted my life back,” she says. “And honestly, I miss my breasts, but I don’t think reconstruction would have replaced them.” Russell “goes flat” and doesn’t use any prosthetics. “It honors my experience,” she says. “I had breast cancer. This is part of who I am. I endured. Here are the scars and flat chest as evidence.”



Be comfortable with your choice

Gest says she chose reconstruction for herself, not her husband, who told her he only wanted what she wanted. “But without breasts I would have felt very self-conscious,” she says. “I would have been worried: What is my husband thinking? Am I still sexy? Now, I don’t have any of those issues.”

No matter how perky, firm or full your new breasts are, reconstruction doesn’t erase the reality that you had cancer. “I think at the beginning people are rationalizing: ‘My breasts weren't what I wanted them to be and now I'll have the breasts I wanted,’” says Glaser. “That changes when they realize what they went through. It wasn't elective. This is not cosmetic surgery. This isn't fun. You don't wake up in a resort surgical center and say, ‘Gee I feel wonderful.’ You're in a cancer facility and you've had reconstruction because you're getting treated for cancer.”

Source HERE

Wow what a hard decision to make when your about to undergo a mastectomy.
I couldn't even begin to imagine what you must go through but it is reassuring to know there are options