Step 5: Decide About Your Look After Surgery
You will look different after surgery for breast cancer, especially if you had a mastectomy. Breast reconstruction is surgery to build a new breast shape after mastectomy. Most women can choose whether or not to have breast reconstruction. This decision should be based on your feelings about your body, your sexuality, and whether or not you want more surgery. Some choose not to have extra surgery and may use removable breast prostheses in their bras. Prostheses are breast-shaped pads that are placed in the bra and can be specially fitted for you. They look very natural with all kinds of clothing, including bathing suits, sweaters or dresses.

Breast Prosthesis
A surgeon can perform breast reconstruction at the time of a mastectomy or months or years later. Reconstruction gives a more natural shape when undressed. The new breast will not have any feeling in it when it is touched, and you will have scars. There are several ways to do this surgery. One way to make a breast shape is with an implant made of man-made materials. Another way to make a breast shape is with a piece or flap of muscle and fat from another part of your body, called a flap reconstruction. If you would like to consider breast reconstruction surgery, try to talk to a plastic surgeon before your mastectomy. If more than one operation is needed, ask about the timing.

An implant is a breast-shaped bag filled with silicone gel (a liquid, plastic material) or saline (salt water) that is placed under the chest muscle during surgery. Depending on the size of the implant, the space where it will be placed may need to be stretched out first. A "tissue expander" is put in first to stretch the space. This is a temporary, empty implant bag, like a "baggie." Over several office visits, the doctor slowly fills the implant through a valve until the implant is the right size. It is later replaced with a permanent implant of the same size.

Flap reconstruction uses a flap of your own muscle and fat, which is moved to the chest to build a breast shape. The tissue can be brought from the tummy through a tunnel under the skin (a "TRAM flap"), or from the back (a "latissimus flap"). A nipple shape can be made as well and tattooed on later. This "flap" surgery takes longer to do than implant surgery. It also takes longer to recover from "flap" surgery. Sometimes it is not possible to do this surgery due to a woman's body shape or other medical conditions.

TRAM flap reconstruction