Breast Reconstruction After Mastectomy

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Preparing for breast reconstruction surgery

Your surgeon can help you know what to expect from your breast reconstruction surgery and be as prepared as possible. You should have realistic expectations of how your body will look and feel after surgery, and understand the benefits and risks of the type of reconstruction you are having. Increase your chances for a successful outcome by following your surgeon’s instructions carefully.

Knowing what to expect

As you prepare for breast reconstruction surgery, talk to your surgeon about what to expect. Breast reconstruction can make you feel better about how you look and renew your self-confidence, but keep in mind that the reconstructed breast will not be a perfect match or substitute for your natural breast. If tissue from your tummy, shoulder, or buttocks will be used, those areas will also look different after surgery. Talk with your surgeon about surgical scars and changes in shape or contour. Ask where they will be, and how they will look and feel after they heal.

Your surgeon (or other doctors involved) should explain the details of your surgery, including:

  • The drugs (anesthesia) that will be used to make you sleep and not feel pain during the surgery
  • Where the surgery will be done
  • What to expect after surgery
  • The plan for follow-up
  • Costs

Understanding your surgery costs

Health insurance policies often cover most or all of the cost of reconstruction after a mastectomy, but this might not always be the case if you have reconstruction after breast-conserving surgery or lumpectomy. Check your policy to make sure you are covered, and find out what portion of the bill you’ll be expected to pay. Also, see if there are any limits on what types of reconstruction are covered.

Make sure your insurance company will not deny breast reconstruction costs. Your surgeon may be able to help you with this if your insurance plan wants to deny coverage, so be sure to ask. It may take some time and effort, because, in the past, health plans have denied coverage for certain reconstruction procedures despite federal laws that require coverage in most cases. They often reverse such decisions on appeal.

Getting ready for surgery

Your breast surgeon and your plastic surgeon should give you clear instructions on how to prepare for surgery. These will probably include:

  • Help with quitting smoking if you’re a smoker
  • Instructions to take or avoid certain vitamins, medicines, and supplements for a period of time before your surgery
  • Guidelines on eating and drinking before surgery

Plan to have someone take you home after your surgery or your stay in the hospital. You may also need them to stay and help you out for a few days.

Where your surgery will be done

Breast reconstruction often means having more than one operation. The first creates the breast mound. This may be done at the same time as the mastectomy or later on. It’s usually done in a hospital.

If follow-up procedures such as filling expanders or creating the nipple and areola are needed, they may also be done in the hospital, or they may be done in an outpatient facility. This decision depends on how much surgery is needed and what your surgeon prefers, so you’ll need to ask about this.

What kinds of anesthesia are used?

The first stage of reconstruction is almost always done using general anesthesia. This means you’ll be given drugs to make you sleep and not feel pain during the surgery.

Follow-up procedures may only need local anesthesia. This means that only the area the doctor is working on will be made numb. A sedative drug may also be used to make you feel relaxed but awake. You might feel some discomfort.

Be aware of the possible risks

Certain risks go along with any type of surgery, and breast reconstruction may pose certain unique problems for some women. Your surgeon will go over the possible risks of reconstruction surgery with you. Be sure to ask questions if there’s anything you’re not sure about. For more on the possible risks after surgery, see “What to expect after breast reconstruction surgery.”


Last Medical Review: 12/05/2014
Last Revised: 04/25/2016