The Road To Breast Reconstruction: Understanding Your Options

In 2009 when I was facing a breast cancer diagnosis and a double mastectomy there was one silver lining in my dark cancer cloud: I could choose to have my breasts reconstructed. "Choose" is an important word with a cancer diagnosis because none of us choose to have cancer. But we face many choices for surgery, treatment and reconstruction.

If you are having a mastectomy, ask your breast surgeon if your nipples can be preserved and if breast reconstruction is an option for you. Meet with a breast reconstruction surgeon to review different procedures and decide when you want to reconstruct. With many patients, and in my case, breast reconstruction surgery can take place immediately after the mastectomy.

The 1998 Women's Health and Cancer Rights Act (WHCRA) requires group health plans, health insurance companies to provide coverage for breast reconstruction surgery.

Breast reconstruction is safe, and you can choose the type of that may be best for you physically and emotionally.

Breast Implants are the most common procedure for reconstruction. After your mastectomy the reconstructive surgeon implants tissue expanders in your chest wall. Every few weeks your surgeon will inject a solution into the breast mound to fill the expander and prepare you for the "implant exchange." Separate procedures involve creating areola and nipples through surgery or tattooing the area. 3D tattooing of the areola and nipples is a nice non surgical option with natural looking results. Breast implants will not have the sensitivity of a natural breast. And they can be temperature sensitive. Yours may feel cold or clammy after a swim!

Natural "Autologous" Tissue Breasts are rebuilt from fat, tissue, and sometimes muscle from another part of your body, such as your abdomen, back, buttocks, or inner thighs. It is a more invasive surgery that takes place following your mastectomy unless you are delaying reconstruction. This is a nice, natural option if you have enough body fat to form new breasts. An added bonus is the effect of a tummy tuck once fat is removed from your abdomen. Plan for a longer recuperation period and expect additional surgical scars. Natural tissue breasts change size if you gain or lose weight, and you will regain some sensation in your breast.

Autologous Fat Transfer employs needles similar to those used in liposuction to transfer fat to the breast from another area of the body to create a breast mound. Several injections are required to build up the area. Autologous fat transfer has also been used to fill in breasts after lumpectomies and to fill out uneven areas after implant surgery.


BRA Day USA (October 16) is an initiative by the American Society of Plastic Surgeons (ASPS) and the Plastic Surgery Foundation "to promote education, awareness and access regarding post-mastectomy breast reconstruction."

Breast cancer survivor Melanie Young is author of the new book "Getting Things Off My Chest: A Survivor's Guide To Staying Fearless and Fabulous in the Face of Breast Cancer" (Cedar Fort Inc.) Available online at and


Melanie Young

Melanie is a Cancer Survivor, SHARE Supporter, and the Author of Getting Things Off My Chest: A Survivor's Guide To Staying Fearless and Fabulous in the Face of Breast Cancer.