Let’s add a new doctor to the mix

Yesterday, I had a consultation with a breast surgeon, specifically Dr. Kang. Now that I know I’m getting a mastectomy in a few weeks, I need to make a decision on reconstruction. I met with Dr. Kang mainly to get information on the procedure to help me decide on the best choice.

Dr. Kang laid out a whole series of decisions for me. First off, I need to decide on whether I want to do reconstruction or not. If I do decide to do reconstruction, I then have another set of questions to answer – do I have the reconstruction at the same time as the mastectomy or do I wait until later? Do I use my own tissue or an expander for the reconstructed breast? Do I reconstruct just the right breast (which needs to happen due to cancer) or both?

Dr. Kang couldn’t help me too much on the ultimate decision to reconstruct or not, but he did provide me with lots of information on the process and the other decisions. He recommends reconstruction at the same time as the mastectomy. There are multiple advantages of doing the reconstruction immediately. For one thing, there’s just the single surgery so just one anesthesia and one recovery. It does make the surgery longer, but doesn’t add much in terms of risk. There’s a psychological benefit – you go to sleep with breasts, and wake up and still have something on both sides (not something I’m worried about, but can be important for some people). Lastly, the surgeon can take advantage of the natural landmarks (they look for the inframammary fold) during the reconstruction to create a more natural breast, and the skin is more pliable during the expansion process.

There are two choices for reconstruction – the surgeon can use your own tissue, or an expander. If you use your own tissue, they typically pull fat tissue from your stomach and use skin from your back. It does make for a longer operation, provides another spot to heal, and could result in a hernia or abdominal weakness. If they use an expander, you have to go in for weekly visits to add saline to the expander and stretch the skin over the expander until you’re happy with the new cup size.

Finally, the question of one or two implants. If you only get an implant on one side, it tends to look a bit off over time. For symmetry purposes, it’s best to replace both breasts.

So, now that I have all that information, I have to decide what I want to do.