Some would argue that the only real function of the breast is to provide milk for the newborn. Since there is no reconstructive technique capable of meeting this criteria there are those who would argue that breast reconstruction is cosmetic. A second and very important function of the breast is to provide a normal appearance of symmetry. Although none of our paired features are perfectly symmetrical we expect to see in others and to feel and see in ourselves an overall sense of visual balance. When this is lacking the eye is immediately alerted. Patients who seek breast reconstruction after experiencing loss of the breast often cite a feeling of asymmetry or a lack of "wholeness." Each patient's motivation may be different but their goal is to restore a symmetrical appearance and feel which for some women cannot be obtained with an external prosthesis.
TIMING OF SURGERY
Current figures indicate that 12% of women alive today will develop breast cancer. The discovery of a possible tumor on mammogram, by self-examination, or during exam by a health care professional is a very frightening experience. The patient must make a number of decisions at a time when the term stressful situation seems an inadequate expression. Some women may find it difficult or impossible to make a decision about the type of breast reconstruction which might suit them best. Other patients may have thought about this decision, at least in the abstract, or may feel comfortable in making a decision despite the stress of the situation. The main advantage of a delayed reconstruction is that the patient has more time to consider her options. Some, who weren't certain prior to mastectomy, may find that the external prosthesis meets their needs and can then avoid the longer operation and anesthetic associated with immediate reconstruction. Many will later choose a procedure recommended by the plastic surgeon and will be more confident of their choice.
The patient who chooses immediate reconstruction must make the decision at a time of great stress but for some patients the idea of waking up with a breast mound relieves much of the stress surrounding the mastectomy. While some reconstructions can be completed in a single procedure, many techniques may require two or more operations for completion of the reconstructive process. The plastic surgeon will discuss this in detail during the initial consultation. Excellent results can usually be achieved by either immediate or delayed reconstructive techniques.
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