I am about to undergo a mastectomy

Question:
I have been researching breast reconstruction because I am about to undergo a mastectomy. I hear that autologous breast reconstruction is considered the best choice, but I do not really like the idea of taking tissue from another area of my body. I feel like I personally prefer to use the expander and implants, but why this does not seem to be as a popular choice?

Answer:
Actually, tissue expanders and implants are much more commonly performed than autologous tissue reconstructions. I am not surprised though to hear that you think the opposite is true, because autologous tissue reconstruction seems to get more attention in the media. I suppose that’s because it seems more exciting than simply using tissue expanders and implants.

But since you are the patient, I cannot blame you for being more interested in what your best choice is, as opposed to what’s the most exciting. It is true that autologous tissue can get very nice reconstruction, but so can tissue expanders and implants! Autologous tissue is sometimes absolutely required, especially after a patient has had radiation in treating the area of the breast after mastectomy. Other than that, there are usually multiple options. Certainly, the simplest option with the easiest recovery and the least downtime is tissue expander and implants, and that is why most patients chose this. In fact, when done at a time after the mastectomy, all stages of this type of reconstruction can be done as an outpatient. Most patients do stay overnight after mastectomy, though, and having a tissue expander reconstruction at that time usually does not require the patient to stay any longer than the normal one night. Also, there is the ability with tissue expanders and implants to basically choose your size, within some anatomical limits, as the expansion process goes on. In other words, you do not have to commit to a final implant size until the end, particularly in case of doing mastectomies on both sides.

Implants and expanders definitely have downsides such as complications like fluid collections around the implants or even infection, which can require the removal of the expanders. If this happens, it is basically back to stage I six months later. Nonetheless, for most patients, expanders and implants are actually a much simpler and very satisfactory option for most breast cancer patients.