Can a reconstructed breast look like a normal breast?

Does the timing on when I choose to have breast reconstruction surgery done influence the aesthetic outcome? Is it better if I choose to do it at the same time as the mastectomy? Going through breast cancer is a terrible enough experience; I don't want to look at my breasts and be reminded of what I went through. That's the main reason I want my breasts to look normal again. Is this realistic?


F, 50, California

Tags:woman age 45-54 breasts natural looking mastectomy

Hi.  There are so many different variables that affect the outcome in breast reconstruction, and each one is specific to each individual person.  But, in general, there is usually a better outcome when the first stage of the reconstruction is done at the same time as the mastectomy.  The skin is normal at that time, and if done later, then the skin may have areas of irregularities.  It is realistic to expect that you should achieve an excellent outcome from breast reconstruction, especially if you go to a plastic surgeon with a lot of experience and a good reputation.  But, even the best reconstructed breast doesn't look exactly like a "normal" breast, so there will be a few differences.  These are typically not visible in clothes.  Definitely go for a consultation with a surgeon or surgeons who can give you a more detailed answer after they can see what you look like, and that way you can have a more realisitic idea of what to expect.  Best of luck!

These are great questions.  25 years ago, the standard of care was to have the mastectomy first and then get a delayed reconstruction later on.  Today, that is no longer the case.  Most reconstructions nowadays occur at the time of the mastectomy (or at least the first stage of the reconstruction).  There is a psychological benefit to having the process start earlier.  From a reconstructive standpoint, there is also the advantage that tissues that would otherwise be discarded at the time of the mastectomy can be used for the reconstruction when it is started at the time of the mastectomy.  

With respect to the appearance of the reconstruction, advances in techniques in the past 10-15 years have resulted in reconstructions that are very natural and often look better than preoperatively.  There are two main options - using your own tissues, which primarily come from your abdomen if you have enough tissue; or using implants.  Both are excellent options.  I strongly suggest you consult with a board certified plastic surgeon with extensive experience with breast reconstruction procedures.   Good luck!