To Reconstruct or Not?

If the first stage of a mastectomy (or indeed a lumpectomy in many cases), is to surgically dismantle the breast then it follows that the second stage is to reconstruct it again. Or is it?

The decision to reconstruct is a complex and deeply individual one with many factors to consider.

There are various options available for breast reconstructive surgery, some of which start during mastectomy and can include additional procedures post mastectomy.

Viability for surgery most often depends on a patient’s type of cancer and treatment plan or even the side effects of a patient’s treatment. But it also depends on her circumstances. A women’s entire breast reconstruction surgery is not always covered by medical aids in South Africa and can be an expensive and lengthy process.

Some women don’t feel they can face more surgery.

Some feel guilty for putting their families and possibly employers through another period of lessened productivity and recuperation.

Others are sure that reconstruction is the clear path for them, and involve a plastic surgeon from the first talk of surgery.

Still others hold off on deciding for a while, seeing instead how they, and their bodies, adjust to life without breasts before deciding whether to get new ones.


Sure or unsure, many women are surprised to find appointments with plastic surgeons and discussions around reconstruction to be intimate and discomforting. Some say they were able to talk about their breasts quite objectively while undergoing treatment, but discussing the size and shape of their new nipples with a surgeon feels much more personal.

Many are stumped by the question: ‘How would you like your new breasts to look?’

‘Like they did before,’ is generally the most common answer.

And possibly this is the biggest factor to consider. Are we doing it because we want to reconstruct the ‘Before’? Will straightening the furniture and re-hanging the drapes help us forget an earthquake passed through?

Will new breasts help us heal?

Recommended reading:

Have you had reconstruction? Decided against it? We’d love to hear your views.

Later this month we will tell the story of someone who chose reconstruction. Would you like us to tell the story of your choice? Send an email to


4 thoughts on “To Reconstruct or Not?

  1. Hello! Hello! Great initiative with the Blog. I am one of those women referred to in the writing above – that “Some women don’t feel they can face more surgery.” I dread having to go through another surgery. Some fellow survivors shared that their reconstruction surgery was painless – post the procedures, One has some disappointment which she has not been able to explain what the disappointment is actually about, but she just doesn’t encourage it. Almost 3 years since I had the mastectomy, I am still undecided whether to reconstruct or not. I am sure it would have some psychological benefit for me, being a young woman, as my surgeon encouraged from the onset. I am still going through the ups and downs. xxx

    1. Mashego you the only one that should make that decision. I think if you comfortable with only one breast then great for you. If you feel you tired of wearing a prosthetics silicone or softie then move or rise above all the pros and cons about reconstruction and trust your medical team and go for it.

      I had a bilateral mastectomy at 42 and I am 50 this year and enjoying my breasts, love my body. And let me tell you my experience post reconstruction was not like others who shared their experience with me. I know it’s three years later but remember the surgery this time is not to remove the cancer but to reconstruct your flat chest. So look forward to that my dear.

      Go for it!!! It’s your body !!!!

    2. Thank you for your response and I think a very valid one!
      No need to make a hasty decision take your time and do the operation if and when you feel really convinced that you are ready for it . Your mind-set and emotional wellbeing is much more important than having surgery that you are not yet ready for. You know yourself and your needs the best and will know when the time has come if ever. If you have real concerns on an emotional level you might consider going for some counselling to assist with the processing of the emotional roller-coaster you have been trough since your diagnosis with cancer and then re assess where and what you needs are in terms of the way forward . Do not let anybody bully you into any procedure you take control of your journey with cancer and do it your way !!
      You are in charge of creating meaning and adjusting to your cancer journey your way and your healing will only take place at your own pace so take it slow ….and sing your own song!

      1. Hello…I’m very happy to have read this cause myself, was diagnosed with a breast cancer in April 2013. Had a lumpectomy in May and am going for my 6th and hopefully last chemo treatment on October 21, 2013. Since the day I was diagnosed, my first initial thought was to have a full mastectomy, but my surgeon discouraged me to do so as I was too young (41) and should keep my breasts, etc. So I didnt push it. As it remained in my mind, I talked to my oncologist about it during my last visit and he highly recommended it. My husband and I were really surprised. So I gave him the ‘green light’ to go ahead and start the procedures for a bilateral mastectomy with reconstruction. My gut feeling tells me to go for it and when I think about it, I get a happy feeling. I am not afraid of surgeries so that doesn’t worry me. So I’m gonna ‘sing my own song’ and go for it!! Thank you! 🙂

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