There is more than one path forward after risk-reducing breast surgery

By the time you've had risk-reducing breast surgery, you've already made many important decisions. For some women, that includes choosing to have breast reconstruction at the same time as their surgery. Others decide to wait until they've healed before considering reconstruction, while some choose not to have reconstruction at all. Every one of these choices is valid.

"The best choice after risk-reducing breast surgery is not the one that meets other people's expectations," says Professor Carol Benn, Specialist Breast Surgeon and Breast Disease Specialist. "It's the one that is medically appropriate, well informed and feels right for the woman herself."

Understanding your options

If you've already had reconstruction, your body will continue to heal over the weeks and months ahead. Swelling will settle, your scars will continue to heal and the shape of your reconstructed breast will continue to change. It takes time before you see the longer-term result.
Some women choose delayed reconstruction instead. This means they don't have reconstruction during their initial surgery but may decide to have it months or even years later. Waiting can give you time to recover physically and emotionally before making another decision.
When the time feels right, your surgeon can talk you through the options available to you. Reconstruction may involve an implant, your own tissue from another part of your body, or a combination of both. Some women also choose procedures such as nipple reconstruction or medical tattooing later on, depending on what is suitable for them.
Delayed reconstruction isn't the right choice for everyone. Some women decide that they don't want any further surgery after their initial recovery. Others feel more comfortable taking extra time before making another decision.
Some women choose not to have reconstruction at all. This is often called choosing to remain flat. It is an active, considered choice - not the absence of one.
"Choosing to remain flat is not a lesser option," says Prof Benn. "For some women, it gives them the greatest sense of comfort, confidence and control."

You don't have to decide everything now

If you've delayed reconstruction - or you're simply unsure what you might want in the future - remember that you don't need all the answers today. Your priorities may change as you recover.
If you're considering reconstruction in the future, it may help to think about what matters most to you.
You might want to ask questions such as:

• How much more surgery am I comfortable having?
• How important is breast shape or symmetry to me?
• How might further surgery fit into my work, family life or other commitments?

Your surgeon can help you understand the benefits and limitations of each option so that you can make an informed decision when you're ready.
The first few days after surgery are about healing safely. Decisions about further surgery, prostheses or other options can often wait until you're physically stronger and emotionally ready to consider them.
"You do not have to decide how you will feel about your body forever in the first few days after surgery," says Prof Benn. "The first task is to heal safely. The rest can be approached one step at a time."

Comfort comes first

In these early weeks after your surgery, focus on what helps you feel comfortable.
Soft, front-opening clothing can make dressing easier while your movement is limited. If your surgeon has recommended a post-surgical bra or compression garment, wear it as instructed.
If you haven't had reconstruction, you may later decide to wear an external breast prosthesis. Some women wear one every day, some only on certain occasions, and others choose not to wear one at all. Again, there is no right or wrong choice.
Ask your healthcare team when it is appropriate to be fitted for a prosthesis and which type may suit your recovery. There are different types available, including soft prostheses for the early weeks after surgery and silicone prostheses that are usually fitted once healing is further along.

Give yourself time

Whether you've had immediate reconstruction, delayed reconstruction or have chosen to remain flat, remember that your body - and your feelings about it - may continue to change over time.
There is no deadline for feeling comfortable in your body or with your decision.
"The way forward isn't about choosing the option that someone else thinks is best," says Prof Benn. "It's about finding the path that allows you to feel comfortable, confident and at peace with your own decision."
Whatever path you've chosen - or choose in the future - it deserves respect. Right now, your only job is to give yourself the time and space to heal.