American Society of Plastic Surgeons
For Medical Professionals

Innovation supports women's personal choice for post-cancer breast reconstruction

One in eight American women will be diagnosed with breast cancer at some point in their lives, and when they are, it helps to have choices for breast reconstruction after cancerous tissue removal. Thanks to innovations in surgery, women now have more options than ever when it comes to post-cancer breast reconstruction.

This increase in personal choice empowers the latest generation of women to enhance their post-cancer survival with the type of plastic surgery that suits them best. From implants to flap surgeries, there are a variety of options available.

When she discovered breast cancer in February 2021, Wendy Godinez weighed her treatment options and knew what she wanted the first time she met with her oncologist.

"As soon as I walked in, I told her, 'I don't know exactly what I have, but I want it gone. I want a double mastectomy. I want reconstruction. I want this done. I don't want radiation. I don't want chemo,'" Godinez said.

Godinez, 51, had watched her best friend navigate breast cancer just three months earlier, and with the trail already blazed, she felt she was in a good position to choose her treatment plan before her doctor even laid out the options.

"I think my oncologist was pretty surprised," said Godinez. "I already knew what I wanted to do. And I think she was a little surprised at my determination, that it was what I wanted. I told her, 'I can't go through this again. I only want to do this one time. And my decision was respected.'"

Having options for breast reconstruction

Godinez appreciated having options for reconstructing her breasts and having her decision respected made her feel empowered at a time when cancer made so many other things in her life seem outside of her control.

"I got referred to a local plastic surgery unit. I thought initially I would go in and have implants," said Godinez. "After reading the information that I was given, I made the decision to do a DIEP flap procedure. So on my second appointment, I went in and told them that is what I wanted to do."

Many women opt to have a plastic surgeon implant saline or silicone sacks to replace their lost breast tissue. But Godinez said implants did not appeal to her and instead preferred the idea of using her abdominal tissue to reconstruct her breasts.

"You don't have the coldness of an implant. You have more of your own tissue. You have a more natural look," said Godinez.

Getting DIEP flap breast surgery

The DIEP flap procedure Godinez underwent involved building breasts out of skin and fat removed from her lower abdomen. The removal of the abdominal fat is similar to an abdominoplasty or tummy tuck.

Deep Inferior Epigastric Perforator (DIEP) is an artery that runs through the abdomen. Surgeons preserved this artery for Godinez when they removed a strip of fat and skin from her belly and brought it up to her chest. They used microsurgery to carefully attach arteries in her chest to those of the flap transferred from the abdomen.

"I went to sleep with breasts, I woke up with breasts – I never had to go without," said Godinez. "I thought the idea of being able to have a tummy tuck on top of having my breasts reconstructed really was an attractive selling point for me to be able to get this procedure."

Her newly reconstructed breasts became fully functioning tissue integrated with the rest of her body, and though it takes time, the sensation will eventually return.

"The possibility of long-term sensation returning was something that was really important to me," said Godinez. "Right now, I'm about six months out, so I don't have a lot of sensation. I still feel myself healing, so that's the sensation I have. But, you know, the chances of it returning over the next six months to the next two years is great."

A personal decision

Many women like Godinez face complicated choices about their breasts and how to reconstruct them post-cancer. So much about Godinez's breasts were tied to her sense of self and femininity. And because implants did not feel like the right choice for her, she was grateful that advances in reconstructive surgery meant she could augment her breasts in a way that felt right for her through DIEP flap surgery.

"The thought of using my own body to be able to replace my breast tissue was such an amazing concept to me," said Godinez. "And the fact that you had a tummy tuck out of it was, of course, a bonus."

Godinez's journey through breast cancer and reconstructive surgery has uniquely positioned her to empathize with other women facing a similar path.

"The decision to have reconstruction is an incredibly personal decision. You know, we all have to come around to a decision that feels right for us," said Godinez. "And for me, it was about feeling like a woman again. It was about not being daily reminded that I was a cancer patient. It was about returning to life as normal as I could be. And today, I feel normal. I look normal. No one would know the journey that I've gone because of the reconstruction option."


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