One woman's story

Breast reconstruction with breast implants: One woman's story
Jane Getting had bilateral mastectomy so she'd never again face a breast cancer diagnosis. Breast reconstruction with implants let her resume the life she loves.

Jane Getting had bilateral mastectomy so she'd never again face a breast cancer diagnosis. Breast reconstruction with implants let her resume the life she loves.

Jane Getting chose breast reconstruction with implants after her mastectomy surgery.

No amount of mental preparation could have blocked Jane Getting's reaction to her first look in the mirror after her bilateral mastectomy. In the split second before she could redirect her thoughts, two words flashed through her brain: "How ugly."

Like most women who develop breast cancer, Jane considered herself an unlikely candidate for the disease She was only 44. She ate healthy foods and enjoyed physical activity — water skiing in the summer, walking her beagles through all four seasons. She never smoked.

But breast cancer usually strikes at random. For Jane, the ordeal started the day she found a lump in her breast.

Firmly convinced that a lumpectomy and a course of radiation would remove her cancer, Jane had scarcely glanced at the breast reconstruction photos her doctor showed her.

But when the planned lumpectomy revealed evidence of cancer throughout Jane's breast, she took a completely different course. She opted to have both the diseased breast and the healthy breast removed. That way, she reasoned, she'd never go through the trauma of being diagnosed with breast cancer again.

One factor in her decision was the availability of reconstructive surgery. In fact, it never crossed her mind not to have reconstruction. For Jane, it was all part of her journey to better health. Also, she felt that breast reconstruction on both breasts at the same time gave her the best odds of achieving breast symmetry.

Choice of techniques: Reconstruction with implantsForgoing

reconstruction and using prostheses — artificial breasts placed in a bra — didn't appeal to Jane. She didn't want to worry about the prostheses moving out of place while swimming or water skiing.

Jane briefly considered a transverse rectus abdominal muscle (TRAM) flap — in which the surgeon takes abdominal muscle and tissue to create a new breast mound. But she dismissed this idea because she didn't want to lose any abdominal strength. Women who have had TRAM flap surgery often experience diminished abdominal strength after surgery because the surgeon constructs the new breast using part of a major abdominal muscle. TRAM flap surgery can lead to difficulty in lifting and performing daily tasks, depending on how much muscle is taken. For Jane, this wasn't a risk worth taking. "I was way too active," she said.

Instead, Jane opted for breast reconstruction using permanent breast implants. This method usually requires multiple surgeries. Initially, a surgeon inserts tissue expanders, which are temporarily used to gradually stretch the skin and underlying tissues. Several weeks later, the surgeon removes the tissue expanders and inserts the permanent implants.

For Jane, preparation for breast reconstruction started with the mastectomy. Jane's surgeon took care to make both surgical sites as similar as possible. The surgeon performed the mastectomy on her diseased breast and then removed an equal amount of skin and tissue from her healthy breast. This gave the plastic surgeon equal areas to work with and gave Jane the best odds for symmetrical appearance and a good cosmetic outcome.

Tissue expansion: Gradual, sometimes uncomfortable process

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Tissue expansion

A few weeks after her mastectomy, Jane began the first step toward reconstruction — tissue expansion. At the end of her mastectomy surgery, her plastic surgeon placed saline tissue expanders under her chest muscle.

"You couldn't tell that by looking at me, of course," Jane said, "but they were there. I was flat as a board, but I could feel the expanders beneath my skin."

Having the tissue expanders in place when she woke up from surgery didn't affect Jane's post-surgical care. Initially, the tissue expanders weren't uncomfortable in themselves.

Tissue expansion involved weekly visits to her doctor to have the expanders filled with saline. This was an accelerated pace for expansion — many women opt instead for two- to three-week intervals for the expansion injections. But Jane wanted to be done as quickly as possible. As long as she could tolerate the discomfort associated with each expansion visit, her doctor agreed to the schedule.

The drawbacks of more rapid tissue expansion included the potential for stretch marks on the breast skin and discomfort during the process.

For many women, there is some discomfort associated with the tissue expansion process. Jane experienced pain that typically peaked one to two hours after her tissue expanders were filled, and tenderness and discomfort that continued for a few days afterward. The pain and discomfort Jane experienced were due in large part to her accelerated tissue expansion process. For Jane, the entire process took only eight weeks, and she avoided developing stretch marks.

Breast implants and nipple reconstructionEventually, Jane had surgery to remove the tissue expanders and place her permanent implants. The surgeon used the scars from her mastectomy surgery to make the incisions, so Jane has only one set of scars. The scars run horizontally across Jane's breasts not quite the entire width.

A few weeks after getting her permanent implants, Jane underwent nipple reconstruction. Nipple reconstruction concealed her scars to a certain degree. After two tattooing sessions to color the skin surrounding the new nipples, Jane's breast reconstruction was complete.

Jane realizes that she'll need to have her implants replaced at some point, for instance if she develops troublesome scar tissue or if an implant ruptures. And that means another surgery. "But I'm OK with that," she said. "I knew going in to the surgery that they would need to be replaced." Although she plans to wait on that decision until she's faced with it, Jane anticipates that she will have her implants replaced.

Getting used to a new self

There are a few things that Jane's more aware of after breast reconstruction. She massages her breasts daily, which helps keep the tissue loose and prevents capsular contracture — a buildup of fibrous scar tissue that constricts the space where the implants are located.

Jane also pays attention to heat and cold, and the effect they can have on her breasts. Because she has less sensation than she used to, she takes care not to burn herself, for instance from cooking splatters. She also bundles up in cold weather. The thin layer of skin and muscle covering her breast implants doesn't offer much blood flow to keep the tissue warm. This increases her risk of frostbite and tissue damage if she gets too cold.


Life after breast cancer: Better than everLife has settled back into place for Jane. She's up to speed at work, and she's returned to her active lifestyle. In fact, on the one-year anniversary of her breast cancer diagnosis, Jane marked the occasion by participating in a three-day, 60-mile breast cancer walk. She's back on water skis, too.

Her breast reconstruction complete, Jane has returned to her passion — water skiing.

Jane has no regrets about her decision for mastectomy and breast reconstruction. Despite going through the anxious and traumatic ordeal of having breast cancer, Jane now focuses on the positive things that have come from her experience. Drawing on this in her role as a physician's assistant, she's better able to counsel her patients who have breast cancer.

"I've walked in their shoes. I know what it feels like. It's so rewarding to be there for them and to reassure them. It's one of the greatest gifts from something horrible that came into my life."

Editor's note: Since first sharing her story in 2005, Jane remains very happy with her choice in breast reconstruction. Her nipple tattoos faded somewhat, so she repeated the tattooing process, but she learned this is common in nipple reconstruction. Jane's enjoying her active lifestyle and thankful for her good health.