Christina Applegate's Mastectomy: FAQ
Breast Cancer Survivor Christina Applegate Opts for Preventive Double Mastectomy and Breast Reconstructive Surgery
What's involved in breast reconstruction? continued...
Which option to pick? "Oftentimes, it comes down to a woman's preference,"
says Brendan Collins, MD, plastic and reconstructive surgeon at Mercy Medical
Center in Baltimore.
Each approach has pros and cons.
With autologous tissue, you "don't have to worry about potential problems
related to the implant," such as eventually needing to replace it, says
Collins. But it's a longer surgery and recovery process, since two parts of
your body -- your breast area and the place where the fat came from -- need to
heal. And very lean women may not have enough fat to transplant as breasts.
Getting artificial implants for breast reconstruction doesn't happen right
away. First, surgeons typically insert tissue expanders at the time of
mastectomy. The tissue expanders "are like a salt water balloon that's put
underneath the muscle," says Friedman.
Doctors inflate those tissue expanders gradually to stretch the skin and
make room for a permanent salt water or silicone implant. Doing that is an
in-office procedure in which doctors use a syringe to inject more fluid into
the tissue expander, Avisar explains.
That goes on for several months, until the breast reaches the desired size,
and then surgery is done to replace the expanders with permanent implants.
After that, surgeons can create an artificial nipple by raising some of the
new breast's tissue, and then tattoo on coloring to simulate the areola (the
dark area around the nipple). The new breast may also need some cosmetic
How long does breast reconstruction take?
"Give it about a year," says Collins.
For Alvarez, her process took a year and three months. "You have to be so
patient," she says. With all reconstructions, "it takes a long time until you
finally have your final result."
She kept a photographic journal of her progress and shared it with her
colleagues. "I just made it like an educational opportunity. ... We never know
what the patients go through when they leave."
Does it hurt?
Alvarez says she had pain after the mastectomy, but
"the other processes were not as uncomfortable."
After the mastectomy, Alvarez says she was "uncomfortable for about a week
and a half" and did occupational therapy exercises to get her range of motion
What kind of reconstruction is Applegate getting?
She hasn't said. But Good Morning America reports that her
reconstruction will take eight months.
"The majority of patients ... don't go the whole 9 yards," says Avisar.
"Most of them do the first step. Many of them never come back to have the
nipple and areola reconstructed. They are just tired and they have had
Applegate may be different. "She is an actress and may be more aware of her
body," says Avisar.