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    Christina Applegate's Mastectomy: FAQ

    Breast Cancer Survivor Christina Applegate Opts for Preventive Double Mastectomy and Breast Reconstructive Surgery

    What about the emotional aspect of the decision?

    "It is a difficult decision and an emotional decision, and it is not that simple to decide to lose your breast," says Avisar.

    Alvarez says she took her time before choosing preventive double mastectomy. For her, breasts were "such a part of being a woman, so there [were] a lot of emotional factors" to consider.

    "Little by little, I just went through the options," she says. One by one, she ruled out her other choices and felt that after mastectomy, she would "be able to live my life peacefully and life goes on."

    Alvarez also said it helped that she works on a floor of Mercy Medical Center where women recover from mastectomy and breast reconstruction, so she knew what to expect. She also had seen women be upset by their appearance immediately after mastectomy.

    "They just don't want to look at themselves ... it's an extremely difficult experience," says Alvarez. "I never really had a problem with that only because I knew what that was going to be like."

    What's involved in breast reconstruction?

    The first step is creating the breast or breasts, which can be done in two ways:

    • Option No. 1: Transplant your own fat [autologous tissue] from the belly or elsewhere in the body and implant it where the breasts were.
    • Option No. 2: Get saline or silicone implants.

    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.

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