Breast Cancer Health Center

Christina Applegate's Mastectomy: FAQ

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 adjustments.

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 back.

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 enough."

Applegate may be different. "She is an actress and may be more aware of her body," says Avisar.