The Pros and Cons of Prophylactic Mastectomy

Woman considering prophylactic mastectomy pros and cons
Considering a prophylactic mastectomy is no small choice. If you have a high risk of developing breast cancer because of family history, genetic predisposition, or other factors, then you may be considering preventative surgery.  Prophylactic mastectomy and ongoing surveillance are the two main options for those who are at high risk of developing breast cancer. Arm yourself with the pros and cons of prophylactic mastectomy before deciding which option is right for you.

Getting a Prophylactic Mastectomy: Pros and Cons

For high-risk individuals, one way to regain a sense of comfort and control can be through choosing a prophylactic mastectomy and reconstruction. Continuously monitoring and waiting to see if and when cancer develops causes a considerable amount of stress. Over time, that sustained stress can negatively impact your overall physical and mental wellness, leaving you vulnerable to illness and injury. Increasingly, brave women everywhere are choosing to forego living in wait by eliminating their risk of developing breast cancer altogether.  While it might seem strange to undergo surgery for a problem that hasn’t occurred yet, preventative surgery may be the safest and most proactive decision for those who are at high risk of developing breast cancer. Like all surgeries, prophylactic mastectomies have pros and cons for undergoing the procedure, which are listed in the table below.

Prophylactic Mastectomy Pros and Cons

Pros Cons
  • Almost total risk reduction for developing breast cancer
  • More convenient
    • Fewer appointments for ongoing monitoring
    • Fewer surgeries
  • Psychological benefits
    • Lower anxiety about developing breast cancer
    • Increased sense of autonomy and control
  • Better aesthetic outcomes
  • No emergency rush to decide treatment
    • Can plan surgery with the outcomes in mind
    • Can select the plastic surgeon of your choice
  • Surgical Risks
  • Recovery time
  • Temporary loss of sensation
    • Can be restored with additional “resensation” surgical techniques
  • Impact on body image
  • Emotional and psychological effects
    • Acknowledging you’re at high-risk of developing breast cancer and removing your breasts can be a very difficult process for women

Reconstruction Options After Prophylactic Mastectomy

Most women considering prophylactic mastectomy opt for an immediate reconstruction. When your breast surgeon and plastic surgeon are working in conjunction, you are able to undergo the mastectomy and reconstruction during the same operation, saving you time and effort.  One of the immediate pros of reconstruction after prophylactic mastectomy is that you can plan your surgery starting with your desired outcomes. You and your plastic surgeon can discuss which reconstruction options will work the best for your lifestyle and desired aesthetic outcomes. Surgical and reconstruction options following prophylactic mastectomy include:

Options for Prophylactic Mastectomy and Reconstruction

Surgical Options Reconstructions
Nipple Sparing Mastectomy Implant Reconstruction
Skin Sparing Mastectomy Autologous Flap Reconstruction
Aesthetic Flat Closure Areola Reconstruction
Nipple Reconstruction

Choosing the Best Plastic Surgeon for Your Prophylactic Mastectomy

Another pro of prophylactic mastectomy is the ability to consult with a plastic surgeon as a first consult without the urgency of a cancer diagnosis, which requires rapid decisions. You have time. Ultimately, understanding the details of the reconstructive surgery and the possibilities of aesthetic outcomes can be empowering in the process of making a decision about prophylactic mastectomy. You can find the best surgical team and understand the details of your insurance coverage, which usually will cover prophylactic mastectomy and reconstruction in cases of genetic predisposition to breast cancer or other markers of high risk.  You should look for a plastic surgeon who meets all of the following criteria:

Have You Considered All of the Prophylactic Mastectomy Pros and Cons?

Harris Plastic Surgery is here for you. If you have more questions or want help walking through each step of the process, we can help. 

Our goal is to empower women who are faced with the difficult decisions surrounding breast cancer risk, diagnosis, and treatment. Wherever you are in the process, we have the resources and experts to help you feel comfortable and secure in your choices. 

Contact us online or by phone/text message if you have questions or are ready to schedule your consultation. 

Stephen U. Harris, MD FACS

Dr. Stephen U. Harris is a board-certified cosmetic surgeon and recognized expert in breast reduction and reconstruction surgeries, having performed thousands in his career. When it comes to patient care, his philosophy is that every surgery should improve his patient’s overall quality of life, not just their appearance. Dr. Harris stays up-to-date on all the latest advancements in breast augmentation, reconstruction, and reduction and is a recognized innovator in the field. In fact, he was the first surgeon at Good Samaritan Hospital to offer primary prepectoral implant breast reconstruction, as well as secondary prepectoral revision surgery.

Dr. Harris also serves as Chief of Plastic Surgery at Good Samaritan Hospital in West Islip, New York and is an active staff surgeon (and former Chief of Plastic Surgery) at South Shore University Hospital in Bay Shore, New York.

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