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Why Breast Reconstruction Is Not A “Boob Job”

There are many reasons why breast reconstruction is NOT a boob job. This particular post is an attempt to cover just one of these reasons. Breast reconstruction is not a boob job because quite literally – breast reconstruction is not a boob job.

I’m stating and then restating the obvious to make a point; breast reconstruction and “boob jobs” are very different procedures done for very different reasons.

Seems like a no-brainer, right?

Well then, why do so many women facing mastectomy decisions (including prophylactic) keep hearing things like, well at least you’ll get to have a “free” boob job.

Yes, getting new “permanently perky reconstructed breasts” is still too often portrayed as an amusing, even fun “benefit” of breast cancer.

Of course, reality is quite different isn’t it? For a dose of that, click here.

I hate to admit it, but even I got caught up in this misguided thinking. And it is misguided.

I remember very clearly a stupid offhand comment I made to dear daughter one day shortly after my cancer diagnosis during that time of appointment frenzy that went something along the lines of:  well, at least maybe I’ll get better boobs out of this mess. Shame on me, right? The really odd thing is, I don’t care much for the word boob and I never use it. Well, almost never. That whole conversation was very weird and out of character for me, but then again, so was/is cancer.

Clearly that comment was way off base, further off than I ever could have imagined back then. Clearly I was trying too hard to make light of a not-at-all-light situation. Clearly I was over-compensating for some crazy reason. Clearly I was under-informed. Clearly I was so wrong!

Most clearly of all, I was masking my true feeling at the time – fear. And let me tell you, I was darn scared.

I have heard comments from time to time about this “free boob job benefit” that supposedly often accompanies a breast cancer surgery, or a prophylactic mastectomy as well. I’ve even heard a few (very few) women who’ve had breast reconstruction state publicly that they like their new breasts better. Hmm….seriously?

I can’t fathom such a thing.

I do not feel that way. At all. I miss my originals. A lot.

Correct me if I’m wrong, but the term “boob job” more often than not, means breast augmentation. (Because bigger is always better, right? Wrong! More on that later). However, it can also refer to breast reduction or a breast lift. I have a friend who has done augmentation. I also have a friend who has had breast reduction. Choosing either procedure is a very personal matter and nobody else’s darn business.

There still seems to be considerable confusion for some about the differences between a “boob job” (going with augmentation assumption here) and breast reconstruction.

The purpose of this particular post is to clarify the basic differences between these two very different procedures.

What exactly is a boob job breast augmentation?

Please keep in mind I’m attempting to keep both of these explanations brief, but accurate.

The American Society of Plastic Surgeons states the definition of breast augmentation, or as it’s clinically referred to, augmentation mammaplasty, on their website to be the following:

Breast augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts.

Breast augmentation is usually an outpatient surgery. It’s a cosmetic procedure with immediate results. The scars are in most cases pretty undetectable, there are generally few complications and recovery time is usually complete after a few weeks.

Without minimizing the procedure (it is surgery after all), it is quite different from breast reconstruction following a mastectomy.

What is breast reconstruction?

The same website describes breast reconstruction with the following statement:

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy. Although breast reconstruction can rebuild your breast, the results are highly variable.

The two definitions do a pretty good job explaining the differences, especially if you read between the lines a bit.

Though often times breast reconstruction is done immediately following mastectomy, the entire process from beginning to end can still take months. Even with immediate reconstruction (utilizing most common implant option) at the time of the mastectomy, temporary tissue expanders are put in place first and then filled slowly over weeks and even months allowing the skin to stretch slowly and somewhat less painfully. At the determined time, another surgery follows during which the expanders are removed and implants are put in place.

Sometimes reconstruction is delayed for months, even years for various reasons such as more pressing cancer treatment, side effects, radiated skin damage issues, personal choice and others.

And of course, some women choose not to do reconstruction at all. All choices women make about their own bodies are personal matters and need no further judgment by others. This cannot be stated often enough IMO.

In addition to implants, there are other various surgical options available for reconstruction such as DIEP, Latissimus Dorsi, TRAM, TUG and GAP flap techniques. These procedures are even more complex and carry greater risk for complications. After reconstructing the “basic” breast(s), there are options for nipple reconstruction as well, which of course require a woman to consider further surgery, more risk, additional expense and still more recovery time. And then there’s the tattooing option…

In short, compared to breast augmentation, breast reconstruction is a far longer and much windier road. It’s more risky, requires considerable more recovery time, carries potential for more complications (which can and sometimes do arise) and again, the results are highly variable.

Of course along with the breast reconstruction, there is often additional cancer treatment to deal with, not to mention the unilateral or bilateral mastectomy itself. And women who choose prophylactic mastectomies deal with the same issues, minus the cancer treatment parts of course. Choosing this option is their attempt to avoid those parts. Again, no judgment needed. Regardless, it’s a lot to throw at any woman.

So breast reconstruction following mastectomy sure as heck is no boob job, not even close. 

Have you ever heard the comment, “Well at least you get (got) a free boob job”?

How do/did you react to such a remark? 

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45 thoughts on “Why Breast Reconstruction Is Not A “Boob Job”

  1. I heard a lot of comments about “getting a free boob job” when I was first diagnosed. And people seemed to think it was so “easy.” Just take out the cancer and slide in an implant. Oh the false ideas. So many people can’t seem to understand why I couldn’t get immediate reconstruction. When I try to explain I will have to get DIEP (because of radiation) and what that will entail, they go, “oh, good, you get a tummy tuck, too.” What part of major surgery do people not understand?

    1. Elizabeth, Oh, I had to chuckle when I read these words you wrote, “Just take out the cancer and slide in an implant.” LOL! But of course it’s not really funny at all is it? And yes, the tummy tuck comment, that’s another doozie. Thanks for sharing.

  2. That’s the whole part of the misconception with Breast Cancer. There are so many things about this disease that are misunderstood. Breast reconstruction one of them. During the time post surgery and during Chemo i did quite a bit of reading to see if it was an option for me. I am satisfied with my decision. Of course I miss having breasts but not to the degree of undergoing so many surgery procedures.. Then the potential of infections and not looking right was also a factor. I have had those same comments levied at me. It’s a very personal choice you do it or not for yourself not based on opinions of others who just have no idea…..Alli xx

    1. Alli, You’re so right. Lots of misunderstanding is out there. I’m so glad you feel satisfied with your decision. Sometimes facing more surgeries is just too daunting for many reasons. Reconstruction is not for everyone and it’s too bad some who opt out are forced to explain themselves.

    1. Cancer Curmudgeon, I know, right? Even on the plastic surgery sites, they make statements which make it pretty clear there is confusion about what these surgeries are all about. And you’re so right about those expectations that are out there. It’s all about personal choice – or should be. Thanks for sharing your thoughts.

  3. I had a few people say things to me like “Well, at least your mom will ‘get’ a new set.” One person even added, “That will be nice. Is she going to go bigger? Might as well.”

    They are trying to make light of the situation and really do mean well, but it’s still insensitive.

    1. Lindsay, So now I’m wondering what you said as a comeback… Let’s just say I wish I still had my old set. And bigger is not necessarily better. I plan to write a post on this at some point… Thanks for sharing those comments you heard. And yes, generally people do mean well, but still…

  4. Very well said, Nancy. Although I didn’t have a mastectomy, as an advocate I try and explain all options available. You’ve done a great job in clarifying something that really needed to be clarified!!

  5. I heard this all too often and I ALWAYS made it very clear to people that this was NOT something I would ever in the world have decided to do and that it was NOT in any way “like a boob job.” I was in your camp, never wanted any boobs other than the 2 I had, never ever wanted to do anything to change or enhance them. But then you get breast cancer and all of those decisions change. Thanks for the very honest post on how it really is. xo

    1. Claudia, Good for you for always setting people straight. I wasn’t as on top of things when I started all this… Let’s just say, I know better now. Thanks for your comment.

  6. Wow Nancy. I related to everything in this post. Like Diane Mapes in the article “Breast Cancer is not a Boob Job”. I too had many complications from a radiated breast and a bilateral mastectomy. I’ve had 8 breast surgeries including a botched lat flap and I still need a few more. I do miss the real ones so much. Thank you for saying so much of what I am feeling and thinking. Hugs and xoxo- Susan

    1. Susan, I’m sorry you relate so well. And gosh, that’s a lot of surgeries you’ve had. I included the link to Diane’s article in my piece. I loved it. Thanks for sharing.

    1. Eileen, That’s a good one. I sure could have done without this “prize”. Thanks for reading and commenting. Thinking of you this holiday season – the first without your mom.

  7. I haven’t had to endure breast cancer, but I think anyone who would make such a remark as “at least you’ll get new boobs” is completely insensitive. It’s also a commentary on our society that the appearance of one’s breasts is valued more than that person’s health and survival. Similarly, larger people who get cancer are often told awful things like “well, at least you’ll lose some weight now.” Our society is far too focused on appearances rather than what counts: the worth and dignity of every person, regardless of physical appearance.

    1. The Real Cie, Sometimes I think people are well-meaning and don’t intend to be insensitive, but yes, I completely agree that our society is more than a little appearance obsessed. And breasts, well… This is one reason Breast Cancer Awareness Month is so popular IMO. Breasts always get lots of attention, even in cancer. I hadn’t thought of that comment you mentioned that larger people probably do hear… another thing not to say. Thanks for adding to this conversation. Much appreciated.

  8. Thanks for this post Nancy and thanks to all who have left comments. As a woman who chose not to have reconstruction, I sometimes feel like I need to justify my decision. No justification needed. It was my decision and I don’t regret it. My two main reasons for not having reconstruction? 1)Nothing could replace my God-given pair. 2)I wanted to be able to continue to run and run comfortably and therefore avoided the risks of further surgeries and more scarring. I do think we as a society put too much emphasis on the exterior, and that puts pressure on some when they are faced with difficult decisions after a BC diagnosis. I am pleased with my prosthetics when I wear them, and I am fine with my flat chest when I run. I think those who make insensitive comments are often speaking from their own place of fear. Your blog helps inform them as well. Thanks again!

    1. Lisa, No woman should have to justify her decision to opt out of reconstruction. Your reasons for choosing to do so sound totally resaonable. I agree with you about society putting way too much emphasis on physical appearance and it’s really hard for any woman to feel like she measures up. After a breast cancer diagnosis, it can be really tough. We need strong, confident and beautiful women like you to keep speaking up. Thank you for doing just that, Lisa.

  9. dear Nancy,

    what an excellent job you did with this post! I feel so bad for all the BC people who have had to field insensitive and uninformed comments about mastectomies and reconstruction being “boob jobs”. so many have had to suffer in silence. your well-written words offer such compassionate support and much needed validation, as well as information that, hopefully will help arm the next victim of a comment that is perhaps not intended to wound, but perpetuates the appearances are everything culture. thank you for what you have so thoroughly laid out for us – especially with breast reconstruction vs. breast augmentation. your advocacy sure shined through in this post!

    much love and light,

    Karen, XOXO

  10. I have not heard the words “well, at least you get a free boob job,” but when I was discussing my upcoming bmx with an oncologist, I was offered reconstruction as a ‘consolation’ prize. He comment, “at least you can have immediate reconstruction,” was so out of place. I told him I most likely would not have reconstruction and he reminded me that I could always change my mind and have delayed reconstruction. But he wouldn’t answer the question I was there to ask him, about lymph node dissection. I still get mad when I think about it.

    1. Lisa, I’m sorry you were upset by that comment from your oncologist. You aren’t the first woman who’s mentioned that she felt she had to convince her doctor that she truly wanted to opt out of reconstruction. And not answering the question you really wanted answered, well, that’s just as bad. I don’t blame you for still getting mad when you think about it. Thank you for sharing your feelings on this.

  11. I had a breast removed 3 years ago. I am now on medicare and call it what you want, ins won’t help me replace it and the one I have is large and heavy. I wear sports bras and baggy shirts.

    1. Cynthia, I’m confused because I think Medicare is required by law to cover breast reconstruction following a mastectomy. Or are you referring to a prosthesis? Isn’t Medicare required to cover the cost of that too, at least the majority of it?

  12. I had my Mastectomy Sept 6th this year. I still have my expander in “painful and uncomfortable” Being only 34 I heard a lot of free boob job comments. The thing that bothered me the most while hearing these comments, This FREE boob job just cost me my family we were going to try and have. I know some people try and make light of bad situations. Between the physical, emotional, and losing months of pay at work. I really don’t think people understand how much these so called FREE boobs actually cost us.

    1. Seana, I agree completely. And I’m sorry about all you’ve been forced to deal with. Nothing free about it is there… Thanks for sharing and I hope you’re doing well.

  13. i’m considering reconstruction. i’ve had many “free boob job” comments. i’ve had people tell me that i should ‘start shopping for a nice new rack’. if i get reconstructed, it will not be ‘free’. it cost me nine months of my life. it cost me a body part. it cost me standing up and looking death square in the eye and choosing to fight for my life. and that’s BEFORE all the recon surgeries, pain, recovery time and risks.

  14. I am a three year breast cancer survivor. I chose to have bilateral mastectomy with immediate DIEP flap reconstruction. My results were astounding! I never saw myself flat. I have actually said, “I like my new ones better.” (Well, they are awfully close, but not better.) I have actually said, “At least I got a tummy tuck out of it.” I KNOW, from personal experience, that a reconstruction is no easy surgery, although it is not a particularly painful one. I’ve had two much more painful surgeries on other parts of my body. In addition to the recovery, the limitations were daunting: Going three weeks without raising your arms above your head, or standing up straight, or drinking coffee, or wearing pullover shirts, or lifting ANYTHING, and six weeks of sleeping only in a recliner, and two months of not sleeping on my side. It was three months before I started feeling like I had my energy back after the first surgery. The second surgery, the nipple creation, I recovered from in a few days. The tattooing, was an outpatient procedure with no down time at all. I was diagnosed in January, had surgery in April, had second surgery in August, and tattoing in November. The whole thing took almost a year out of my life. Was it worth it? Absolutely! I got my life back, and my femininity in the process. I agree that reconstruction is no “boob job”, but I also don’t think that someone saying that it is, who has never been through the tears and fears of a cancer diagnosis, and who is simply trying to make their friend feel better is being insensitive. Like someone whistling past the cemetery to keep their nerve up, I have used humor, and the hope of having a somewhat reshaped (for the better) body to keep my own spirits up. I lived through months of fears, tears, nightmares and depression while going through the diagnoses, biopsies, and treatment choices. I was determined to fight cancer, and not let it keep me down. I fought to regain my future (meaning LIVING to see my children grow up) and my beauty (meaning not seeing the results of cancer in the mirror for the rest of my life). So, yes, I laughed in the face of cancer, and bragged, “I’m getting a boob job and a tummy tuck out of this”. No, it’s not the same, not by a long shot, but to me, not at all insensitive. It’s a coping mechanism I proudly claim as my own.

    1. Linda, The point of this particular post was to share some differences between the two very different procedures. As far as the boob job comments go, to me they are still insensitive. Thanks for reading and sharing your perspectives. I hope you’re continuing to do well.

    2. LInda, I have long maintained there is a difference between someone who has not had breast cancer and has not had to make the choices that breast cancer patients do and a breast cancer patient making comments about “free boob jobs.” You are entitled to say whatever you want about your experience. But someone who has not had breast cancer is not entitled to make such comments without being perceived as insensitive.

  15. Outstanding post, Nancy! You know, like you, I made an offhand comment to a friend that, in getting my DIEP flap surgery, I’d be getting a boob job and a tummy tuck. Looking back, that was foolish of me. Maybe I was overcompensating. The key is to forgive ourselves when we find ourselves making such comments. We are only human.

    I never uttered these words again. My friends are respectful, but now and then I do read about how someone equates reconstruction with a boob job. It infuriates me now.

    I’d like to show them the following post I wrote awhile back that discusses the reality of the DIEP flap. Thanks for a great, thought-provoking post!

    http://bethgainer.com/going-off-the-diep-end/

  16. Thank you so much for this blog! I am a 33 year old Mom of 4 and this boob job talk has really had me perplexed. I wish I was choosing a boob job and not a double mastectomy. The whole process is much longer and taxing then I expected! This read was so refreshing and I thank you for writing it! Blessings

    1. Marcie, It is perplexing, isn’t it? Comparing a boob job to a mastectomy/reconstruction situation is way out there… way out. Wishing you my best and thank you for reading and sharing.

  17. Dear Nancy, thank you for admitting that you made the same comment. When I was much younger and stupider, I made a similar (not verbatim) comment to a dear friend and coworker, who was kind and gracious enough to explain to me why the additional surgery was such a burden (she is also a nurse). Almost 15 years later, she still is a friend, and I inwardly cringe every time I see a post like this and remember when I was such an ill-informed clod.

    1. Rachel, Thank you for sharing that. The fact this topic still makes you cringe indicates to me you’re a very sensitive person and definitely not a clod. I’m glad to hear your friend was so kind about the matter and it’s wonderful you’re still friends.

  18. The two are nowhere near each other. For a mastectomy, they take away as much as they can first–that means you can end up concave and that can extend to under your whole armpit. So they are starting with a deficit of skin and flesh to begin with. Then you might have to add radiation to that, and the skin that’s left is not like normal skin at all. Sadly, most reconstruction techniques aren’t even close–that’s what people should know. I’ve listened to the comment in question quite a few times from some smart people who just don’t know the reality.

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