Breast Reconstruction's Modern Look

After prophylactic mastectomy, reconstruction looks more natural these days.

ByABC News via logo
August 21, 2008, 8:09 AM

Aug. 21, 2008 — -- For Heather Fineman, testing positive for the breast cancer gene was one of the most heart-wrenching moments of her life.

"I felt like a sitting duck, just waiting to get cancer," Fineman, 37, said.

So, in November, Fineman decided to take a drastic step: prophylactic mastectomy and reconstruction.

Fineman joined an increasing number of women who've turned to prophylactic mastectomy, which is the removal of breasts in an attempt to prevent or reduce the risk of breast cancer. More than 57,000 reconstructions were performed in 2007, including many breast survivors, up 2 percent from the year before, according to the American Society of Plastic Surgeons.

Actress Christina Applegate told "Good Morning America's" Robin Roberts Aug. 19 [click here for story] that she too will undergo reconstruction in the next eight months, her usual humor in tow.

"I'm gonna have the best boobs in the nursing home, I'm telling ya," Applegate bravely joked with Roberts, who's also a cancer survivor. "I'm gonna be the envy of all the ladies around the bridge table, right?"

Fortunately for Applegate, Fineman and thousands like them, the nature of reconstructive breast surgery has come a long way from the days when the procedure left women with deformed breasts, said Dr. Mia Talmor of the Iris Cantor Women's Health Center at the Weill Cornell Medical College in New York City.

"Twenty years ago our goal was to make a breast mound; it was just something to fill a bra," Talmor said. "Ten years ago we started to move into skin mastectomy, so the breast shape became a little natural. Nowadays, we are going into total skin, nipple and arousal preservation with completely hidden scars."

Fineman had her surgery done nearly a year ago. "I had one step -- mastectomy and reconstruction all in one step."

She said doctors left her nipples intact, making incisions under her breasts to remove tissue. "[It] didn't feel like I had reconstruction," she said. "When I woke up I had breasts, just different stuffing."

The Chicago mother of two had seen her own mother go through a mastectomy. But her mother chose not to have reconstruction, a factor that influenced Fineman's decision.

She said her mother's surgery "looked to be something out of a horror movie. Growing up watching your mother like that, it affected me."