For a long time, when we spoke of breast cancer, the conversation was almost exclusively focused on treating the disease. Today I believe we also need to discuss what happens afterward: how a woman returns to her life once she has faced the diagnosis and undergone treatment.
As a plastic surgeon, that part of the process is something I observe up close. A breast operation does not end when the patient leaves the operating room. Recovery follows, along with changes in the body and, in many cases, an adjustment process that can take time. In recent years, the approach to breast surgery has also evolved. When a woman requires a mastectomy, we can now discuss from the outset the possibilities of reconstruction and plan the treatment together with the other specialists involved.
Alternatives and personal decisions in reconstruction
The Buenos Aires Society of Plastic Surgery considers both immediate reconstruction, performed at the time of surgery, and deferred reconstruction, done later. The choice depends on each case, the oncological treatment, and the characteristics and expectations of each woman. Some want and can reconstruct immediately, others cannot and must wait. There are also those who decide not to pursue reconstruction. There is no single answer, nor any obligation to follow a specific path.
For some, reconstruction can help them feel comfortable with their body again. For others, it may not be a priority. Our job also includes explaining the options, listening to what each woman needs, and supporting her in that choice. A similar situation occurs with the postoperative period, which for years was closely associated with rest and waiting for the body to be fully recovered. Today we pay much more attention to pain, mobility, and the possibility of gradually resuming activities.
Accelerated recovery protocols in breast surgery are part of this change. It does not mean rushing a woman back to her routine. It means trying to minimize discomfort, avoid unnecessary interventions, and foster a progression that allows her to regain her autonomy.
Beyond the disease: the body and daily life
The World Health Organization also incorporates rehabilitation into the breast cancer care framework and emphasizes the importance of helping patients regain function and participate in daily life. In practice, this confirms something we see every day: treating the disease is one part of the journey, but returning to activities and feeling again in control of one’s life also matters. And there is a question that does not always appear when we talk about surgery: how a woman feels about her body after cancer.
A mastectomy can change far more than anatomy; it can alter how one dresses, the relationship with the mirror, intimacy, or the way a woman feels about herself. Each person experiences it in a different way. That is why I do not believe reconstruction should be thought of solely as an aesthetic matter. It can be a tool within that process, but the choice must always come from the woman and what she needs. Sometimes, when a woman finishes treatment, those around her feel that the worst is over. But she may still be trying to accommodate everything she has lived through.
Returning to work, exercising, being with the children, reclaiming intimacy, going out, traveling or simply looking at yourself in the mirror with calmness are all part of that return. Therefore, in October, in addition to stressing the importance of controls and early detection, I think we should talk a bit more about what comes after. Because surviving cancer is essential. But equally important is how we accompany a woman so she can reconnect with her body, her autonomy and her everyday life.
*Dr. Juan Manuel Serén (MN 107,174) is a plastic surgeon, soon-to-be president of the Buenos Aires Society of Plastic Surgery and creator of the ERABAS Protocol for Rapid Recovery in breast surgery
