There are basically two reasons women choose to have a mastectomy: to rid themselves of breast cancer or as a preventative measure if they are at a high risk of developing the disease. The American Cancer Society says more than 182,000 women are diagnosed with breast cancer each year and 43 percent will opt for a mastectomy, according to a National Cancer Institute study. Traditional mastectomies remove the entire breast, including the nipple/areola area. Three variations — skin-sparing, nipple-sparing, and total-skin sparing — make breast reconstruction easier and it is usually done immediately after the tissue is removed.

In a radical mastectomy, the surgeon will remove all the breast tissue, lymph nodes in the arm pit and chest muscle.  Once common, this surgery is now rarely performed.  A much easier, modified procedure still involves removing the breast tissue and lymph nodes, but also giving the patient the option of  immediate or delayed breast reconstruction. The surgery generally takes 2-3 hours and afterward, the patient is usually hospitalized for 1-7 days.

After-effects of the surgery include phantom sensations in the area as the nerves regrow, as well as itching and pressure. The area may also be sensitive to the touch for several months. Regular arm exercises are key to speeding the recovery and to lessening the effects of scarring.

• Both breastcancer.org and the American Cancer Society are vital resources for women facing breast cancer themselves or who have a family history. Both sites also offer information to help women decide on whether or not to have breast reconstruction surgery. ACS also has trained staff available around the clock to talk via its toll-free number 800-ACS-2345.

• Reuters reports that the rate of preventive mastectomy is rising.

Mammoplasty is primarily the term used for breast reduction surgery, although it can be used for any alteration (larger or smaller) of the breast.  Unlike breast augmentation, reduction surgery is often done for medical reasons.  The surgery makes overly large breasts more proportionate to a women’s body and helps to alleviate back, neck and shoulder pain, avoid skeletal deformities and in some cases, can improve breathing.

The cost range is $5,000-$10,000 and is sometimes even performed on a single breast. The surgery can take from 90 minutes to 4 hours and is done under general anesthesia. Excess fat, glandular tissue and skin are removed and the nipple repositioned.  Afterward, the breasts are wrapped in gauze, there may be drainage tubes for a couple of days, and the patient will wear a support bra — even while sleeping — for 4-6 weeks until the swelling and bruising subside, much the same as if the patient had breast enhancement. Discomfort will last for about a week, and there may be random shooting pains or a recurrence of pain if the breasts swell during menstruation. Scars will fade over several months. Also be aware that changes in sensation are common — the breast and/or nipple can become more or less sensitive. This is more likely if the position of the nipples has been moved during surgery. Numbness can be permanent. Depending on the surgery, you may not be able to breast feed after the operation.

• This British website provides an easy to read fact sheet.
• Mayo Clinic features a woman who opted for the surgery and had terrific results.