Reconstruction of the breasts after their surgical removal to treat breast cancer may improve body image and sexual satisfaction among women, a study published in Psycho-Oncology suggests. Women who had implant-based or deep inferior epigastric artery perforator (DIEP) flap reconstruction experienced great improvement in these areas in the months following either surgery.
Background and Goals
Breast cancer surgery can cause a change in sexuality and body image. The diagnosis and treatment of the disease can also impact how a person views their femininity, attractiveness and sexuality responsiveness.
Past studies explored whether the type of surgery a woman has effects body image and sexual satisfaction. Surgery may be lumpectomy, mastectomy or mastectomy with reconstruction. Though findings showed the effects are often the same with all types of surgery, a few differences led researchers to believe breast reconstruction plays an important role.
To find out, the trial team surveyed two groups of women: those who had implants and those who had DIEP flap reconstruction. During DIEP flap reconstruction, surgeons use tissue from the abdomen to rebuild the breasts. Both groups of women had delayed reconstructive surgery, meaning they waited for a period of time after lumpectomy or mastectomy to have it done.
Ninety-eight women already taking part in another study on breast reconstruction were surveyed for this trial. These women had chosen to delay reconstruction for one reason or another.
Researchers asked each woman to fill out the study survey before her reconstructive surgery, 6 months after surgery, and when her reconstruction was considered complete.
The survey was made up of questions related to:
- body image
- satisfaction with their current sex lives
- satisfaction with their partner or relationship
- amount of distress from the breast cancer diagnosis itself
- their current general emotional and physical health
The survey results demonstrated:
- body image and sexual satisfaction improved after reconstruction, whether implant-based or DIEP-flap
- women who reported less cancer-related distress, better emotional health and more satisfaction with partner relationships had much better body image
- women who reported more satisfaction with their partner relationship, better emotional health and who had better body image were much more sexually satisfied
In this study, the DIEP-flap surgery was only performed at cancer centers where surgeons specialized in the technique. Because of the specialty focus, surgeons and healthcare teams at those centers may have a greater understanding of how the surgery impacts body image and may provide additional support and education related to these topics.
It is also important to note that these results may not apply to women who have immediate reconstruction.
Additionally, there was no baseline assessment of body image or sexual satisfaction taken before or at diagnosis for the researchers to use as a comparison for how the women felt after surgery. Because of this, they could not assess how either changed over time.
What This Means for You
This study shows reconstruction may have a strong, positive impact on your body image and sexual satisfaction after breast cancer. Yet, every woman is unique. While breasts are an important part of the intimate experience for some, they are less important to others. Be sure to consider what you want before making a decision about whether to have reconstructive surgery.
You may find comfort in knowing both body image and sexual satisfaction increased over time, no matter which surgery a woman chose. In general, doctors recommend DIEP-flap surgery to women who carry more weight. Some very thin women may require implants. Even if you are limited to one or the other, these findings show you can still see positive improvements in your body image and sex life.
If you are struggling with body image or sexual satisfaction, consider talking with a healthcare professional who is knowledgeable in these areas. Both were related to emotional health and a healthcare professional can help you find ways to cope with changes to your body.
If you are partnered, you also may wish to take a look at your current relationship and consider how you are supported. Satisfaction with partner relationships positively influenced both body image and sexual satisfaction. If you are unhappy with your relationship, this should be addressed for your overall health, especially while you undergo treatment for cancer.
To learn more about reconstruction and about sex and intimacy after breast cancer, read our Guide to Understanding Intimacy and Sexuality and listen to LBBC expert Dr. Stephen Copit discuss breast reconstruction options.
Gopie, J, ter Kuile, M, Timman, R, Mureau, M, Tibben, A. Impact of delayed implant and DIEP flap reconstruction on body image and sexual satisfaction: a prospective follow-up study. Psycho-Oncology. 2014; (23): 100-107.