This leaflet is for patients who have been referred to the psychology team within the department of plastic surgery. You have been referred because you are considering having breast reconstruction surgery.

This page answers common questions about what will happen when you meet with the psychologist. If you would like further information, or have any particular worries, please do not hesitate to ask your nurse or doctor. 

Why have I been referred to a psychologist?

If you are having, or have had, treatment for breast cancer, which may include a mastectomy (removal of the whole breast) or a lumpectomy (removal of the cancerous tissue from the breast), you may be deciding about whether or not you wish to have breast reconstruction surgery.

A member of the team looking after you, usually your nurse or your surgeon, will have referred you to the psychology team as part of our care for women considering breast reconstruction surgery. This team specialises in supporting patients with physical health conditions and those having surgery that results in changes to their appearance.

There is a lot of information to consider about whether to have breast reconstruction or not, such as when to have the surgery (immediately, delayed or as a two-stage reconstruction) and what type of breast reconstruction (e.g. implants or using your own tissue).

Surgery also involves a change to your body: what it looks like, how it works and what it feels like. In such circumstances, it can be difficult to make a decision. After surgery, you and those close to you might also need to adjust to the changes.

Seeing a psychologist is an opportunity to talk through your options and your thoughts about these with somebody who is impartial.

This can be helpful if you occasionally find it difficult to talk to your partner, family or friends, who may have their own worries or opinions. You will also get a chance to talk about your expectations and motivations for your choice of treatment, how you might adjust to the changes to your body and what might be helpful steps to support you in getting used to the change. 

Psychological research suggests that women who have the chance to talk through their surgery and their expectations are less likely to regret the decision they make and are more likely to adjust (physically and psychologically) afterwards. The appointment can help you feel confident that you have considered all the information and that you have come to the best decision for you.

It is important to note that the psychologist does not make the decision for you, they are there to listen and help you talk through the options.

What will happen at my appointment?

You will meet with the psychologist for 60 minutes though occasionally this can be longer. During your appointment, the psychologist will take notes. These are part of your medical record. If there is any information you do not wish to have on your medical record, then you will need to let the psychologist know. Unfortunately, there may be times where the psychologist may still need to record this information and the psychologist will clearly explain the reasons for this.

The psychologist will ask you about the options you think are available to you. They will also talk to you about your experience of breast cancer. Part of the appointment will be spent talking about your recovery and adjusting to the changes in your body, including when there is no reconstruction, and about the common emotional reactions that women can experience.

The psychologist will also ask about your how you feel about your body and your wellbeing in general and consider the impact of your choice on your body image and your intimate relationships. The appointment should provide you with a space for you to share your thoughts and concerns.

You are welcome to bring your partner, a family member or a friend to the consultation. Bringing your partner can be particularly helpful when you are concerned about the impact of surgery on your relationship.

What happens after my appointment?

Where you have further questions or concerns, the psychologist can arrange for you to speak to the professional in the team who is best placed to help you. This might be the breast care nurse, the clinical nurse specialist, the breast surgeon or the plastic surgeon.

You can also have a further appointment with the psychologist if needed, as well as one after the surgery if you feel this would be helpful. We are able to support you should you have any difficulties in adapting to the change in your body. This can include how you feel about your body and what you feel able to or not able to do.

After your appointment, the psychologist will write to the professional that referred you to summarise the discussion, highlight any particular concerns that you may have, and provide some recommendations in terms of your follow-up care if appropriate. You will get a copy of this letter, as will your GP and any other professionals who are involved in your care.

If there are any reasons why you would prefer for certain information not to be copied to certain professionals, please speak to the psychologist about this at the appointment.

If you have any questions or particular concerns, you can contact the psychological service team, Monday-Friday, 9am to 5pm, by calling: 020 7472 6247.