Reconstructive surgery offers more than treatment of breast cancer

Lynn Kamau (not her name) recalls walking into the hospital for what she believed was a routine mammogram. There was no pain, no visible warning, nothing that suggested her life was about to tilt in a new direction.

At 42, she was focused on raising her two children, managing a demanding legal career, and living with chronic back pain she had long attributed to an old spinal injury. Breast cancer, or anything close to it, was not on her mind.

“I felt completely fine,” she recalls. “There was no pain, no lump I could feel. I was just doing what women are encouraged to do, going for a routine check.”

What followed was a chain of discoveries that would force her to confront fear, mortality and the limits of how we understand healing. Three lumps were found in her right breast. More appeared after further testing.

“They found additional lumps and took several biopsy samples,” she says. “That’s when the reality started sinking in.”

A biopsy confirmed the lumps were pre-cancerous. Surgery was necessary. So was a decision she never imagined she would have to make: whether to undergo reconstructive surgery.

For years, plastic surgery in Kenya has carried a narrow and often unforgiving label. It is widely seen as cosmetic, indulgent and reserved for those chasing perfection.

In everyday conversation, it is treated as a luxury rather than medicine. But behind that perception lies a quieter reality, one rarely discussed and even less understood. For many Kenyan women, reconstructive surgery is not about appearance. It is about survival, dignity and the chance to feel whole again.

Lynn never imagined plastic surgery would become part of her life. Chronic pain had followed her for years. Her back, neck and shoulders were constantly sore, a discomfort she had come to accept as the cost of earlier injuries to her spine.

In 2014, she sustained two injuries within weeks of each other. She fell in the bathroom, landing on her coccyx. Two weeks later, she rolled down a flight of stairs, again landing on the same spot. The injuries left her in persistent pain. For years, she managed it through physiotherapy and hydrotherapy until the discomfort became manageable. Later, doctors explained that her heavy bust was contributing significantly to the strain on her spine, worsening the pain in her upper body.

“I had always known my bust was heavy,” she says. “But I didn’t realise how much it was worsening my back and neck pain until doctors explained it.”

Anne Waithaka, the plastic and reconstructive surgeon who later treated Lynn, says such cases are common but often overlooked.

“Many women live with chronic pain for years without being told that breast size can significantly affect spinal health,” Dr Waithaka explains.

“Reconstructive or reduction surgery can be both therapeutic and life-changing.”

The mammogram itself had been precautionary, the kind of responsible health decision women are constantly encouraged to make. The results, however, were unexpected. More lumps were identified. Samples were taken. Then came the waiting.

“I have never been that scared in my life,” Lynn says. “Thinking of the worst and considering I have two young kids. The one-week wait for the biopsy results was torturous. I could not eat. I could not sleep.”

Like many women, her fear was not only about illness. It was about what illness could take from her. Her children. Her independence. Her body.

As an advocate, she was used to giving people hope, guiding them through uncertainty. Now she had to practise that same discipline on herself, even when it felt overwhelming.

Her family became her anchor. Her parents, a close aunt and her best friend surrounded her with prayer and reassurance.

Her sister and brother-in-law, both doctors, patiently explained the medical process, helping her understand what was happening without minimising the risks.

Knowing she had gone for screening early offered some comfort. If it was cancer, she reasoned, it would likely be caught at an early and treatable stage.

When the results came back, the diagnosis was serious but not terminal. The lumps were pre-cancerous. There were six in total.

Doctors advised that they needed to be removed entirely and evaluated further. Leaving them in place carried a high risk of progression to cancer.

Surgery was no longer a question of if, but how.

Alongside the removal of the lumps, reconstruction was recommended. For Lynn, the idea raised new fears. Surgery itself was frightening. Would she wake up from anaesthesia? Would there be complications? Would she look the same afterward? Would her body ever feel like her own again?

She briefly considered external prosthetic options, such as specialised bras designed to simulate breast shape. But she was unwilling to settle if there was a better, more permanent solution available.

The turning point came through conversations with friends. Two women she trusted had undergone similar procedures under the care of Dr Wangui. They spoke openly about their outcomes, their healing and the professionalism they experienced.

Through them, Lynn was introduced to a surgeon whose work sits at the intersection of cancer care, reconstruction and psychosocial healing.

From the first consultation, Lynn felt seen.

“She saw me as a whole person, not just a patient,” Lynn says.

“She explained everything in clear detail, answered all my anxious questions patiently and tailored the plan to address my concerns  with the aim of restoration.”

Waithaka is among a small but growing number of Kenyan surgeons with advanced training in oncoplastic breast surgery. Oncoplastic surgery combines cancer removal with reconstructive techniques, allowing surgeons to treat disease while preserving or restoring the breast’s shape and function.

“In breast surgery, survival should not be the only outcome we measure,” Waithaka says.

“We also need to think about quality of life, body image and mental wellbeing. Women live with the results of these surgeries for decades.”

In Kenya, reconstructive surgery is often misunderstood, even within healthcare settings. Many patients are never informed that reconstruction is an option. Others assume it is cosmetic and therefore unnecessary or unaffordable. Waithaka challenges this thinking directly.

“Reconstructive surgery is part of treatment,” she says. “It is not vanity. It is about restoring form and function after disease, injury or congenital conditions.”

Beyond cancer, women may seek reconstructive or reduction surgery for medical reasons including gigantomastia, a condition where excessively large breasts cause chronic pain, skin infections and posture problems, trauma, burns, congenital asymmetry or complications from previous surgeries.

International bodies such as the World Health Organisation and the American Society of Plastic Surgeons recognise reconstructive surgery as essential care, not elective enhancement.

For Lynn, reconstruction addressed more than cancer risk. It also eased the physical burden she had carried for years. The surgery included removal of excess tissue along the sides of the breast, improving balance and reducing strain on her spine.

Recovery was not easy. Healing the wound and finding dressings that did not react with her skin were among the biggest challenges. Cost was another hurdle. Insurance covered about Sh130,000. She paid between Sh300,000 and Sh400,000 out of pocket.

Cost remains one of the biggest barriers to reconstructive care in Kenya. Many women simply cannot afford it.

Waithaka acknowledges this reality, noting that access depends heavily on insurance coverage, hospital policy and individual circumstances. Some facilities offer subsidised care for extreme or needy cases, but these options are limited and not widely known.

The financial strain is compounded by stigma. When reconstruction is framed as cosmetic, it becomes easier for systems to exclude it from coverage. Patients are left to choose between living with physical and emotional scars or plunging into debt.

Not all women opt for or qualify for reconstruction. For many who undergo mastectomies, prosthetic breasts offer an alternative path to normalcy. These artificial forms are designed to replicate the size, shape and weight of a natural breast. However, traditional silicone prostheses remain unaffordable for many women, placing yet another layer of inequality onto survivorship.

“Healing looks different for every patient,” Waithaka says. “What matters is that women are supported to choose what works for them, whether that is reconstruction, prosthetics or a combination of both.”

Globally, breast cancer remains the most common cancer among women, according to the World Health Organisation.

In Kenya, more than 6,700 women are diagnosed every year, with more than 3,100 deaths annually. Behind these numbers are women like Lynn, navigating fear, motherhood, careers and bodies altered by illness.

For Lynn, healing came in stages. Physically, her body recovered. Emotionally, she slowly reclaimed a sense of freedom. One moment stands out. After healing, she wore a strapless dress for the first time.

“I always used to dream of wearing a strapless dress,” she says. “That was the first thing I wore after I healed.”

It was a small act, but a powerful one. It marked a return to confidence, choice and self-ownership.

Today, Lynn speaks with gratitude for every medical team that walked the journey with her, and especially Waithaka. What mattered most was not just surgical skill, but companionship through vulnerability.

“She and her team walked the entire journey with me,” she says. “Through the surgery and the recovery period, I felt supported, heard and never alone. She gave me back a sense of control and partnership in my own healing.”

Her message to other women is simple but urgent. Do not let fear stop you from going for routine mammograms and Pap smear tests. Lumps can be painless. You may not feel anything at home. Early detection saves lives.

Waithaka echoes this call, adding that Kenya must broaden its understanding of what healing truly means. Survival is only the beginning. Restoration matters too.

As conversations around cancer care evolve, stories like Lynn’s challenge long-held assumptions. Plastic surgery, when viewed through the lens of reconstruction, is not about vanity. It is about giving women the chance to live fully after illness. To move beyond survival. To reclaim dignity.

In a healthcare system often stretched thin, these conversations are overdue but they are necessary because healing, at its best, is not just about staying alive. It is about feeling whole enough to step back into life.