Breast cancer affects one of every eight women. Ages range from 30s to the 80s. When you find a lump or have an abnormal mammogram, you need to see your doctor immediately. Plastic surgeons become involved when you have been diagnosed with cancer and are going to have a mastectomy, a total removal of the breast tissue.
Breast reconstruction is done to restore the breast lost to cancer. It is one of the most rewarding breast enhancement surgical procedures available today. With modern refinements, we can create breasts that come close in form and appearance to matching a natural breast. Sometimes the shock and the number of necessary decisions are overwhelming when a woman is diagnosed with breast cancer. Reconstruction can be done immediately, at the time of mastectomy, or it can be delayed. Reconstruction can be done with an implant/expander or with your body’s own tissue.
Some women choose to have breast reconstruction, others do not. The choice is a personal one. When you meet with a plastic surgeon, we can help you identify what decision is best for you. I have assisted many patients in determining whether undergoing breast augmentation is the right choice for them. We can meet in the comfort of my Palo Alto office and discuss all the options available to you.
When you are first diagnosed, the world turns on its ear. Make the decisions you need to, and don’t think about the rest yet. You will need to figure out:
1. Lumpectomy or Mastectomy? Your general surgeon and oncologist will help you in this decision. Things to consider are aggressiveness of your cancer, lymph node status, pathology, BRCA status, size of breast, etc.
2. If mastectomy, do you want reconstruction?
Dr. Greenberg was very thorough in explaining the results to me and I gave her my full trust and rightly so – she did a beautiful job with both breasts – one that was 35% missing tissue due to breast cancer. I could not be more happy about the results.
– M.M., Saratoga
There are two fundamental types of reconstruction. Tissue expander ( implant) or autologous (your natural tissue).
When you have a mastectomy, the nipple, areola, and some breast skin is removed. This tightens the breast envelope. As the skin flaps are thin, an expander is placed underneath the pectoral muscle to slowly stretch the skin. The expander is inflated through multiple office visits, using a simple, painless 15-minute procedure. This breast enhancement technique will gradually stretch out the skin to accommodate an implant. The implant is placed at a second surgery. As for size, what kind of implant you will need, saline versus silicone, etc, do not focus on that now. Your primary decision at this juncture is simply do you want to do an expander implant reconstruction?
The most common procedure done in this group is the TRAM flap. A TRAM flap uses your body’s own fat and skin from the abdomen to reconstruct the breast. It has the additional benefit of giving an abdominoplasty. The surgery and recovery time are longer than the expander/implant reconstruction. In an appropriate patient, it is a great breast enlargement surgery. There is definitely a benefit in feel and softness to use natural tissue. I find many of my Bay Area patients don’t have enough fat on their abdomen to do this surgery.
This procedure is done to the contralateral (the other) breast to help the breasts look alike. This may involve a breast lift, breast enlargement, breast reduction or a combination of these breast enhancement procedures during surgery. This is covered by insurance.
This occurs months after your initial reconstruction. The nipple is reconstructed by using a local skin flap. The areola is reconstructed using a skin graft or tattoo. Examples of both can be reviewed.
Depending on your surgery, you can have surgery at Stanford, the Menlo Park surgery center (has overnight stay capabilities), or an outpatient center in Palo Alto.
There are a multitude of Internet sites, community groups, and supports. I have information in my office on everything from support groups to where to buy a good wig. Much of my information comes from my patients. When a new patient comes in, I try to match them with a similar age/diagnosis patient. I find this is a difficult time, as many women try to be strong for their family, husbands, colleagues, and children. I strongly urge you to find a doctor whom you like. Breast cancer is about far more than the surgery.
I am a regular speaker at the Thursday night open house at Breast Cancer Connections in Palo Alto. They are a great, free resource, and I would strongly urge anyone in the Bay Area who has been diagnosed to go in. In addition to information, they have open houses, buddy systems, and therapists to help you. They are off California Avenue in Palo Alto. www.bcconnections.org