Breast Cancer: What Will I Look Like After Surgery?
Varci Vartanian on 25 Oct 2013 at 9:00am
After tackling chemo and radiation for ovarian cancer, veteran healthcare executive Tamarin Lindenberg no longer recognized herself in the mirror.
“I didn’t [appear] as the perky, spunky, 100-pound blonde I once had been - I was a woman with a hefty medical file, a hat on my head and a diagnosis that frightened people,” she says.
Tamarin had the BRCA gene mutation too, which put her at 86% risk for breast cancer -- but she wasn't going to let cancer call all the shots. She opted for double mastectomy and embarked on countrywide search for the right surgeon to help rebuild her self-confidence.
Through this process, Tamarin founded CALIEB – a platform that assists women in restoring themselves on an aesthetic level after chemo, radiation and cancer surgery. And, she spearheaded a study on the post-cancer woman with breast reconstruction pioneer and plastic surgeon, Dr. G. Patrick Maxwell.
Their research revealed that women (even ones that paid little attention to their appearance, weight or fashion) – were fiercely protective of their right to a visually-pleasing outcome after breast reconstruction.
“[Looking good after reconstructive surgery] is linked to a woman’s sense of femininity, sexuality and ability to move past cancer,” says Tamarin, “Women say they have two thoughts when they are diagnosed, ‘Will I live? And, what will I look like?’”
With this in mind, we sat down with Tamarin and Dr. Maxwell (pictured below) for some decision-making insight after breast cancer diagnosis.
RealSelf: What's the first thing a woman should know if she's considering breast reconstruction after mastectomy?
Tamarin: You should see a plastic surgeon that focuses the majority of his/her practice on breast reconstruction. Many women don’t realize the role of a breast surgeon is to remove the breast tissue and the role of the plastic surgeon is to build the breast – and that planning [both surgeries in tandem] is critical to success. The breast surgeon can completely compromise whatever the plastic surgeon is able achieve [aesthetically] -- simply by the way the tissue is removed.
RealSelf: What should a woman keep in mind when interviewing her surgeon?
Tamarin: It’s critical that women know words like nipple sparing mastectomy, implant reconstruction versus a DIEP or TRAM flap reconstruction. There are many options.
When a woman is diagnosed, the only thing in her vision is, “Get me out of this.” Often women don’t even know what kind of cancer they have or where the tumor is, so they are highly influenced by their doctors. But, you’re going to have to be responsible for your own case, and step forward as a partner in your own care.
Have the ability to articulate your vision for the future. If your surgeon isn’t an expert in nipple-sparing mastectomy [and that’s an option you want to discuss] -- that may not be the best person to rely on for an expert opinion.
Women come to breast reconstruction with their own perception of beauty and their own definition of an optimal visual outcome. Ultimately, the best surgeon is meeting that definition, not the concept of beauty as defined by the surgeon.
RealSelf: Dr. Maxwell, which surgical option do you recommend for women desiring breast reconstruction?
Dr. Maxwell: First, it's about eradicating cancer, or the risk thereof -- then choosing the technique best for the patient, the variables of their case, and their personal expectations. So, for example, even though I am a strong advocate for implant reconstruction, I will almost always include [an option for a] flap procedure if the patient has undergone radiation.
That said, the use of ADM [acellular dermal matrix], the shape and texture of the newer implants, fat grafting and the proven efficacy of the nipple sparing procedure -- have enabled us to create a reconstructed breast that rivals the visual result of breast augmentation.
The integration of breast surgeons and plastic surgeons working together as a team has created an entirely new level of advancement.
RealSelf: Tamarin, can we ask what procedure you chose and are you satisfied with your results?
Tamarin: Dr. Maxwell performed a nipple sparing, prophylactic mastectomy with implant reconstruction. The procedure involved ADM, fat grafting, and the Allergan 410 anatomically-shaped implant with an inframammary incision. It was a two-stage process.
I was actually had breast implants prior to my decision to have a prophylactic mastectomy. My breasts look better now than they did after the augmentation.
When I saw myself for the first time after surgery, I was unwrapped with my back to a large, full-length mirror. I was then was turned around to see myself -- and I was ecstatic and could not contain my reaction of pure joy.
I will always remember the tears in Dr. Maxwell's eyes as he watched my reaction. It is that moment that defines the relationship between a patient and their surgeon.