Why So Much Talk About BREAST RECONSTRUCTION? by: Vincent Lepore MD
It’s not your imagination. You are hearing more about Breast Reconstruction. And that’s a good thing.
A few years ago, the American Society of Plastic Surgeons (ASPS) instituted "BRA Day." It’s a nice play on words, and a good opportunity for visuals. It stands for- Breast Reconstruction Awareness Day, a day singled out during “Breast Cancer Awareness Month,” in October.
WHY DOES ‘BREAST RECONSTRUCTION AWARENESS’ NEED ITS OWN DAY?
Because; even though all of us these days are in-the-know, high-tech, cutting edge, and health-conscious – thousands of women facing breast cancer are still not aware of the choices and options they have, to restore the appearance of their breasts, or breast.
Believe it or not, there still exists an undercurrent of “judgment” in our society toward women who want their pre-cancer appearance back.
It may take the form of a comment from a friend, co-worker, or even a loved one: “You’re battling breast cancer- why bother with cosmetic concerns or an extra surgery now?”
Or: “You’ve just beaten breast cancer – be thankful and move on.”
For the woman who is battling, or who has beaten breast cancer, those kinds of comments remove part of her power or choice to act.
Ask anyone who’s had the experience. After surviving cancer, making a positive choice to act, is very empowering.
HERE’S WHAT YOU NEED TO KNOW
You do have choices. Not one, but many.
Very often, women are given little or no information about Breast Reconstruction, when being diagnosed and informed about their breast cancer. The hope is, that this sharing of information, for complete care of the patient, will eventually be available at the first point of treatment.
You should know your medical treatment options, along with options for reconstructive surgery, and a list or reference to local Plastic and Reconstructive Surgeons.
- Do you want to have Reconstruction of your breast, or breasts?
- What do you need or want?
Nipple Sparing Mastectomy with Reconstructive Implant
Depending on the circumstances dictated by your cancer treatment (mastectomy, lumpectomy, radiation, etc.), you may choose a nipple sparing mastectomy, leaving you with much of your own breast skin, and your natural nipple. Reconstructing your breast in this case, would most often involve insertion of a special implant, along with possible augmentation or reduction of your other breast (to match), if you’ve had disease in one breast only.
Mastectomy with Reconstructive Implant
A mastectomy may leave you without a nipple. In that case, your plastic surgeon might insert a Tissue Expander, and later, an implant, using your own skin to cover the implant. Your surgeon may need to use a combination of your own tissue with a special cellular material for coverage. Some of your skin would be used to create a “nipple” – which would, at a later time, be tattooed (probably by your surgeon), to match your other nipple.
Microvascular “Flap” Reconstruction
This more extensive surgery, involves taking a ‘flap’ of tissue from one of several areas of the body (abdomen, buttock, thigh, or back), then tailoring that tissue to form ‘breast mounds,’ which will be attached to the chest area by connecting many small blood vessels, as well as the outer skin. Again, nipples will be created from your tissue, and tattooed at a later time. This surgery usually does not require the use of an implant.
DO YOU HAVE TO WAIT A SET PERIOD OF TIME- BEFORE RECONSTRUCTION?
- In most cases, Reconstruction can be performed, or begun, right at the time of cancer surgery (mastectomy or lumpectomy). In the case of a Nipple-sparing mastectomy, your reconstruction can be done in one stage at that time. Your plastic surgeon and general surgeon will work together on your treatment.
- Reconstruction may have several stages, such as an immediate post-mastectomy placement of tissue expanders (they will stretch the skin in preparation for an implant), which may be replaced with permanent implants after a number of weeks.
- Reconstruction may also be delayed if you choose, either due to ongoing medical treatment, or personal preference. You may want more time to consider. And, yes, you may opt for reconstruction at a later time.
- There are other methods, and surgeries available, but in the interest of space, we’ve described the most-used procedures.
The other major fact you need to know, is that health insurance plans are now required to include Breast Reconstruction surgeries. Please check with your plan to see how it’s described.
IS BREAST RECONSTRUCTION RIGHT FOR ALL WOMEN?
No. It is true that most women could successfully have Reconstructive Breast Surgery.
But, many women choose to proceed without it. There’s that word again – choose. We believe strongly that it’s an important one.
The point is- you can’t make a reasoned choice, if you don’t know what your options are. You do have them. We hope raising awareness about them, will aid you, or someone close to you, should you ever need to make that decision.
[Dr. Vincent Lepore is a Board-Certified, Stanford-trained Plastic and Reconstructive Surgeon, who has treated thousands of women and men, performing both Cosmetic and Reconstructive procedures.]