BREAST Cancer RECONSTRUCTION

About Breast Cancer Reconstruction

Women are more aware than ever about the importance of performing self-breast exams and undergoing screening mammograms.  Despite this heightened awareness, a new woman is diagnosed with Breast Cancer every 3 minutes.  The diagnosis of cancer can be a frightening experience, but Breast Cancer is unique in the burden it places on women in our society.  Breast Cancer presents itself as a life-threatening challenge, but Breast Cancer survivors are often left feeling permanently altered or scarred by the surgeries that were employed in saving their lives.  The perception of femininity is intimately tied to the female form and figure and it is common for Breast Cancer survivors to struggle at times with what they perceive as a loss of femininity, sensuality, and sexuality if they are left with scars upon their breasts or a Mastectomy defect. 

Many women touched by this disease understand their options with regard to the surgical and medical treatments, but many women still do not understand their options when it comes to Breast Reconstruction.  The vast majority of women with Mastectomies do not undergo Reconstruction.  A wide variety of factors influence a woman’s limited knowledge  regarding Breast Reconstruction options,  including the lack of access to a Plastic Surgeon, distance from an adequately-equipped medical center, socio-economic reasons and simply not desiring Breast Reconstruction.

In the interest of establishing a comprehensive center for breast surgerywe have founded the Rocky Mountain Center for Breast Surgery at Park Meadows Cosmetic Surgery.  It is our desire to offer women of the Rocky Mountain region the latest techniques in aesthetic and reconstructive breast surgery.  Our partnerships with local hospitals, oncologic surgeons, medical and radiation oncologists all serve to ensconce the comprehensive care we believe our patients deserve.

Our goal at the Rocky Mountain Center for Breast Surgery at Park Meadows Cosmetic Surgery is to educate Breast Cancer patients regarding their options in an effort to reassure women with Breast Cancer by providing a sense of hope.  We recognize that the treatment of the cancer is preeminent.  However, we have found that survivorship is enhanced when we have the opportunity to come alongside our patients, helping them to understand their options for Breast Reconstruction and assist them in realizing their reconstructive goals.

Our mission at the Rocky Mountain Center for Breast Surgery at Park Meadows Cosmetic Surgery is to:

• Provide hope in a caring environment through education and compassionate care.
• Maintain the lofty aesthetic goals for Breast Reconstruction that we believe survivors deserve.
• Bring state-of-the art surgical techniques for Breast Reconstruction to the women of Colorado and the region, such as “perforator-based microsurgical” techniques like DIEP Flaps, SGAP Flaps, and TUG Flaps for Breast Reconstruction.
• To seek proven strategies for Breast Reconstruction and to improve upon them, advancing our specialty and improving care to women of the Rocky Mountain region

The creation of a new breast can dramatically improve the self-esteem, self-confidence, and quality of life for a cancer survivor.  Despite the lofty aesthetic goals for Breast Reconstruction and the plastic surgeon’s ability to give you a relatively natural-looking breast, any reconstructed breast will look and feel different than your natural breast.  With advances in Breast Reconstruction by using your body’s own tissue, these differences are diminishing.

• Every reconstructed breast will have permanent scars from the Mastectomy; however, some scars can be hidden more than others. 
• The skin sensation will never be normal because removing the breast tissue and cancer require cutting the nerves to the skin.  This will result in numbness of the skin.  Cutting edge techniques for nerve Reconstruction are currently being studied to return more normal skin sensation to a reconstructed breast, but final, long-term results are not yet known.  Dr. Christopher Williams is specially trained in this area of surgery as well.
• A breast reconstructed from a woman’s own fat and skin feels more natural, is usually softer, and can often have a more natural shape and contour than an implant Reconstruction.  Breasts reconstructed using a woman’s own tissues will actually change size as a woman gains or loses weight, just like the abdominal tissue would if it was still on the abdomen

Is Breast Reconstruction Right For Me?

The desire for Breast Reconstruction after cancer surgery is very personal and varies greatly among women.  The only reason a patient should undergo the extra surgery to reconstruct her breast is for herself—and not to please anyone else—like a spouse or significant other.  Surgeries carry risks, but these risks are almost always outweighed by the benefits of the end result.

The best candidates for Breast Reconstruction are:

• Patients without other major medical illnesses who can safely go through the surgical processes required to reconstruct the breast.
• Patients who can cope well emotionally with their diagnosis and treatment and can understand the risks of surgery.  Set-backs can occasionally occur, so patients need to have the emotional ability and support structure to help cope with set-backs. 
• Patients who have a realistic expectations on the final results of Breast Reconstruction.
• Patients who have a positive outlook and who will partner with her surgical team to get the best result that can be achieved, but understand that every patient is different and every patient’s results are different.

Every Breast Reconstruction is unique just as every patient is unique.  There are many techniques that can be used to reconstruct a breast depending on the patient’s physical characteristics and desires. 

IMMEDIATE AND DELAYED RECONSTRUCTION

The first major choice a patient has to decide is whether she desires Immediate or Delayed Breast Reconstruction.  Sometimes the Cancer Surgeon and Plastic Surgeon will direct the patient one way or the other depending on the tumor characteristics.  Breast Reconstruction can be immediate, which means the procedure is performed on the same day as the Mastectomy.   Breast Reconstruction can also be delayed, which means the procedure is performed anytime after the Mastectomy—even as early as the day after the Mastectomy.  Patients may also wait days, months, or years to have this reconstructive procedure performed.

IMPLANT-BASED AND AUTOLOGOUS (TISSUE-BASED) BREAST RECONSTRUCTION

The second major choice a patient has to decide is if she wants an Implant-Based Breast Reconstruction where a silicone Tissue Expander is first used to help shape the breast skin and pocket.  The Tissue Expander is slowly inflated to stretch the skin and muscle.  The Tissue Expander is removed at a second stage and is exchanged for a much softer, permanent silicone or saline breast implant.  This method usually includes a more timely operation and no other incisions are needed during this procedure.  The recovery stage for this method is usually more tolerable as well.  However, patients who choose this method will usually need additional operations to maintain a more natural-looking implant. 

Patients who do not want implants may choose a technique that uses her own body (Autologous) tissue (fat and skin) to rebuild the breast gland and skin.  In these techniques, the surgeon “borrows from Peter to pay Paul.”  In other words, the surgeon looks to one of the standard body areas that usually contains extra skin and fat that a woman would not miss.  These donor sites usually are the abdomen, buttock, back, or inner thigh.  The tissue is removed from these locations and then moved to the chest to reconstruct the missing breast tissue.  This technique usually creates a more natural-looking and feeling breast as there is no artificial implant used, and a woman can usually benefit from a “Tummy Tuck” if the abdomen is used as a donor site.  These are bigger operations that require a second incision, but the results are highly beneficial and rewarding for the patient. 

Your surgeon will help you decide the best option for you based on your own desires, body and cancer characteristics, as well as the timing of surgery. 

Stages Of Breast Reconstruction

Patients should know that almost all techniques are “staged.”  That means there are at least 2 and often 3 steps to a complete Breast Reconstruction that includes the breast, the nipples, and the areola. 

Stage One - is usually the biggest operation and is frequently performed the same day as a Mastectomy, also termed Immediate Breast Reconstruction.  The patient usually spends 1 night in the hospital if tissue expanders or implants are used.  If a patient chooses to use her own tissue (DIEP Flap) from her abdomen, then the patient usually stays 2 to 4 days in the hospital.  For Delayed Breast Reconstruction, a Stage One Implant-Based Reconstruction is usually an outpatient procedure, while a DIEP Flap Reconstruction requires a 2 to 4 day hospital stay.

Stage Two - is almost always a much quicker operation than Stage One and has a much shorter recovery time.  These are typically outpatient surgeries after which the patient can go home.  Many of them may conveniently be performed at our own Park Meadows Outpatient Surgery Center.  Stage Two is usually a shaping procedure and includes time on the contralateral, or the non-cancerous breast, to help match the shape and contour of the reconstructed breast.  Sometimes, Nipple Reconstruction can be performed during the Stage Two as well.

Stage Three - if needed, is usually reserved for any final shaping, revision of donor sites, and Nipple and Areolar Reconstructions.

• Autologous (Tissue) Breast Reconstruction

• Expander & Implant Reconstruction