Breast Reconstruction Conversation Starts When Cancer Is Detected.
By Vanessa Voge, MD, Jacqueline Osland, MD and Dr. Therese Cusick, MD
Dr. Vanessa Voge combines surgical acuity and personalized care to improve function and appearance for patients. Dr. Voge is a plastic surgeon and director of Plastic Surgical Specialists, 316-263-0234.
Dr. Jacqueline Osland and Dr. Therese Cusick are focused on proactive breast healthcare, risk reduction, and early detection and treatment of breast cancer. Dr. Osland and Dr. Cusick are breast surgeons and co-directors of Breast Care Specialists, 316-263-2013.
For more than 25 years, October has been synonymous with Breast Cancer Awareness Month. Most of us have been touched by cancer in some way. The wonderful news is more women are triumphant over breast cancer, and the focus of surgery is often not merely on surviving but thriving after the cancer is removed.
As surgeons, our job is to walk women through the most personal and emotional choices they need to make in their cancer battle: breast removal vs. conservation surgery; immediate reconstruction vs. delayed reconstruction vs. no reconstruction.
The goal of reconstruction is to provide similar shape, size, position and texture to the opposite breast. It’s important to remember that a reconstructed breast will not have the same sensation or feel.
The most common procedures include reconstruction during mastectomy and delayed reconstruction. Each has its benefits and the decision is based primarily on the individual patient’s journey and desires.
We encourage our patients to start discussion about plastic surgery immediately after diagnosis.
Reconstruction during Mastectomy
Completing reconstruction during mastectomy can often improve a survivor’s self-esteem and confidence. Plastic surgery options vary greatly and are tailored for each patient based on her desired outcome.
Some women choose to use tissue from other areas of the body to fill the breast skin, providing a similar appearance to the healthy breast. Reconstruction can be completed during mastectomy. It creates a seamless path between the cancer removal and new physique.
Others women prefer implants to attain the size they desire and minimize scarring. Several factors determine if this surgery is completed in one surgery or two. During the two-step surgical process, the most common process, the plastic surgeon inserts a tissue expander during breast removal and later replaces it with an implant. This is the preferred surgical treatment for patients who need radiation therapy, or when post-surgical treatment is undetermined at the time of mastectomy.
Delayed Reconstruction
For women who have already had a mastectomy, plastic surgery is still an option. It’s common for women to delay surgery because the prospect of choosing immediate breast reconstruction is overwhelming. Their focus is on cancer treatment decisions or they simply aren’t interested initially in reconstruction. Some simply want to try using breast forms or prosthesis before having plastic surgery. Regardless of the reason, if a woman chooses to delay reconstruction, she may still be a candidate for surgery if her circumstances change over time.
We encourage a team approach to breast cancer care that includes an oncologist, breast surgeon and plastic surgeon. Together, we walk patients through the choices and decision-making process to find the best-suited approach. The options regarding reconstruction can seem endless and overwhelming. However, the timing of breast cancer treatment and the decision to undergo plastic surgery can greatly impact a patient’s options, results and quality of life.
