Many of us recognize the month of October as the height of Autumn.  The month of October is also National Breast Cancer Awareness Month.  Here at Iowa Plastic Surgery we would like to discuss how women are using plastic surgery to regain their form after this disease.  Dr. Van Raalte has been practicing since 1989 and has treated many breast reconstruction patients in his 20 year career.  With his experience and training in both general and plastic surgery and his continuing education he continues to help many women with breast cancer. 

 

The chance of a woman having invasive breast cancer sometime during her life is about one in eight.  An experienced plastic surgeon should be contacted as soon as breast cancer has been diagnosed because they can help the patient on choosing their right options. 

 

There are several decisions to be made.  First the patient, along with her general surgeon, has to decide if partial mastectomy and radiation, or mastectomy is their best option.  Then the decision whether to have immediate or delayed reconstruction is also contemplated.  Add to these decisions, radiation therapy and chemotherapy with the help of the oncologist are being made, it is no wonder when the patient visits the plastic surgeon they are usually scared, confused, sad, and overwhelmed.

 

Iowa Plastic Surgery understands this.  The procedures for breast reconstruction can often be complex.  We usually meet with patients at least twice to give them all the information they need to make their best decision.  We show educational videos, realistic pictures, and help determine which methods would work best for that patient.  Our staff works with them closely.  We know this is a difficult time for the patient.

 

There are several methods of breast reconstruction.  Although a complete discussion is longer than this newsletter, the most common types are a tissue expander type of implant or a flap reconstruction.  The tissue expander is the easiest and fastest recovery.  It works by slowly adding saline to a port in the expander so it can stretch the skin.  Once the expansion is done, it is replaced with a permanent implant, revisions are made, and then the nipple can be reconstructed. 

 

A flap is composed of the patients own tissue attached by its blood supply and moved from one part of the body to the chest.  The transverse rectus abdominus myocutaneous flap (TRAM) is a flap that uses excess abdominal tissue to make a breast.  It is much of the same tissue that is removed during a tummy tuck but this time it is used to reconstruct the breast.  It creates a softer, more natural breast, but has a much longer recovery and more risks.  It may also be the better choice when there has been previous radiation treatment.

 

Other options include are what to do with the remaining breast for symmetry, including lifts, augmentation, or reduction.

 

In addition, breast reconstruction includes surgery that may not be due to cancer.  There are many grey areas that are between traditional aesthetic or cosmetic surgery and reconstructive surgery.  This month Dr. Van Raalte treated one woman who had a congenital heart problem and heart surgery that resulted in one breast being much smaller than the other.  In addition, she was very self conscious about the very noticeable chest scars.  Breast augmentation corrected the difference in size, made the scars less obvious, and the woman less self conscious.  Another case involved a young lady who had a difference in size and one breast much more ptotic (droopy or saggy) than the other.  Breast augmentation with expandable implants and a breast lift (mastopexy) on one side made a vast improvement.  Neither of these is covered by insurance, but the improvement made in these ladies lives and self images where evident.

 

Awareness of methods of breast reconstructive surgery are helping women to feel complete again.  Many women who have undergone breast reconstruction experience a faster and more complete emotional recovery from the loss of their breasts.  Please feel free to call our office (563) 322-8877 to talk to Christina if you would like any information about breast reconstruction surgery.  We are also glad to send this information to you or someone you know who could use more information on any breast reconstruction surgeries.