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Breast Reconstruction - Getting Started
It's devastating when a woman is told that she has breast cancer. Many questions flash in her mind: "Will I survive?" "Will I be there for my children, my husband, my job and my friends?" "If I do survive, will I have to live my life with a physical deformity?" "What activities will I have to give up?" "How do I lead my life with minimal change?"
The first step is to accept that a mastectomy is the procedure that can best prevent breast cancer from reoccurring locally. In many cases, it is either the recommended procedure, or one of the choices. And with modern breast reconstruction surgery techniques, undergoing mastectomy does not mean having to give up a feminine or natural breast appearance.
Once a woman has chosen to have a mastectomy, the discussion of breast cancer reconstruction naturally follows. Choices include:
- No reconstruction
- Wearing an external breast prosthesis
- Reconstruction using breast implants
- Reconstruction using autologous tissue (such as DIEP flap or TRAM flap
No choice above is the "right" choice for every woman. While I am an advocate of DIEP flap breast reconstruction or, if that is not appropriate, other means of autologous breast reconstruction such as SIEA flap or GAP flap, a patient should do as much or as little as she needs to do to feel good about herself.
While the breast surgeon may not bring up the issue of the other breast, most of my patients have had some thoughts about what to do with the other breast. At the very least, this should be brought up and perhaps discussed at length.
Timing Your Breast Reconstruction
Timing for breast reconstruction is also important. While delayed breast reconstruction (after mastectomy) is almost always possible, the best reconstructions are usually performed at the same time as the mastectomy. There are very few patients who have cancer that is so advanced that immediate reconstruction, at the time of the mastectomy, is contraindicated. Knowing how and when your reconstructive surgery fits into your treatment plan will give you an increased sense of control and peace of mind. It's important to understand that the decision for reconstruction should not be made to please a spouse or loved one, but rather to help the patient who is dealing with breast cancer herself.
Many of my patients have researched their different reconstructive options before their consultation. The breast surgeon is a good place to start, but keep in mind that there are breast surgeons who are not familiar with all of the choices, or are dated in their understanding of breast reconstruction techniques. The Internet is also a very good source of information for patients trying to become familiar with the different choices. Together with her loved ones and support group, the breast cancer reconstruction patient must be an advocate for her health and obtain the information necessary to make an informed decision. For instance, there are several Web resources that are excellent sources of information for women considering breast reconstruction.
To find out if you may be a candidate for breast reconstruction on Long Island and the New York metro area, click here to request a phone consultation from Dr. Keller, a renowned plastic surgeon specializing in reconstructive flap procedures.