Breast Cancer Awareness: Plastic Surgeon Relays Latest Reconstructive Options

Most of us have been touched by cancer in some way, and many women face the challenge of breast cancer. For over 25 years, October has been designated as "Breast Cancer Awareness Month." We wear pink ribbons and participate in Lee Denim Day to raise funds that will benefit breast cancer research. For those women afflicted with the disease, it is very much an individual journey requiring choices.

Deciding what to do after a mastectomy--implants or natural tissue reconstruction, breast forms or nothing at all--is among the most personal and emotional choices women make in the breast cancer battle, says Dr. Robert Grant, Plastic Surgeon-in-Chief for the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital/Columbia University Medical Center and New York-Presbyterian Hospital/Weill Cornell Medical Center, the University Hospitals of Columbia and Cornell.

Dr. Grant shared the following information with me on the latest available reconstructive options after a mastectomy.

Lack of Information
Unfortunately, women may not be receiving the breast reconstruction information they need when they are afflicted with breast cancer. While most women are aware of silicone implants, a survey by the nonprofit Cancer Support Community last year found that 40 percent of women didn't receive full information about reconstruction. They were not made aware of the newest advancements and options.

Latest Reconstruction Options

TRAM or DIEP Flaps: Using living tissue from the abdominal region or upper back, doctors create a new breast that has a live blood supply. Fat can be taken from the abdomen and hips, helpful for women without much extra body fat or those needing to match a larger breast. DIEP uses extra tissue and fat, without disturbing the muscles.

Nipple and Skin-Sparing Mastectomies: There are an increased number of these types of mastectomies that translate into a dramatic improvement in the aesthetic results. The skin-sparing technique preserves the skin but not the nipple. The nipple-sparing mastectomy maximizes breast tissue removal while still attempting to enhance cosmetic outcome.

Adjustable Saline Implant: The implant is put in at the time of mastectomy and injected with saline--post-operatively during doctor's office visits--until the desired breast size is achieved. Adjustable implants may reduce the need for tissue expanders, according to Grant.

Undergarments & clothing options

Breast forms: Professional fitters find forms to match the existing natural breast, age or body type. Mastectomy bras, lingerie and swimsuits with pockets to hold breast forms are being made in increasingly attractive styles.

Dr. Grant works with each of his breast cancer patients to "identify and reach that balance of inner and outer beauty that is theirs and theirs alone, and to maintain that balance through every life stage." You should expect the same from your doctor, especially when choosing reconstructive options after a mastectomy.

Reference:
Robert T. Grant, MD, MSc, FACS.: Interview; October 2011

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