Breast cancer affects every woman in America in one way or another. One out of eight women will get the disease, and the other seven are friends and family of someone stricken. Our board-certified plastic surgeon Dr. Roberta Gartside was one of the eight and is also member of the American Society of Plastic Surgeons (ASPS). It is from both perspectives that Dr. Gartside wishes to provide women with the following critical information regarding breast cancer and their options for aftercare.
Speaking as a breast cancer survivor and plastic surgeon, Dr. Gartside wants you to know your options and insists upon the team approach to breast cancer care. For more information about your breast reconstructive options, call or schedule a cosmetic surgery consultation with Dr. Roberta Gartside by completing the form on this page or calling 703-742-8004. We proudly serve those who live in Reston, Fairfax, and Mclean, Virginia and nearby areas Washington, D.C.
- A Team Approach to Breast Cancer Aftercare
- What to Expect for Breast Reconstruction Consultation
- Post Lumpectomy Breast Reconstruction
- Post Mastectomy Breast Reconstruction Using Back Muscle Flap
- Post Mastectomy Tissue Expander Implant
- Post Mastectomy TRAM Flap
A Team Approach to Breast Cancer Aftercare
When breast cancer strikes, a woman is faced with a number of difficult and emotional decisions related to her treatment and care. Among them, how do I save my life? Do I rid my body of the cancer through a lumpectomy or mastectomy? Do I have my breast reconstructed? Do I have the breast reconstruction surgery immediately following the mastectomy or delay it until another time? What type of reconstruction options are there for me to consider?
The American Society of Plastic Surgeons has launched a major breast cancer care awareness campaign to start a conversation about key aspects of complete care. Research released through the ASPS indicates that 70 percent of women eligible for breast reconstruction are not told about the many options they have. Those options include reconstruction using implants or a woman’s own tissue. But key decisions depend upon a patient’s anatomy and preference and need to be discussed prior to mastectomy.
Women also need to be aware of the importance of the “team approach” to breast cancer care. Every breast cancer care team should include a plastic surgeon. They are best suited to perform the wide variety of breast reconstruction options that patients have. Working with the oncologist, radiologist, and the rest of the cancer care team, the plastic surgeon can help plan the procedure that will result in the best patient outcome and quality of life after the cancer is gone.
What to Expect for Breast Reconstruction Consultation
Breast reconstruction is a multi-step process to restructure the symmetry of the breasts that was affected in the mastectomy and there are several reconstructive options for women. As with all surgeries, there are advantages and disadvantages to the procedure you choose.
Prior to the date of your procedure, you will have a “pre-assessment” to determine your general health and home circumstances. During this appointment you will be given the opportunity to have any questions answered in regards to the procedure and anesthesia and will be given specific instructions to adhere to in the days before your procedure.
When you have your initial consultation, you will be asked for you and your family’s medical history along with your current health to determine if you are a good applicant for this procedure. It is important to be complete and concise about your medical history to ensure a safe and effective procedure.
Below we will discuss the options for breast reconstruction we offer at New Image Plastic Surgery.
Post Lumpectomy Breast Reconstruction
Dr. Gartside is here to help you through this process by offering different options for the process after your lumpectomy. It’s important to begin the planning with Dr. Gartside since reconstruction may have an effect on other decisions related to the lumpectomy. A lumpectomy can leave the breasts misshapen and disfigured.
A post lumpectomy breast reconstruction or oncoplastic surgery is a procedure to help women regain the shape and volume of the breasts for better symmetry. This procedure may be preferred by lumpectomy patients since they will get an overall better aesthetic appeal and may regain the symmetry of their breasts, depending on personal desires.
Options can range from the placement of a breast implant or tissue expander to modified breast lift of reduction surgery. This type of surgery is particularly beneficial for women who are extremely large breasted and had considered a breast reduction in the past for other reasons such as neck and shoulder pain.
When you meet with your plastic surgeon, the two of you will decide if you are a good candidate for post lumpectomy reconstruction or reduction and if this option is best for you depending on your specific needs and post lumpectomy goals. If this option is best suited for you, this procedure will help create a more natural looking breast and give your breasts a more aesthetic appeal.
The incisions are sealed using surgical staples or stitches and covered in medical bandages. If you desire or need nipple reconstruction, it will typically be deferred until the breast reconstructive surgery is completed in order to properly plan the positioning of the nipple and areola.
Upon completion of the post lumpectomy reconstruction or reduction procedure, you will be monitored in a recovery area by a nurse. Your aftercare will vary depending on the time disparity between your lumpectomy and reduction or reconstruction procedure. You should expect some discomfort for a few days. Your plastic surgeon will prescribe pain medication for your discomfort and will recommend that a bra or special dressing be worn to provide support during the recovery period.
It is essential to understand the importance of a safe recovery to ensure the proper healing and desired results of your post lumpectomy procedure. Your plastic surgeon will provide you with proper recovery procedures for the next few weeks of your recovery period.
Post Mastectomy Breast Reconstruction Using Back Muscle Flap
The post mastectomy latissimus dorsi flap is one of the post mastectomy reconstructive options. This reconstruction procedure uses body tissue, skin, fat, muscle, and blood vessels from the upper back. The breast is reconstructed by tunneling an ellipse of skin with muscle from the back called the latissimus dorsi to the mastectomy area.
This procedure is preferred by many breast cancer patients because the patient's own tissue is used. It is also a good choice for women who are not candidates for a tissue expander or abdominal tissue reconstruction secondary to prior surgery or radiation. Due to the minimal amount of tissue on the back, the procedure may require a small breast implant along with the use of your own tissue.
Back Muscle Flap Procedure
When you meet with Dr. Gartside, the two of you will decide if you are a good candidate for the latissimus dorsi breast reconstruction and if this option is best for you depending on your specific needs and post mastectomy desires. If this option is best suited for you, this procedure will help create a more natural looking breast. Since the reconstructed breast or breasts are formed from natural tissue, the feel and the look of your breasts will be more natural than having implants alone.
You will be asleep during the surgery since it is performed using general anesthetic and ranges from six to eight hours in length. The areas to be performed on will be cleaned using medical grade soap. You will be covered in a sheet in order to keep the operating area clean. The tissue will be formed into a shape appropriate for your body and breasts. The incisions are sealed using stitches and covered in medical bandages.
If you desire or need nipple reconstruction, it will typically be deferred until the breast reconstructive surgery is completed in order to properly plan the positioning of the nipple and areola.
After the operation is complete, you will be moved to a recovery area where you can be closely observed. You should plan to be in the hospital for recovery for 2-4 days.
You will be kept very warm in order to aid in the expansion of the blood vessels which will allow circulation to your new breasts. For the first 48 hours, you will require help from the staff for most activities. During your recovery time, you will be positioned with your knees bent up, with the aid of a pillow, and will be lying almost flat to alleviate any stretching of the newly connected vessels in your new breasts.
Post Mastectomy Tissue Expander Implant
The tissue expander is a process for the post mastectomy reconstruction. It is a staged approach and requires subsequent visits until the desired size is accomplished. A tissue expander is a provisional device used to create a soft pocket in the chest wall to hold a permanent implant. Tissue expanders come in an assortment of sizes and shapes to be used for an appropriate fitting to your body.
Some women may opt for a delayed breast reconstruction with implants or can choose for immediate reconstruction. This will depend on your treatment options. Regardless if you choose a delayed or immediate breast reconstruction with an implant, the first step is getting a tissue expander. At the beginning of the post mastectomy reconstruction process, the tissue expander will be partly filled with saline. The expansion process will begin within a few weeks after surgery, upon your recovery.
After the mastectomy procedure, the tissue expander will be inserted underneath the muscles of the chest wall and will be positioned in the pocket of the tissue. At your request, your surgeon can place a larger volume of saline during the initial reconstructive surgery, this can minimize the amount of subsequent visits but it is important to administer a safe amount to alleviate any added discomfort that is commonly associated with the procedure. This is something that will be discussed prior to the procedure.
The succeeding appointments are generally outpatient procedures that include replacing the expander with an implant which will aide in creating a more distinct and refined shape of the breasts.
Once the tissue expanders have been placed, you will need to wait either until chemotherapy and/or radiation is completed or a few months for healing and recovery, prior to the second stage of your reconstruction which involves removing the expander and inserting permanent breast prosthesis. The discomfort from the tissue expansion is easily counteracted by Tylenol, and the tightness should diminish within the first day after the addition of fluid.
Tissue expanders are temporary and slight discomfort may occur. If you have any pain that persists, contact Dr. Gartside for further assistance.
Post Mastectomy TRAM Flap
The post mastectomy TRAM flap procedure refers to using the Transverse Rectus Abdominis Myocutaneous flap for reconstruction of the breasts. The TRAM is the muscle located in the center of the abdomen and is commonly referred to as “abs.”
This is one of the more popular of the reconstructive options, especially for women who have an excess of belly fat in that area or have an abdomen that has been stretched due to pregnancy. This procedure may be preferred by breast cancer patients because the tissue is retrieved from the stomach tissue and side benefits are sometimes similar to a tummy tuck.
TRAM Flap Procedure
When you meet with your plastic surgeon, the two of you will decide which abdominal flap reconstructive option is best for you depending on your specific needs and post mastectomy desires. This reconstructive surgery is performed using general anesthetic and the procedure ranges from six to eight hours in length.
The areas to be performed on will be cleaned using medical grade soap. You will be covered in a sheet in order to keep the operating area clean. Incisions will be made in the area of your body where the tissue will be retrieved. The tissue will be formed into a shape appropriate for your body and breasts. The incisions are sealed using surgical staples or stitches and covered in medical bandages. Nipple reconstruction is typically deferred until the breast reconstructive surgery is completed in order to properly plan the positioning of the nipple and areola.
Recovery from TRAM Flap Breast Reconstruction
After the operation is complete, you will be moved to a recovery area where you can be closely observed. You will be kept very warm in order to aid in the expansion of the blood vessels which will allow circulation to your new breasts.
For the first 48 hours, you will require help from the staff for most activities. During your recovery time, you will be positioned with your knees bent up, with the aid of a pillow, and will be lying almost flat to alleviate any stretching of the newly connected vessels in your new breasts. This will also reduce any strain on the abdominal area where the tissue was retrieved.
Contact Our Board-Certified Plastic Surgeon Today
Dr. Gartside understands the toll, both physically and emotionally, that it takes on patients who are battling breast cancer. It is her priority to make your breast reconstructive procedure as complication-free and comfortable as possible. You will be guided through the progression to make certain you have a successful passage through the rehabilitation process.
To arrange a consultation with Dr. Gartside, please call 703-742-8004 or contact us online. New Image Plastic Surgery Associates serves women in and around Washington, D.C., and areas of Virginia including Reston, Fairfax, and McLean.