Can Breast Reconstruction Improve A Woman’s Psychological and Sexual Wellbeing?

DIEP flapIn a recent article, titled Advanced Post-Mastectomy Breast Reconstruction Improves Women’s Psychosocial and Sexual Wellbeing, by CANCER Online Journal, a study found that “After a mastectomy, women who undergo breast reconstruction with tissue from their own abdomen experience significant gains in psychological, social, and sexual wellbeing as soon as three weeks after surgery.” (CANCER Online Journal: http://www.canceronlinejournal.com/newsroom)

The study was performed by Toni Zhong, MD, MHS, of the University Health Network Breast Restoration Program in collaboration with several others at the Memorial Sloan Kettering Cancer Center in New York City. They surveyed 51 women who were preparing for their MS-TRAM or DIEP flap reconstructive surgery during the months between June 2009 and November 2010.

Breast reconstruction is restoring the form of a breast that has been damaged, partially removed, or completely removed. Breast reconstruction is almost always done after treatment for breast cancer, although there are some birth defects that can result in the need for breast reconstruction. Breast reconstruction can be performed with implants (the same ones used for breast augmentation), or with the body’s own excess tissue (usually from the abdomen or buttocks), thus avoiding the need to place foreign objects in the body.

The study found that these women who experienced breast reconstruction “reported significant improvements in psychological, social, and sexual wellbeing just three weeks after surgery,” according to the article.

Although The Center for Natural Breast Reconstruction has not performed a formal study on the feelings that patients experience post breast reconstructive surgery, we have found that many of them feel a sense of improved psyche and self-esteem. Just ask Leslie Haywood who underwent breast reconstruction with the Charleston breast surgeons of The Center for Natural Breast Reconstruction: “I have never been happier with my body and I have never been more in shape in my entire life!”

If you know of someone who would be interested in hearing about this study, visit the CANCER Online Journal newsroom where the article will soon publish to: http://www.canceronlinejournal.com/newsroom

What Are My Options for Uneven Breasts?

charleston breast surgeonsThe below question is answered by the Charleston breast surgeons at The Center for Natural Breast Reconstruction.

I had TRAM flap reconstruction in 2002 with revision and a follow up surgery in six months later. Since then some shrinkage has occurred in the reconstructive side and I have a hollow area on the upper portion. Do I have options for more normal looking breast without the hollow area?

You potentially have many options to improve your reconstruction. No one solution is perfect for all situations, but some options include repositioning the flap to a higher location, augmenting the hollow area with your own fat grafts (taken usually from abdomen, thigh, or buttocks), or using any excess skin / fat from under your armpit as an additional flap to lift and augment the TRAM (we call this a 5th intercostal artery perforator flap). Some more aggressive options would include placing a small breast implant under the TRAM flap, or adding a whole new microvascular flap from another area, although this is rarely in practice necessary.

Hope this helps. Please feel free to email or call with any additional questions.

–The Center for Natural Breast Reconstruction Team

Breast Reconstruction Surgeons Answer Your Questions About Reconstructive Surgery

reconstruction optionsThe question below is answered by Charleston breast surgeons Dr. James Craigie and Dr. Richard M. Kline, Jr., of The Center for Natural Breast Reconstruction.

What is the difference between breast reconstruction and augmentation?

Breast augmentation is when you increase the size of a normal healthy breast, almost always with saline or silicone gel implants.

Breast reconstruction is restoring the form of a breast that has been damaged, partially removed, or completely removed. Breast reconstruction is almost always done after treatment for breast cancer, although there are some birth defects that can result in the need for breast reconstruction. Breast reconstruction can be performed with implants (the same ones used for breast augmentation), or with the body’s own excess tissue (usually from the abdomen or buttocks), thus avoiding the need to place foreign objects in the body.

What are the pros and cons of a DIEP versus a TRAM flap reconstruction?

The primary advantage of DIEP flaps over TRAM flaps is a far greater potential for preservation of rectus abdominus muscle function, since no muscle is removed with a DIEP, yet one or both rectus muscles is obligatorily completely sacrificed with every TRAM flap. Additionally, since the muscle does not need to be tunneled under the skin to reach the breast area with a DIEP, the shape of the inferior region of the breast can be better defined.

The primary advantage of the TRAM flap over the DIEP flap is that it can be done by one surgeon who does not have the skills or equipment (microscope and special instrumentation) to perform a DIEP flap. While TRAM flaps can sometimes be performed more quickly than DIEP flaps, this is not always the case, and is very dependent upon the skills and experience of the surgeon. In our practice, DIEP flaps are always performed with two fully-trained perforator flap surgeons present, which we believe contributes greatly to the success and timely completion of the surgeries.

Why don’t more plastic surgeons offer the DIEP procedure?

When the DIEP flap was originally presented by Dr. Robert Allen in the 1990s, it was frequently criticized as being too difficult for many surgeons to learn to perform easily. While many more surgeons now offer the DIEP flap, it is still more technically demanding for the surgeon than many other procedures, and can be quite difficult to learn without spending significant time with another surgeon who has considerable experience with the operation.

Do you have a question for the breast surgeons of The Center for Natural Breast Reconstruction? If so, we’d love to hear from you. Click here to ask us!