IF YOU'RE ONE OF MILLIONS OF BREAST CANCER SURVIVORS OUT
THERE-- CONGRATULATIONS!
AND YES, YOU OBVIOUSLY FEEL SO BLESSED TO BE ALIVE
BUT AT THE SAME TIME YOU PROBABLY ALSO
KNOW HOW DIFFICULT IT IS TO FEEL PRETTY AGAIN.
A CANCER DIAGNOSIS IS EMOTIONAL AND TRAUMATIC.
BUT FOR A WOMAN THE LOSS OF A BREAST
CAN ALSO BE A DISTRESSING AND VERY PERSONAL LOSS.
BREAST RECONSTRUCTION HAS CERTAINLY
COME A LONG WAY OVER THE YEARS.
THANKS TO RENOWNED PLASTIC AND RECONSTRUCTIVE
SURGEONS, LIKE MY GUEST, DR.
KRISTINA O'SHAUGHNESSY.
SHE'S HERE TO TALK ABOUT SOME OF THE SURGICAL CHALLENGES
AND NEW OPTIONS FOR BREAST RECONSTRUCTION.
ALONG WITH HER, ONE OF HER SPECIAL PATIENTS,
KIMBERLY COLLEY.
GOOD MORNING.
THANK YOU SO MUCH FOR BEING HERE.
THANK YOU.
KIMBERLY, LET ME START WITH YOU.
UMMM, CAN YOU SHARE YOUR PERSONAL STORY;
YOUR DIAGNOSIS?
I CAN; IN 2011, I WENT IN FOR MY REGULAR MAMMOGRAM-
-UH HUM AND IRONICALLY, I HAD ALMOST
CANCELLED THAT APPOINTMENT AND I WAS JUST
GONNA' PUT IT OFF JUST FOR A LITTLE BIT
AND UMMM, I TALKED MYSELF INTO FINALLY
JUST GOING, IT WAS NO BIG DEAL.
AND THAT WAS THE DAY MY CANCER WAS FOUND.
UMMM...A LOT OF THINGS HAPPENED REALLY
QUICK AFTER THAT.
YOU HAVE TO MAKE A LOT OF REALLY FAST DECISIONS.
AND I DECIDED TO HAVE A BILATERAL MASTECTOMY
FOLLOWED BY RECONSTRUCTION.
WERE YOU SCARED?
I WAS ABSOLUTELY TERRIFIED.
-AHHH IT WAS THE SCARIEST THING I'VE
EVER GONE THROUGH IN MY ENTIRE LIFE.
DOCTOR, KIMBERLY'S STORY IS A STORY I'VE HEARD SO MUCH.
FROM A DOCTOR'S PERSPECTIVE, WHAT ARE SOME OF THE DIFFERENT
RECONSTRUCTIVE CHALLENGES WITH BREAST CANCER PATIENTS?
SURE, SO IN DISCUSSING THE TYPE AND TIMING OF BREAST
RECONSTRUCTION, I HAVE TO TAKE INTO
CONSIDERATION MANY FACTORS.
AND THE RECONSTRUCTIVE PLAN IS INDIVIDUALIZED FOR EACH
PATIENT.
FROM A PLASTIC SURGEON'S PERSPECTIVE,
THERE ARE MANY RECONSTRUCTIVE CHALLENGES.
AND THEY CAN BE DIVIDED UP INTO PATIENT
ISSUES, SUCH AS COMORBIDITIES, OR INTO PREVIOUS BREAST
SURGERIES OR PREVIOUS BREAST TREATMENTS,
SUCH A RADIATION.
UMMM, OR ISSUES RELATED TO THE MASTECTOMY ITSELF.
AS FAR AS ONE OF THE MAIN RECONSTRUCTIVE CHALLENGES; IT
HAS TO DO WITH PATIENT ISSUES THAT
MAY CAUSE ADVERSE ISSUES WITH WOUND HEALING
AT THE TIME OF THE MASTECTOMY.
PREVIOUS BREAST SURGERY CAN LEAD TO SCARING.
PREVIOUS RADIATION THERAPY CAN CAUSE EXTENSIVE TISSUE
DAMAGE.
AND THEN AT THE TIME OF MASTECTOMY,
THERE CAN BE OBLITERATION OF THE BREAST BORDERS THAT WE NEED TO
RECREATE.
SO WHAT DO YOU DO WHEN YOU'RE FACED WITH ALL OF
THESE CHALLENGES, DOCTOR?
WELL, THE GOAL OF BREAST RECONSTRUCTION IS
TO RECREATE THE BREAST.
AND THERE ARE MANY OPTIONS TO DO THAT.
YOU CAN USE IMPLANT-BASED RECONSTRUCTION LIKE KIMBERLY
HAD.
OR YOU CAN USE YOUR OWN TISSUES, IN THE FORM OF TISSUE FROM
EITHER THE BELLY, THE BACK OR ABDOMEN.
AND IT REALLY DEPENDS ON EACH PATIENT'S INDIVIDUAL SITUATION.
IF A PATIENT HAS HAD EXTENSIVE TISSUE DAMAGE FROM PREVIOUS
SURGERY OR RADIATION SURGERY, THEN IT MIGHT BE BEST FOR THE
PATIENT TO USE THEIR OWN TISSUES FOR
RECONSTRUCTION.
BUT, IF A PATIENT IS GOING TO UNDERGO
RADIATION THERAPY, AFTER A MASTECTOMY,
WE MAY WANT TO START WITH AN EXPANDER.
THERE HAVE BEEN SEVERAL INNOVATED
TECHNOLOGIES ACELLULAR DERMAL MATRICES
OR TISSUE GRAFTS THAT HAVE EXPANDED THE OPTIONS FOR BREAST
RECONSTRUCTION.
AND HAS ALLOWED US TO RECONSTRUCT
BREASTS WITH ADVANCED TECHNIQUES OVER SOME OF THE TECHNIQUES
AVAILABLE TODAY.
I'M REALLY GLAD WE'RE TALKING ABOUT THIS
BECAUSE I DIDN'T REALIZE ALL OF THE FACTORS INVOLVED.
WHEN WE COME BACK, WE'RE GONNA TALK
MORE WITH THE DOCTOR AND KIMBERLY
BECAUSE COMING UP AFTER THE BREAK
WE'RE GOING TO HEAR MORE ABOUT SOME OF
THE GROUNDBREAKING TECHNIQUES AND TECHNOLOGIES THAT ARE NOW
AVAILABLE TO SURGEONS LIKE DR.
O'SHAUGHNESSY AND PATIENTS LIKE KIMBERLY WHO
ARE LOOKING TO FEEL WHOLE AGAIN
AFTER BREAST CANCER.
STAY RIGHT THERE.
(MUSIC) WELCOME BACK.
WE'RE IN THE MIDDLE OF A VERY SPECIAL EPISODE OF THE BALANCING
ACT DEDICATED TO BREAST CANCER.
I'D LIKE TO WELCOME BACK, KIMBERLY COLLEY
AND DR.
KRISTINA O'SHAUGHNESSY.
BEFORE THE BREAK, WE WERE DISCUSSING KIMBERLY'S BREAST
CANCER JOURNEY AND SOME OF THE CHALLENGES THAT
PLASTIC SURGEONS LIKE, DR.
O'SHAUGHNESSY FACE
WHEN TRYING TO RECONSTRUCT A WOMAN'S BREAST AFTER CANCER.
THANK YOU SO MUCH FOR JOINING ME AGAIN.
KIMBERLY, I'M GOING TO START WITH YOU.
TELL ME WHAT YOU OPTED FOR AFTER YOUR DIAGNOSIS AND WHAT YOU DID.
I WENT WITH THE BILATERAL MASTECTOMY.
-OKAY.
I HAVE A PRETTY SIGNIFICANT AMOUNT
OF TISSUE LOST IN MY LEFT SIDE.
I HAD TISSUE REINFORCEMENT AND THEN
I DID THE FAT GRAFTING.
AND I EVEN GOT A LITTLE BIT OF LIPOSUCTION.
OH, WELL, WHOO-WHOO!
WHY NOT RIGHT?
OF COURSE!
HA-HA (LAUGHTER) THAT'S A BONUS.
THAT'S EXACTLY WHAT IT WAS.
(LAUGHTER) DOCTOR, TALK TO ME ABOUT THIS
TECHNIQUES IF YOU WILL.
SURE.
SO THE TISSUE GRAFT THAT KIMBERLY IS REFERRING TO IS
ACELLULAR DERMAL MATRIX OR REGENERATIVE TISSUE MATRIX
CALLED ALLODERM AND IT'S FROM LIFECELL.
AND IT'S PROCESSED IN SUCH A WAY THAT THE CELLS ARE REMOVED.
IT'S DONATED FROM HUMANS AND THERE
IS PROPRIETARY TECHNIQUE AFTER THE CELLS ARE REMOVED,
YOU ARE LEFT WITH A SCAFFOLD THAT
THE PATIENT'S OWN BLOOD VESSELS AND CELLS CAN THEN GROW INTO.
-REALLY?
AND SO IT BECOMES OF THEM; IT'S REGENERATIVE.
IT ACTS TISSUE SO IT MINIMIZES THE RISK OF REJECTION.
SO AT THE TIME OF MASTECTOMY, A TISSUE EXPANDER IS PLACED AND
THEN ALLODERM IS SUTURED FROM THE
MUSCLE DOWN TO THE CHEST WALL TO
HELP TO RECREATE THE BREAST BORDERS
AND TO ALSO HELP TO SUPPLEMENT OR
REINFORCE THE WEAKENED TISSUE THAT CAN BE DAMAGED AT THE TIME
OF MASTECTOMY.
I USED TO HAVE RAISE SURROUNDING MUSCLES
-AHH UMM AND THAT WAS VERY PAINFUL FOR
PATIENTS AND IT WAS ALSO VERY TRAUMATIC.
I NO LONGER HAVE TO DO THAT WITH THE
USE OF ALLODERM.
NOW WHAT ABOUT FAT GRAFTING PROCEDURES?
SO, FAT CELLS ARE TAKEN FROM OTHER
AREAS OF THE BODY; WHERE THERE IS EXCESS
SUCH AS THE ABDOMEN OR THE THIGHS,
AND THEN IT'S TRANSFERRED TO THE BREAST,
TO FILL IN CONTOUR DEFORMITIES OR TO RESTORE SHAPE OR VOLUME.
AND THE FAT IS TAKEN WITH TRADITIONAL
LIPOSUCTION TECHNIQUES AND CANNULAS
LIKE KIMBERLY DESCRIBED.
SO PATIENTS WILL GET AN ADDED BENEFIT TO IT.
SO, TRADITIONALLY, FAT GRAFTING HAS BEEN
A LITTLE BIT UNPREDICTABLE AND THAT'S BECAUSE OF VARIABLE
ABSORPTION RATES.
AND IT'S BECAUSE THERE IS NO STANDARDIZATION OF THE
PROCESSING STEP IN FAT GRAFTING.
SO, A NEW TECHNOLOGY CALLED, THE REVOLVE SYSTEM,
ALLOWS US TO EFFECTIVELY HARVEST AND PROCESS LARGE VOLUMES OF
HIGH QUALITY FAT FOR REINFECTION
INTO THE BREAST AFTER MASTECTOMY.
REVOLVE CONTROLS MANY OF THE CRITICAL VARIABLES THAT ARE
IMPORTANT IN THE PROCESSING STEP OF FAT GRAFTING.
AND ARE ALL THESE NEW TECHNOLOGIES FOR ALL PATIENTS?
WELL, BREAST RECONSTRUCTION IS INDIVIDUALIZED FOR EACH PATIENT.
-SURE.
SO I DO THINK IT'S IMPORTANT FOR EACH PATIENT TO TALK WITH
THEIR SURGEON ABOUT THE RISKS AND BENEFITS OF BOTH ALLODERM
AND REVOLVE TO BE SURE THEY ARE RIGHT FOR THAT PATIENT.
INNOVATIONS AND ADVANCES FOR BREAST
RECONSTRUCTION SUCH AS, REVOLVE AND ALLODERM HAVE REALLY
CHANGED BREAST RECONSTRUCTION.
IT'S OPENED UP MANY OPTIONS AND IT'S ALLOWED US TO OPTIMIZE
OUTCOMES FOR PATIENTS WITH BREAST CANCER
WHO HAVE TO UNDERGO BILATERAL MASTECTOMY
LIKE KIMBERLY.
AND I DO WANT TO BRING YOU IN KIMBERLY, IN TERMS OF YOUR
OUTCOME.
YOU LOOK GORGEOUS.
-THANK YOU.
I KNOW YOU'RE FEELING GREAT.
TELL ME WHERE YOU ARE TODAY.
I'M DOING FABULOUS!
I'M IN REMISSION.
AND I AM JUST DOING WONDERFUL.
I HAVE HAD CANCER, BUT CANCER HAS NEVER HAD ME.
THANK YOU, SO MUCH.
GOD BLESS YOU.
THANK YOU SO MUCH.
THANK YOU SO MUCH SWEETHEART.
DOCTOR, THANK YOU SO MUCH FOR THE INFORMATION.
YOU'VE TAUGHT ME A LOT TODAY AND I'M VERY HAPPY TO HAVE YOU
HERE.
COME BACK WITH ANYTHING NEW YOU MIGHT HAVE TO TELL US, OKAY?
THANK YOU VERY MUCH.
AGAIN, GOOD LUCK TO YOU KIMBERLY.
THANK YOU.
AND MAKE SURE TO HEAD TO THEBALANCINGACT.COM
FOR MORE INFORMATION.
THAT'S THEBALANCINGACT.COM
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