So one of the most common concerns when it comes to a surgery for breast cancer
is really what happens after that cancer and the breast has been removed.
Sometimes you can have a part of your breast called a partial mastectomy that's
removed to take out the cancer,
or you may have a total mastectomy that's the whole breast.
But because screening has gotten so good,
as well as our recognition of cancer and catching it at an early time,
patients are getting a lot younger, right?
With their cancers and the need for surgery.
And the emotional health and the psychological health and physical health of
these patients is very important.
And I'm very happy about the fact that just like treatments and everything are
becoming more innovative to treat cancer,
because we're doing a better job on curing cancer for people through their
lifetime, it's also very important to help the quality of their life.
And some of the things that they may be concerned about long-term. Here,
we're going to talk about some of the options that are kind of newer and really
the evidence shows is maybe safer options to be able to have,
not an implant,
but to reconstruct your breast so that you can have that kind of emotional
aspect really protected through the process as well.
And that's kind of what you specialize in, right? Correct.
Yeah. Reconstructing the breasts with using your own tissue and we call it
autologous reconstruction,
is a well thought out and long lasting technique that's been around for a while,
but some of the ways we do that have changed in the recent years.
Yeah. And so, doing plastic surgery, you can go any direction with it.
And for you, you've always been passionate about doing reconstruction,
but it sounds like here in at least Louisiana,
there's been this focus on what we call this "auto-reconstruction." And as a
hematologist,
what that means for us is we think about autotransplant stem cells. So,
ALLO means you'd have a donor and then you'd put it in and that's for leukemia,
but auto, you use your own stem cells to try to get into remission.
And here it's the same concept.
You read all this stuff about how it can be scary to get an implant or a
prosthesis put in and they may break or they may bust and they need to be
replaced. And those things are concerning.
But it's unfortunate because sometimes that means, well,
unfortunately I do have to just have one breast but I don't want to take the
risks of those things. And that's where this comes in. Is to say,
let's not put in a foreign device,
but let's make people aware that there's a process where it can be literally
your own tissue. I know some people don't like this phrase, but a tummy tuck.
I've had patients say,
"I got a tummy tuck after my mastectomy kind of for free." And I said,
"What do you mean by that?" And they mean, well,
they went in and they took out the adipose tissue or the fat from,
you'll be going into that more technically and putting it into the breast,
correct?
Yeah. So,
one of the gold standard for autologous reconstruction or auto reconstruction is
using a tissue from the lower abdomen. It seems to be a good donor site,
a good area where we can hide the donor scars. And in the wake of that,
you do get a better abdominal contour.
It is not a full tummy tuck as that is a cosmetic procedure,
but it definitely improves the abdominal contour.
Yeah.
And I know there used to be a concern about kind of the strengthening of the
stomach muscles and how they remain intact,
kind of maybe earlier procedures where they tried to attempt the same thing.
I'm told that this actually protects that area, correct?.
Correct. And in the past we used what's called a tram flap,
where we actually took abdominal wall and muscle and transported it with the
tissue. Today,
we found the technology's improved and the techniques have improved.
And we're now able to leave the abdominal wall muscle behind and just take skin
and adipose tissue,
which doesn't provide any structural strength to the abdominal wall.
That's wild,
but what happens if somebody doesn't have enough there to be able to use for
that reason?
So we can look in other areas. There's the inner thighs, the outer thighs,
the posterior back, those areas, also the upper back,
we can also get from there. But in some cases,
sometimes we are able to take multiple flaps,
multiple donor sites and stack those on top of each other to get the desired
volume for the breast.
Is this something that's available everywhere?
In most markets you probably can find it. Not everybody's doing this.
This is a procedure that most private practice surgeons don't incorporate into
their practice,
just due to demand and the technical difficulty of the operation.
But it's a great operation for the patients.
And I think it provides long lasting results.
That's fantastic. Well, here at Doctorpedia,
we're hoping of course to educate you with everything when it comes to curing
your cancer and treating it and equipping you with the kind of knowledge you
need to make something really scary maybe a little less scary, but certainly,
cancers are cured all the time. Breast cancer is one of, well,
the most common cancer in women.
And these kind of long-term things really need to be considered because life is
finite. We all have a start date and an expiration date,
but we really want to maximize the quality that we have,
especially if we're able to achieve a cure or remission.
So we hope that you find this information useful.
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