For a woman, one of the hardest pieces of news to receive may be a breast cancer diagnosis. Many women immediately examine their options for the best way to overcome the disease and bolster their fight to stay alive. It’s important to consider all aspects of life – including reconstruction – on the road to recovery.
Women who have a positive perception of their bodies and the future can feel better equipped to handle and succeed in their treatment regimens. To maintain that positive outlook, many women decide to reconstruct their breasts following mastectomies. Surprisingly, though, many of them don’t know all of their reconstruction options. A University of Michigan study found that seven out of 10 women did not fully understand their reconstruction options. This is disheartening.
Some surgeons are not equipped to provide women with the information they need to even consider breast reconstruction because it is oftentimes considered an afterthought to the mastectomy procedure. Typically, when many women think about breast reconstruction, they only think about the women who have gone to the extreme or the horror stories of capsular contracture. These lines of thought make some women nervous and they completely avoid pursuing reconstruction. In reality, there are several options when it comes to breast reconstruction.
Saline and silicone implants are the most common and well-known of the breast reconstruction techniques. These more common, traditional implants leave more scarring in addition to the already prominent mastectomy reminders. The flap procedure is another common reconstruction technique. While these work for some women, they may not be the best option for all; some women’s bodies reject or have a difficult time adjusting to implants as they are viewed by the body as foreign objects. Aside from these drawbacks, the mere thought of another hospitalization and being cut open again is often unsettling for many women.
Another option available to women is the autologous fat transfer procedure, a 100-percent outpatient procedure that uses needles similar to those used in liposuction to transfer fat from various areas of the body into the breast. The fat cells are grafted into the breast area to serve as natural-looking and -feeling new breasts. This procedure also allows patients to eliminate fat from some of their more troublesome areas like the abdomen and thighs while also regaining the confidence that comes from having voluptuous, fully formed breasts. Another benefit of AFT is that a team of plastic and general surgeons can perform the mastectomy procedure, and then immediately begin reconstruction using only the individual’s own fat, without the need for implants or complex tissue flaps.
Positives of fat
The problems that afflict patients with implants are virtually eliminated with AFT. After the procedure, patients’ breasts still look and feel natural. Those who choose the AFT technique to reconstruct their breasts also find that skin and sensation return to the breasts, which is not the norm with traditional implants. Another downfall of artificial implants is that they can interfere with future mammograms. That is also not an issue with breasts reconstructed using AFT.
Fat is one of the most misunderstood and underappreciated body tissues because of its perceived negative impact on the appearance and the general condition of the human body. Fat contains more stem cells than any other tissue in the body and it is the only tissue that can expand or contract as needed. With continued advances in research surrounding the uses of fat, there are exciting new options, including nanofat skin rejuvenation to lessen the appearance of wrinkles in the hands and face, but none are more notable than breast reconstruction after a mastectomy.
Life after reconstruction
Women often seek to return to their normal lives after experiencing diagnosis, surgery and reconstruction. Staying active is a great way to maintain a new sense of self after beating breast cancer. There are groups such as breast cancer survivors’ dragon boat teams that provide physical and emotional therapy for women. Through an active sport like dragon boat racing, women increase the mobility of their arms and the strength of their chest muscles, which helps heal the scar tissue from their mastectomies.
After beating breast cancer, transitioning to a post-cancer life isn’t always easy. Knowing all the options available to your patients throughout the process is key to their success. More primary care physicians and oncology physicians should be familiar with the various reconstruction options available to women and share them with their patients so that they can enjoy more successful and fruitful lives after winning the breast cancer battle.
By Dr. Jeffrey Hartog
Dr. Jeffrey Hartog is the medical director of the Breast Center at The Bougainvillea Clinique in Winter Park, Florida. Internationally trained, he specializes in fat transfer to the breast and presents nationally and internationally on the subject. Photo by Kira Westland via Flickr.
I have had four fat grafting surgeries. With very little improvement. I was told that was because of radiation treatments I had. My surgeon is against getting implants. My plastic surgeon recommended a Brava Bra and then more fat grafting, but she doesn’t work with the Brava Bra and I am concerned it might not work either.
Naomi, Fat grafting in radiation cases is definitely more difficult and time consuming. Additional technical issues must be considered when performing the fat transfer as well, so it’s not just an issue of using the BRAVA. Having said that, fat grafting is the only procedure that can actually improve the quality of irradiated tissue when performed correctly and the patient has clear understanding of the process, and appropriate expectations.
I have numerous cases that I can show you of significant improvement with fat transfer in radiated cases, but it certainly is more difficult and I would be happy to see you in consultation.