Which Option Is Right for You?

The primary goal of any breast cancer surgery is to completely eliminate all cancerous tissue. Reconstruction is only performed when it will not affect your breast cancer treatment. Your breast reconstruction options may be limited, or the quality of your results may be compromised in the following situations:

• Chemotherapy and radiation. These two cancer therapies can impact the timing and, possibly, the type of breast reconstruction that is right for you. Your reconstruction will need to be timed sufficiently before or after these treatments in many cases, though it is important to note that for certain candidates, single-dose radiation can be performed during oncoplastic breast surgery, both eliminating the staging of the reconstructive procedure and several weeks of radiation follow up appointments. I work closely with each patient’s cancer doctors to ensure that the reconstructive process is not impacted by and does not negatively affect these vital cancer treatments.
• Previous abdominal or chest surgery. TRAM, DIEP, and SIEA flap reconstruction techniques use abdominal tissues for a breast reconstruction. If you have had a tummy tuck (abdominoplasty), liposuction of the abdomen, or certain other abdominal procedures, these techniques may not be an option. A lat flap technique may not be viable for patients who have had prior chest/breast surgery.
• Conditions that limit wound healing. Diabetes may lead to wound-healing problems or infections, while medications used to treat autoimmune diseases such as rheumatoid arthritis and scleroderma may also compromise the ability for incisions to heal. Bleeding disorders, blood thinners, and other agents used to prevent blood clots are likely to increase post-operative bleeding without proper planning ahead of time.
• Smoking and nicotine use. In addition to being very poor for your overall health, smoking before and after breast cancer removal and reconstruction increases your chances of complications. Nicotine, whether from cigarettes, nicotine gum, skin patches, or chewing tobacco, constricts the blood vessels and leads to higher rates of wound healing problems and infections. If you smoke, it is extremely important to seek help quitting before your breast surgery, and you may want to consider medications such as Wellbutrin or Chantix that have helped people beat the addiction.

Every breast reconstruction I perform requires a unique approach to address the specific patient’s issues and challenges. My goal, in concert with the entire cancer care team at Hoag Hospital, is to create a satisfying and beautiful breast reconstruction result in every case. With oncoplastic breast reconstruction in particular, the results we achieve yield beautiful, youthful, natural breasts. Breast reconstruction can help you feel whole again and increase your self-confidence about the look of your breasts.

Before reconstructive surgery, take a look at photos of women who have had the same type of cancer surgery and reconstructive surgery you are considering. In this way, you can develop a better idea of the types of outcomes that are typical and make sure you feel comfortable with what your breasts are likely to look like after surgery.