Breast Reconstruction – Dr. Douglas Mackenzie in Santa Barbara
See Dr. Mackenzie’s Breast Reconstruction photos HERE.
Breast reconstruction is an option for many women facing breast cancer, but also for women with congenital breast problems and asymmetries. These reconstructive plastic surgery breast procedures are typically covered by insurance.
For a woman getting a diagnosis of breast cancer, the shock is understandably enormous, and she will also be daunted by the amount of information that she will suddenly get from her physicians, friends, and other resources, including the Internet. Because of the desire to treat the cancer as soon as possible, this will all happen in a fairly short period of time, and often leads to “information overload”, worsening her anxiety.
Techniques and treatments have thankfully advanced so that breast cancer can often be caught early, and sometimes treated with minimal effect on the breast appearance. However, when mastectomy is necessary, or even if a significant lumpectomy is planned, plastic surgical reconstruction of the breast is available to restore or retain the breast appearance.
The breast reconstruction procedure often requires a series of two or three staged surgeries that can take several months. Patients have generally two broad options for breast reconstruction – implant reconstruction or autologous (using their own tissues) reconstruction.
In implant reconstruction, a synthetic implant is placed under the pectoral muscles, forming the breast mound. In autologous reconstruction, the surgeon moves a flap of skin or tissue from one area of the body, usually the abdomen (TRAM flap) or back (Latissimus flap) to the breast in order to form the breast mound. In a later surgery, the plastic surgeon can create the areola and nipple, completing the breast reconstruction procedure. There are many options and variations regarding breast reconstruction techniques, tailored to the individual patient, and this will be discussed in detail during your consult.
Fat grafting is another tool used by plastic surgeons during breast reconstruction. Fat grafting is typically used to refine the contours of a breast reconstruction, or to provide modest volumes in specific areas, such as when correcting the effects of a lumpectomy. Fat grafting has also been shown to be beneficial to the surrounding tissues in women who have side effects of radiation treatment. Presumably, the unirradiated fat and the stem cells that it contains improve the physiology within the irradiated skin and breast.
You should also choose a plastic surgeon who is well versed and experienced in multiple techniques of breast reconstruction. Every patient is different – you do not want a cookie cutter approach to your breast reconstruction surgery! There are many newer techniques of muscle-sparing TRAM and DIEP flaps, free TRAM flaps, and single staged implant reconstruction with skin sparing or nipple and areola sparing mastectomy.
Because of the sheer amount of information and explanation necessary, Dr. Mackenzie will typically take more time in consultation with the breast reconstruction patient and her significant other than for any other procedure. Dr. Mackenzie understands that after a diagnosis of breast cancer, your life becomes a hectic array of doctor visits, tests, and information gathering. Dr. Mackenzie will discuss any surgical plan with your general surgeon, as the technique of breast reconstruction also depends on the exact surgical (and possible ancillary treatments such as breast radiation therapy) procedure to be performed.
Please also read Dr. Mackenzie’s June 25, 2009 blog post “Breast Reconstruction Outcome also Depends on Mastectomy Technique” on this subject.
Dr. Mackenzie performs breast reconstruction in Santa Barbara at Goleta Valley Cottage Hospital for inpatient procedures and at Goleta Valley or Surgical Arts Surgery Center for outpatient procedures.
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For more information on breast reconstruction or any breast enhancement procedures, contact Pacific Plastic Surgery in Santa Barbara. The American Society for Plastic Surgeons has additional information on breast reconstruction.