Cosmetic Breast Reconstruction
Breast cancer is a devastating disease the permeates every segment of our society. It is estimated that 1:8 women will develop breast cancer sometime in their life. These women are our daughters, mothers, wives, our sisters and our friends. Currently there are multiple treatment modalities for breast cancer. They may involve chemotherapy, radiation, and surgery–and sometimes all 3. Regardless of treatment modality the female breast is affected by this diagnosis. In response to this, plastic surgeons have spent decades advancing and perfectiong breast reconstruction techniques. At Ocean Drive Plastic Surgery, we have developed multiple breast reconstruction techniques to restore the shape and aesthetic outcomes of the female breast.
At Ocean Drive Plastic Surgery, we take breast cancer very personally. There is a strong history of breast cancer in Dr. Durkins family and it has affected him and his family for generations. We stay current and up to date with all modalities of breast reconstruction. We are proud to offer the most cutting edge techniques in breast reconstruction in the world.
Not all breast defects are equal. Some women prefer lumpectomy or removal of part of the breast to mastectomy which is removal of the full breast.. Other women are candidates for an oncoplastic approach, which utilizes breast reduction and breast lift surgical approaches to treat the cancer.
When evaluating lumpectomy defects, the first question to determine is whether or not you have received radiation therapy. Radiation therapy is a durable and proven modality treating for breast cancer. It is safe and effective. Unfortunately, it decreases the native ability of the breast to heal after surgery. Breast cancer of this many lumpectomy defects will not be candidates for traditional surgery. Some defects will require a complete mastectomy followed by flap reconstruction.
In patients where less extensive radiation damage is present, other options exists. Many women are candidates for structural fat grafting. And, some are candidates for vertical mastopexy or inverted T mastopexy. Structural fat grafting involves removal of fat from other parts of the body and purificationof the fat after it is removed. Once purified, the fat is then placed into the mastectomy defect for reconstruction of the defect. Again not all women are candidates however, appropriate candidates commonly achieve good to excellent results with this approach. through
Women who are not candidates for fat grafting will often require a complete mastectomy and this may be covered by the patients insurance. In these women, we are strong believers for autologous reconstruction with or without implants. Implant based reconstruction alone in these women has the potential for significant complication. Very few women in this category are candidates for implant only reconstruction and Dr. Durkin evaluates your skin envelope, medical history, treatment history during your consultation.
A mastectomy is the medical term for removal of the entire breast. There are multiple ways to do a mastectomy:
Nipple sparing mastectomy.
This approach can be utilized LCIS, DCIS, or early stage invasive ductal carcinoma that is unicentric rather than multi centric. In this technique, only the breast tissue and a minimum of skin are removed during the mastectomy.
Skin sparing mastectomy.
The nipple aereolar complex is removed with a minimum of skin. This minimizes subsequent scarring. This technique can be utilized inmost staged breast cancer as long as there is no close skin margin or involved skin margin. We do not advocate this approach in cases of inflammatory breast cancer. As well, depending on body havitus, not all women are candidates for this approach as many women have excess skin prior to diagnosis of breast cancer. In selected patients, however, this approach proviceds excellent aesthetic results with minimal scarring.
In this type of procedure, a horizontal or diagonal incision is utilized to reduce the skin envelope of the breast and remove all breast tissue. This approach, while it does create a greater size scar, has decades of proven success behind it. This treatment modality is often offered to women with large pendulous breasts and excess skin prior to their diagnosis of breast cancer.
The decision on the type of mastectomy taken is created in conjuction with you and the input of your oncologic breast surgeon. Ocean Drive Plastic Surgery is proud to associate only with board certified breast surgeons when we undertake your care. The decision on your surgical therapy we undertake must be thoughtful. It is a journey that we take together.