VIDEO TRANSCRIPT: The question that any patient with breast cancer or who is at high risk for the development of breast cancer should ask is, "Am I a candidate for breast reconstruction?"
And the answer to that is in the vast majority of cases, yes.
Because women today are much more aware of the breast cancer diagnosis or high risk situations, BRCA1 and BRCA2, check mutations, different mutations that place them at higher risk for the development of breast cancer. Breast reconstructive options and breast reconstruction in general has become much more so on the forefront.
I believe that almost every woman today undergoing mastectomy is a candidate for breast reconstruction with rare exception. There are some tumors that are so large or aggressive or have skin involvement where reconstruction may not be appropriate that point in time. That does not preclude her necessarily from future reconstruction. But the majority of the patients that we see today are suitable candidates for what we call immediate reconstruction where the reconstructive process begins at the time of the mastectomy. And the advantage of this is the woman wakes up having begun her breast reconstruction.
There is little doubt that immediate reconstruction decreases sense of loss. I hear it repeatedly when a woman looks down and says, "I already have the makings of my new breast. I've already begun the process." So I think immediate reconstruction is really a technique, a tool of the reconstructive surgeon, that has both decreased sense of loss and improved the quality of our outcomes.
Whether we place a temporary adjustable volume implant called a tissue expander or we use the woman's own tissues at that time, the skin envelope, the skin of the breast, and increasingly the nipple and areola are maintained. Maintaining the skin improves the quality potentially of that aesthetic outcome. Whereas if we remove the skin with the scars that we used to think of as traditional mastectomy, the natural quality of the reconstruction is significantly compromised.
In my practice, I discuss with each patient a variety of incisional approaches that in many instances mimic or borrow from the techniques that we used in aesthetic breast surgery. For example, mastectomies today, particularly in breasts that are smaller or have very little or no droop, incisions using the fold of the breast -- an approach which is used for breast augmentation. In addition, I frequently use a mastopexy or breast lift type incision to accomplish my mastectomies and reconstructions. And I use a variety of other incisional approaches to try to avoid the traditional transverse scar that involves the inner part of the breast, which I try to avoid at all costs.
While that isn't possible in every instance, in my practice it is possible in the vast majority of cases and I think that patients tend to be much happier with scars that mimic or are modifications of more traditional aesthetic surgery scars than what we thought of as the traditional mastectomy and reconstructive approach. So yes, the majority of patients we see today are candidates for breast reconstruction. Most of them are candidates in the immediate setting, and the immediate setting decreases sense of loss and potentially significantly improves the cosmetic outcome. And even women who are deemed not to be suitable candidates for immediate reconstruction are not precluded from subsequent delayed reconstruction that still may be pleasing to that individual. The technique used, the incisional approach and the timing of the surgery is best decided after lengthy discussion between that unique patient and her surgeon.
I'm Dr. Jay Orringer at The Renaissance Medical Center for Aesthetic Surgery. If you have questions regarding this procedure or any other plastic surgical procedure, please feel free to contact us at 310-273-1663 or visit our website at www.drorringer.com.
