By Rich Adams
Midland plastic surgeon said patients often are overwhelmed with information
A diagnosis of breast cancer often can overwhelm a patient with information on the severity of the cancer and the variety of treatments available, such as radiation to shrink the tumor, chemotherapy, and lumpectomy or mastectomy.
Some of the decisions women with breast cancer face is whether to have reconstruction surgery, what type of surgery to have and what to expect once the restoration is complete.
“Just as they are given a mountain of information regarding their cancer treatment, there is an equal amount of information regarding the options for reconstruction,” said Dr. David Yonick of Yonick Plastic Surgery and Aesthetics Center in Midland. “The options are almost endless between tissue expanders and implants versus using the patient’s own tissue.”
Each option has different pros and cons, Yonick explained.
- Tissue expanders, where an inflatable device is placed at the time of breast cancer surgery, is designed to “grow” a breast mound by stretching the tissue over time. Pros: reconstructive surgery is shorter. Cons: A second surgery will be necessary to replace the expander with an implant.
- Placement of an implant at the time of breast surgery. Pros: Only one operation is necessary and the patient leaves with completed breasts. Cons: The patient will be slightly smaller-breasted from where she started.
- Using the patient’s own tissue or a “flap” option. Pros: Breasts are complete after surgery and patients can avoid an implant. Cons: Operative time is significantly lengthened, and a longer hospital stay is required.
“I find the best approach is to meet with my patients twice before surgery. Most patients will have multiple questions after our first meeting,” Yonick said. “In the end, a patient should not feel ashamed or embarrassed to ask questions. They are given a lot of information to process in addition to all the decisions they need to make regarding treating their cancer. It is not surprising a patient may feel overwhelmed.”
Yonick said the decision to undergo breast reconstruction surgery could be made anytime during the process. The exception might be when there is a need for post-surgery radiation treatment when the reconstruction can take place using a patient’s own tissue.
“However, with the advent of routine screenings, most patients’ cancers are detected at an earlier state,” he said. “This alone has limited the number of women who need post-radiation surgery and even reconstruction surgery.”
Recovery time can vary as well, Yonick explained.
“Patients who elect to undergo tissue expander or implant-based reconstruction can expect to have shorter recoveries,” he said. “Most women return to their normal routines between two and four weeks after surgery.”
The biggest factor is how the patient feels after each subsequent tissue expansion, where each “fill” increases the breast mound in size by further stretching the tissue.
“Women report feeling sore, heaviness, pressure and even muscle spasms after each expansion,” Yonick noted.
Recovery after “flap” surgery depends on the complexity of the surgery, he said.
“These women tend to require longer use of pain medication secondary to the larger surgery,” Yonick said. “Most of these women return to normal routines between six and eight weeks after surgery.”