Leahy: Breast reconstruction is more than cosmetic

Cosmetic breast surgery has gotten something of a bad rap over the years. The idea of “having some work done” on the breasts may actually be keeping many women who might benefit from breast reconstructive surgery from considering it.
Each year, more than 254,000 American women battle breast cancer. But according to a new study, less than one-fifth of women who undergo mastectomy currently choose to have breast reconstruction.

A stigma equating elective cosmetic surgery with reconstructive surgery is partially to blame, along with a woman’s hesitation to put herself first. There are also lingering perceptions that surgery can affect the chances of cancer returning, when in fact studies exist, including high volume studies in literature, that indicate that reconstructive surgeries have been shown to increase a patient’s survival rate and quality of life.

The American Society of Plastic Surgeons is more optimistic, estimating that 93,000 women in America underwent breast reconstruction following mastectomies last year, an increase of nearly 20 percent from a decade ago.

The study’s author urges the medical community to educate patients about reconstructive surgery before mastectomies and other surgeries are performed to help them make a well-informed decision, which is now law in New York, and the vision statement of the National Breast Reconstruction Awareness Day.

In reconstruction surgery, plastic surgeons can help re-create lost breast tissue from mastectomy through a variety of treatment options. The fact that the patient has options and choices at this stage of treatment is one major reason why plastic surgeons enjoy working with these patients.

Options range from simple to more complex, depending upon the situation. One option is NOT to have reconstruction. I believe all patients should at least have the benefit of meeting with a surgeon to discuss their cases. I sometimes utilize a breast implant to re-create the lost volume, and other times I borrow the patient’s own tissues to do the job. This would be followed down the road by nipple and areolar reconstruction to help the woman feel better about herself moving forward.

Sometimes women are born with deformities of the breasts that lead to small or distorted growth of the tissues, often only on one side. This leads to similar problems mentioned above, and especially feelings of self-consciousness during the teenage years and early 20s. These conditions can also be greatly improved by plastic surgery.

While I may not be able to hit a particular cup size, owing to differences in design and manufacturing, the goal is to provide a natural appearance to the breast that is symmetric and balances the rest of the patient’s figure as well.

Plastic surgeons take the initial consultation with patients considering breast procedures very seriously. We encourage patients to bring a friend or family member to help ask questions and to remember the information. Plan to take some time on your first visit, so you can talk with your surgeon in a relaxed fashion. I try to provide as much detail as the patient is interested in hearing, focusing on the goals and expectations of the procedure, recovery and potential complications that can develop.

For cases covered by third-party insurance companies (breast reduction/reconstruction), there may be other steps that are required in terms of documentation. Make sure your surgeon’s office is aware of these nuances and can help negotiate this process.

The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy.

There are trade-offs. In some situations, it may not be possible to achieve optimal results with a single surgical procedure, so another surgery may be necessary. But most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole again.

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