Light at the end of the tunnel

One of my favorite patients had her nipple-areola tattooing this past week and her husband had remarked to me what a difference breast reconstruction had made in her life... She was a patient who had, from the beginning, several decisions to make relating to chemotherapy and ultimately planning reconstruction. Breast reconstruction, to coordinate with planned therapy, is ultimately secondary to certainly cancer treatment, but a close second at that!

Partial mastectomy reconstruction

I just read about a recent development in Oregon, where the legislature at the end of May, voted to have insurance companies cover reconstruction of partial mastectomy patients, or patients having lumpectomies. Previously, only full or total mastectomies were covered in the state. This is a significant occurrence, as patients elsewhere may also may be able to have breast reconstruction, even in the cases of partial mastectomy.

Unilateral versus bilateral reconstruction timing

We saw a patient this past week who had had bilateral breast reconstruction using abdominal tissue.... only at two different settings with mastectomies at different times... on one side a tissue expander was placed and the skin expanded over time following a mastectomy. At a later time, the other mastectomy was performed with immediate reconstruction using abdominal tissue along with removal of the original tissue expander followed by breast reconstruction using abdominal tissue...

Not to add too many varibles, but it is important that with bilateral reconstruction with abdominal tissue (one side immediate, the other side delayed), that the "outside" skin incisions, etc will look different...

Evening of Gratitude program at Beth Israel Deaconess Medical Center

This past week there was a special event at the medical center honoring cancer patients and their caregivers. One of our breast reconstruction patients made a generous donation to the medical center on my behalf. A very thoughtful, generous, and nice token of appreciation, and there are many folks at the hospital to also thank who make it possible to take the best care of our patients!

Caffeine and breast reconstructive flaps

I had a patient recently who was a 2-3 cup a day coffee consumer who asked about caffeine intake after surgery... indeed, there may be a situation where your plastic and reconstructive surgeon asks patients to decrease or even temporarily discontinue caffeine intake for a period of time after surgery to optimize wound healing... just a thought to perhaps be able to begin the taper-off period to avoid caffeine withdrawal headaches afterwards!

This past week

I would like to thank a patient of mine who I saw this week who had undergone bilateral mastectomy with implant based reconstruction, and, at this point, bilateral nipple reconstruction... on course for her nipple-areolar tattooing. Her comment was that breast reconstruction, including the nipple-areola reconstruction, was more than simply just that.... it really completed a person's entire persona and feeling as a whole person.....

Breast Cancer Coordinated Care Conference in Washington DC

The BC3 conference is going on in washington DC currently and there is an interesting section on partial breast reconstruction. This field was first popularized in Europe, and is currently increasing in frequency at centers in the US... Essentially, the technique revolves around reconstruction of a lumpectomy defect by a plastic and reconstructive surgeon following the excision of a breast mass by rearrangement of the breast tissue in order to preserve the breast shape as much as possible...