A Behind-the-Scenes Look at Breast Surgery - Lumpectomies, Mastectomies, & Immediate Breast Reconstructions
In my previous post, I walked you through what excisional biopsies are like. These are used to determine a more accurate diagnosis for what is going on in the breast. Is it ductal carcinoma-in-situ (DCIS) or something more?
Now, let's move onto the next level. If, god forbid, you are diagnosed with breast cancer, you have a few options based on the severity. If your breast cancer is not metastatic and contained to one region of the breast, you are a good candidate for a lumpectomy. This basically means that the trouble area or "lump" can be excised surgically. You get to keep your breast, but you just lose a bit of it. Sometimes this is called a "quandrantectomy" if let's say you have a whole quadrant of the breast that is cancerous. If you are unlucky and the cancer is spread in multiple areas or throughout the breast, then you are a will likely require a mastectomy.
I am going to make an assumption here and say that women are scared of mastectomies, I know that I am. I feel like, for better or for worse, breasts are a defining feature of women and femininity. It's something unique to our sex, they are a food source for babies, and a source of pleasure for men/women. Breasts are important, so the idea of having to remove a breast because some cells decided to misbehave, it's a daunting decision.
I spent almost one year working with Dr. K and I met many of her patients that required mastectomies and one thing that always amazes me was how upbeat they were. Sure, they acknowledged that the decision was hard, but their ability to cope with the impending loss of their breast and their passion to live, to this day, amazes me. I have such respect for these women.
Lucky for them, mastectomies aren't as primitive and horrible as they used to be. I heard horror stories from oncologists and some of Dr. K's older patients of how surgeons used to practically hack the breast off and no care was put into ensuring the the breast still looked good; removing the cancer trumped cosmetic appearance. One patient told us how you could go into the OR for a routine lump removal and wake up with no breast! How scary is that?!
Nowadays, Oncoplasty and immediate breast reconstructions allow for less traumatic and more aesthetically pleasing post-mastectomy results...Once Dr. K performs her portion of the surgery, and removes the breast, she switches with a plastic surgeon, who finishes the procedure and performs immediate breast reconstruction. It's tag-team surgery and it is amazing. I'd say the whole procedure can take about 2~2.5 hours, if you are using tissue expanders. I can be longer with other means of reconstruction.
There are several types of breast reconstruction surgery available to cancer patients: tissue expanders, TRAM flap, DIEP flap, GAP flap, TUG flap, and Latissimus dorsi flap reconstruction. I have seen the tissue expanders (most popular & common), TRAM flap, and Latissimus dorsi flap reconstruction surgery. They are all amazing. I would talk in greater detail, however, that would take me hours. For more information click here.
Dr. K predominately works with two plastic surgeons, Dr. S and Dr. B. For some reason, when I am in the OR, Dr. S is always there, which is wonderful, since I absolutely adore him. Dr. S. is NOT like Dr. Christian Troy on "Nip/Tuck." Not at all. Actually, he sort of reminds me of Woody Allen, whom I love. Dr. S is sort of paranoid, which is good for a surgeon, but so so so cool and hilarious. Also, his craftsmanship is phenomenal. He is truly a gifted surgeon and the time and effort he puts in is amazing. Dr. S is a total perfectionist and will not finish a case until the patient looks perfect. If I ever require plastic surgery, I would go to him, without a doubt.
When I am in the OR, Dr. S usually does tissue expander reconstruction. This is the most common. I saw him perform a TRAM and Latissimus dorsi flap once, but those took almost 4 hours! Anyway, the tissue expanders essentially are placed into the removed breast, since the skin is still there, and they are essentially placeholders. You need to allow the breast to heal, so rushing in to put implants isn't a good idea. The tissue expanders, which are eventually filled with very dense liquid once the surgery is over, serves as a shape holder, allowing the breast to heal, whilst maintaining its shape. Several months later, once the breast(s) is healed, the tissue expanders are surgically removed and replaced with implants. It's a pretty amazing process.
Let me say, of the post-ops that I have been fortunate enough to see with Dr. K, their reconstructions are GORGEOUS. I mean, really stunning work. Dr. K and Dr. S are such amazing and talented surgeons, and their patients really look wonderful. Post-op, you can barely tell that these women have had mastectomies, and when I have seen them months later or even a year later, I forget completely that they had reconstructive surgery...they look THAT good!
So, I hope you guys found these past two posts interesting and hopefully informative? As the child of a surgeon and patient to other doctors, I know that sometimes medicine can be overwhelming and the word "surgery" is scary. I've been in that position where I think, "oh my god? What have I gotten in to? What is going to happen? What IS this procedure?" and for that reason, I wanted to share my "behind the scenes" experience with you. I hope this has helped...if not...sorry!
Now, let's move onto the next level. If, god forbid, you are diagnosed with breast cancer, you have a few options based on the severity. If your breast cancer is not metastatic and contained to one region of the breast, you are a good candidate for a lumpectomy. This basically means that the trouble area or "lump" can be excised surgically. You get to keep your breast, but you just lose a bit of it. Sometimes this is called a "quandrantectomy" if let's say you have a whole quadrant of the breast that is cancerous. If you are unlucky and the cancer is spread in multiple areas or throughout the breast, then you are a will likely require a mastectomy.
I am going to make an assumption here and say that women are scared of mastectomies, I know that I am. I feel like, for better or for worse, breasts are a defining feature of women and femininity. It's something unique to our sex, they are a food source for babies, and a source of pleasure for men/women. Breasts are important, so the idea of having to remove a breast because some cells decided to misbehave, it's a daunting decision.
I spent almost one year working with Dr. K and I met many of her patients that required mastectomies and one thing that always amazes me was how upbeat they were. Sure, they acknowledged that the decision was hard, but their ability to cope with the impending loss of their breast and their passion to live, to this day, amazes me. I have such respect for these women.
Lucky for them, mastectomies aren't as primitive and horrible as they used to be. I heard horror stories from oncologists and some of Dr. K's older patients of how surgeons used to practically hack the breast off and no care was put into ensuring the the breast still looked good; removing the cancer trumped cosmetic appearance. One patient told us how you could go into the OR for a routine lump removal and wake up with no breast! How scary is that?!
Nowadays, Oncoplasty and immediate breast reconstructions allow for less traumatic and more aesthetically pleasing post-mastectomy results...Once Dr. K performs her portion of the surgery, and removes the breast, she switches with a plastic surgeon, who finishes the procedure and performs immediate breast reconstruction. It's tag-team surgery and it is amazing. I'd say the whole procedure can take about 2~2.5 hours, if you are using tissue expanders. I can be longer with other means of reconstruction.
There are several types of breast reconstruction surgery available to cancer patients: tissue expanders, TRAM flap, DIEP flap, GAP flap, TUG flap, and Latissimus dorsi flap reconstruction. I have seen the tissue expanders (most popular & common), TRAM flap, and Latissimus dorsi flap reconstruction surgery. They are all amazing. I would talk in greater detail, however, that would take me hours. For more information click here.
Dr. K predominately works with two plastic surgeons, Dr. S and Dr. B. For some reason, when I am in the OR, Dr. S is always there, which is wonderful, since I absolutely adore him. Dr. S. is NOT like Dr. Christian Troy on "Nip/Tuck." Not at all. Actually, he sort of reminds me of Woody Allen, whom I love. Dr. S is sort of paranoid, which is good for a surgeon, but so so so cool and hilarious. Also, his craftsmanship is phenomenal. He is truly a gifted surgeon and the time and effort he puts in is amazing. Dr. S is a total perfectionist and will not finish a case until the patient looks perfect. If I ever require plastic surgery, I would go to him, without a doubt.
When I am in the OR, Dr. S usually does tissue expander reconstruction. This is the most common. I saw him perform a TRAM and Latissimus dorsi flap once, but those took almost 4 hours! Anyway, the tissue expanders essentially are placed into the removed breast, since the skin is still there, and they are essentially placeholders. You need to allow the breast to heal, so rushing in to put implants isn't a good idea. The tissue expanders, which are eventually filled with very dense liquid once the surgery is over, serves as a shape holder, allowing the breast to heal, whilst maintaining its shape. Several months later, once the breast(s) is healed, the tissue expanders are surgically removed and replaced with implants. It's a pretty amazing process.
Let me say, of the post-ops that I have been fortunate enough to see with Dr. K, their reconstructions are GORGEOUS. I mean, really stunning work. Dr. K and Dr. S are such amazing and talented surgeons, and their patients really look wonderful. Post-op, you can barely tell that these women have had mastectomies, and when I have seen them months later or even a year later, I forget completely that they had reconstructive surgery...they look THAT good!
So, I hope you guys found these past two posts interesting and hopefully informative? As the child of a surgeon and patient to other doctors, I know that sometimes medicine can be overwhelming and the word "surgery" is scary. I've been in that position where I think, "oh my god? What have I gotten in to? What is going to happen? What IS this procedure?" and for that reason, I wanted to share my "behind the scenes" experience with you. I hope this has helped...if not...sorry!
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