CNN covers breast reconstruction surgery story

CNN has done a nice human interest story on a lady who had bilateral breast reconstruction after mastectomy and radiation therapy using a fairly new microsurgical technique called the S-GAP flap. The link is here. It's good to get the word out about these newer options for breast cancer patients.

There are several important "teaching points" about this story:

1) Even today, many breast cancer patients don't realize that breast reconstruction is possible and available to them. A 2009 survey from the American Society of Plastic Surgeons found that 7 of 10 women don't fully understand their options for breast reconstruction after mastectomy. Breast reconstruction after mastectomy is covered by all health insurance plans - by law.

2) There are multiple methods of performing breast reconstruction. For the lady in the CNN article, since she had radiation therapy, most experts recommend some form of autologous tissue reconstruction (using your own tissue) rather than using an expander or implant. While radiation can be quite effective at sterilizing any remaining cancer cells, it also has permanent side effects on the tissue. All surgeons know this, but few radiation oncologists seem to discuss it with their patients!

3) Although the article made it sound a little like she had some form of fat injection to the breast, it is probably more likely that she actually had a microsurgical tissue transfer called an S-GAP flap (explained here). This is a relatively new technique, developed around 1993, in which a small blood vessel and its attached fat and skin is microsurgically transferred from the buttock area to the breast, to bring new tissue and a new blood supply to the reconstructive site. It's a pretty cool method!

4) Even once the cancer has been treated, and reconstruction has been finished, that doesn't mean that cancer survivors can let down their guard. Studies show that we really have to be on the look out for a sneaky recurrence of the disease for up to 20 years!

Thanks CNN, for spreading the word about this reconstructive option for breast cancer patients.

CNN article on "wanna-be" cosmetic surgeons

Here's an article from CNN Health, which talks about how many physicians are trying their hand at cosmetic medicine and cosmetic surgery, regardless of their training, board certification, or experience.

Link

It's clear that some physicians think that the "grass is greener" on the plastic surgery side of the fence...but they don't want to invest the time to train properly in plastic surgery, since that takes years. So, more and more frequently, these docs take a one-day course on saturday, then start using their new laser or liposuction machine on monday. It's a recipe for problems, and the patient is the one who suffers.

I think the most insightful quote in the article is this one, from Dr. Brent Moelleken, a plastic surgeon in California. "If patients heard about a plastic surgeon expanding his practice to include Pap smears and hysterectomies, they would be horrified. But they think little of having laser procedures or liposuction done by a gynecologist. And there is no law against either."

Remember, just because it's cosmetic doesn't mean it isn't real surgery, with real potential for complications. Do your research. Stick with experienced, credentialled surgeons who practice within their field of training. Review their before and after pictures. Talk to some other patients. Extra time taken when selecting your surgeon pays dividends later.