Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.
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1 9 w w w. s p i r i t o f w o m e n . c o m S U M M E R 2 016 S P I R I T O F W O M E N SHUTTERSTOCK A s scary as a breast cancer diagnosis can be, new plastic surgery options are helping more women rebound from the diagnosis both physically and emotionally. "Plastic surgery is a profession that's all about innovation," says Dr. Hans Serleth, a plastic, reconstructive and hand surgeon with Winona Health in Winona, Minn. Here's a look at two of the latest developments in reconstructive surgery that can help women who have been treated for breast cancer look and feel more like their old selves again faster. FILLING IN THE GAPS Women who opt for a lumpectomy (tumor removal) plus radiation, or a partial mastectomy (breast removal) with reconstruction, can sometimes be left with a persistent hollowed- out appearance in the upper part of the affected breast. That's where fat grafting can help: Fat cells are surgically removed via liposuction from one part of the body, usually the abdomen, and injected into the concave area. "Fat grafting is a technique that has been around awhile and continues to improve," says Dr. Serleth. "It uses your own tissue and offers a permanent result." With each graft, roughly 50 percent of the injected fat cells will die, while the other 50 percent will establish a blood supply and become part of your body. To ultimately achieve the best appearance, "you almost always need more than one treatment," Dr. Serleth explains. But by six months after the first fat injection, the upper part of the breast should be appropriately plump and stable for the long haul. "Most women are happy with fat grafting because they [also] get a liposuction out of the deal," Dr. Serleth says. SINGLE-STAGE BREAST RECONSTRUCTION Until recently, women who chose mastectomy plus breast reconstruction had to undergo three surgeries, including tissue expansion and nipple reconstruction, a process that can take months. But a new technique— single-stage breast reconstruction— skips these steps and offers a type of one-stop shopping. A breast surgeon and a plastic surgeon work together to surgically insert a silicone breast implant in the breast area at the same time as the mastectomy, and the patient's natural nipple and areola are preserved. Because mastectomy and reconstruction are combined into one surgery, patients undergoing single-stage reconstruction can recover faster, with less pain and downtime. "From mastectomy to final recovery, six weeks is more than enough," says Dr. Ben Moosavi, an aesthetic plastic surgeon affiliated with St. Mary's Medical Center in Huntington, W.Va. In addition to setting the stage for a speedier recovery, "single-stage breast reconstruction emphasizes the best final aesthetic outcome," say Dr. Moosavi. The improved breast implant devices that are used aren't as round and smooth as older generation implants, resulting in a more natural-looking breast. Surgical incisions are strategically placed in locations where scarring will be less conspicuous too. The best candidates for single- stage breast reconstruction are women with small to moderate size breasts who have lower-stage disease, adds Dr. Moosavi. • S I Z I N G U P a plastic surgeon In addition to performing breast reconstruction surgery, plastic surgeons do a variety of cosmetic procedures including tummy tucks, breast reduction, breast augmentation, face- and eye- lifts, Botox and other injectable treatments to reduce the appearance of wrinkles, and rhinoplasty (commonly referred to as a nose job) to reshape or resize the nose. To fnd the best plastic surgeon for your situation, do your homework and have a clear idea of the procedures you're considering. Then meet with several surgeons and compare their approaches. "Ask the surgeon, 'What special training have you had?'" says Dr. Steven Evelhoch, a maxillofacial, cosmetic and reconstructive surgeon with Winona Health in Winona, Minn. For example, if the procedure you need is cosmetic, such as a face-lift, look for somebody who has done a cosmetic surgery fellowship, he suggests. Compare the style of the offce and the support staff too, since they'll also be working with you. Although a physician's experience and solid track record can be a major plus, don't necessarily dismiss plastic surgeons who are recently out of medical school. They may have the advantage of being trained in the latest cosmetic and reconstructive surgical techniques and devices, since the feld of plastic surgery is constantly evolving. And keep in mind that the selection process is a two-way street. For many plastic and reconstructive surgeons, smoking is a deal breaker. "I won't operate on smokers because wounds don't heal correctly and can easily break open," says Dr. Evelhoch, and it's not uncommon for plastic surgeons to test their patients for nicotine use.