Transcription:
Breast Reconstruction After a Mastectomy

Caitlin Whyte (Host):   Hello and welcome back to Aspirus Health Talk. I'm Caitlin Whyte, and today we’re talking about breast reconstruction after a mastectomy both the surgical skill and emotional adjustment involved with plastic surgeon Liz Renaker-Jansen. Liz, what are the different options for breast reconstruction?

Elizabeth (Liz) Renaker-Jansen, DO (Guest):   So the different options for breast reconstruction is to either use an implant based breast reconstruction where you have a tissue expander which goes to a permanent silicone gel implant or there's techniques that we can use your own body tissue to recreate a breast mound.

Host:   Now how will I know what type of breast reconstruction makes the most sense for me?

Liz:   I think this is a great question because everybody is different. I think it’s really a matter of having the right conversation with your plastic surgeon to find out your different options and see what fits you as a patient based on your medical  condition, the surgeries you’ve had, and your lifestyle. Not everybody can tolerate all the options of breast reconstruction.

Host:   How will I know if I'm a good candidate for breast reconstruction?

Liz:   To know if you're a good candidate, I think you really have to have a conversation with a plastic surgeon. Once you get diagnosed with breast cancer, the next step is to go talk to a plastic surgeon to see if reconstruction is a possibility. That’s when you really just find out all the kind of details about it. Prior to the consultation, I do have a lot of patients who go to the Susan G. Komen website, which is a breast cancer website. They do talk about breast reconstruction there. A lot of patients will get just kind of the basic information so when they come to talk to me, they already have a little bit of a knowledge.

Host:   Now once we’ve decided to have the procedure, what are some of the risks and benefits for each reconstruction option?

Liz:   So the risk of just having reconstruction tissue expander based is we usually do it at the time of surgery. So you're increasing your amount on anesthetic time. Other than that, I just use the pocket that the mastectomy was already created from to put my tissue expander in to recreate that breast pocket. So there's not a lot of increased risks that aren’t already associated with a mastectomy. Now sometimes we’ll do a tissue expander after a mastectomy. With those risks you have a risk of bleeding and infection, but they are a low risk they’re just still there. As far as our practice, we do reconstruction using your own body tissue as kind of what we call an adjunct procedure. Meaning if you need something done then at a later time, we will use your body to help us recreate the breast mound. We do not do free flaps which is what some people do to recreate the breast mound using your own tissue.

Host:   What will the recovery process be like?

Liz:   The recovery process is usually about four to six weeks long. There are drains after surgery. So we have to leave those drains in for about two to four weeks. Once we’re able to get the drains out, we start to let you have increased activity and move your shoulders more and do more. Once the drains are in, we really don’t want you doing a lot. You do have the same scars that you would after your mastectomy. Each patient is different as to their approach of the mastectomy, but we use the same incisions that they use for the same mastectomy. Even when we go back in to put the silicone implant in, I use the same exact scar from that surgery as well.

Host:   How long will the reconstruction last?

Liz:   So reconstruction lasts forever. However the implants that we last usually only last for about 10 years. Plastic surgery society has made a shelf life of these implants for about 10 years. We don’t know how the integrity of the implant is after that length of time.

Host:   Will I need to stay in the hospital?

Liz:   I think it all depends on the patient. Sometimes we’re able to send you home the day of surgery. Sometimes patients do spend the night. It’s more for post-op pain control and to make sure the patient’s feel comfortable going home after surgery, but it’s not necessary.

Host:   Will reconstruction interfere with chemotherapy?

Liz:   Reconstruction does not interfere with chemotherapy. We have a process of getting your expansion completed before you need to do any type of chemotherapy, or sometimes we just juggle your expansion around when you're getting your chemotherapy to make sure that your immune system isn’t too low to have the expansion done.

Host:   How about radiation treatments? Would reconstruction interfere with those?

Liz:   It does not interfere with radiation treatment. We try to get reconstruction pretty much done before you need to proceed to radiation. Sometimes radiation has to be pushed off for maybe a week or two, but it does not cause any type of long-term problems.

Host:   Well thank you so much for joining us today Liz. Find more information and podcasts just like these at aspirus.org/renew. If you enjoyed this episode, please subscribe, and share it with your friends. I'm Caitlin Whyte. Stay well.