Breast reconstruction is a procedure performed on a woman to restore the breasts after a lumpectomy or a mastectomy.
It is achieved through several plastic surgery techniques to return the breasts to near normal shape, size and appearance and can be performed on one or both of a woman's breasts.
If you are in need of breast reconstructive surgery, listen to Dr. Peter Hyans, board-certified plastic surgeon and director of Summit Medical Group's Plastic Surgery Center, discuss who is a good candidate for this surgery and what patients can expect from this procedure.
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Breast Reconstruction After Mastectomies
Featured Speaker:
Dr. Hyans believes that well-informed patients have realistic expectations and feel confident about their procedure. That is why all his consultations are thorough and thoughtful, why he listens to each patient's concerns, and why he provides honest, expert recommendations about what will yield the best results.
Plastic Surgery Center - Summit Medical Group: Dr. Hyans
Peter Hyans, MD FACS
Peter Hyans, MD, FACS, is Medical Director of the Plastic Surgery Center and Chair in the Department of Surgery and Surgical Specialties at Summit Medical Group. A board-certified plastic surgeon, Dr. Hyans has more than 20 years' experience in plastic surgery. His expertise includes facial rejuvenation, body contouring, and cosmetic and reconstructive breast surgery. He is the author or coauthor of articles about plastic and reconstructive surgery, which are published in prestigious, peer-reviewed scientific journals and popular regional lifestyle magazines. In addition, Dr. Hyans is a contributing author of the book, Be Your Best: A Comprehensive Guide to Aesthetic Plastic Surgery, which offers patients expert advice on all aspects of cosmetic plastic surgery. A gifted speaker, he has participated in local and national invited presentations in his field.Dr. Hyans believes that well-informed patients have realistic expectations and feel confident about their procedure. That is why all his consultations are thorough and thoughtful, why he listens to each patient's concerns, and why he provides honest, expert recommendations about what will yield the best results.
Plastic Surgery Center - Summit Medical Group: Dr. Hyans
Transcription:
Breast Reconstruction After Mastectomies
Melanie Cole (Host): Breast reconstruction is a surgery to rebuild a breast after the breast has been removed for treatment of cancer, a mastectomy. My guest is Dr. Peter Hyans. He’s the medical director of plastic surgery center at Summit Medical Group. Welcome to the show, Dr. Hyans. Tell us about the reasons that a woman would need breast reconstruction surgery.
Dr. Peter Hyans (Guest): Hello, Melanie. Thank you for having me. Breast reconstruction surgery is a procedure that is performed on women to try to recreate the natural appearance of their breast that they lost in most cases due to cancer. This is usually done in patents that have had a lumpectomy or most commonly in patients that have had to require a mastectomy.
Melanie: Okay. So a woman gets the diagnosis of cancer. She goes through treatment. She decides what the best options are for her, and then if she chooses mastectomy, does she come and see you before she actually goes through with that? Do you do it all at the same time, the reconstruction and the mastectomy? How does the timeline work?
Dr. Hyans: That’s correct. What we like to do is we work very closely with our breast surgeons here at the Summit Medical Group. Once the diagnosis of cancer is made, the patient is then referred to our office, and then we will be involved as a team to design a plan for the patient in terms of their cancer treatment and their reconstruction. Most of the reconstructive procedures that we’ve performed are performed at the time of mastectomy. So the patient is going to require a mastectomy. We will discuss the various options in terms of breast cancer reconstruction. This may involve the use of an implant or their own tissue to recreate the breast. We will also discuss the options of doing another reconstruction or mastectomies and reconstructions on both breasts or any other procedure that maybe necessary on the other side in order to give the patient symmetry.
Melanie: So giving the woman symmetry, that is important. Is there a medical reason to do both at the same time?
Dr. Hyans: Bilateral mastectomies have become more common. Some of the reasons are due to medical reasons. Because now we have more information, we know which women are at higher risk for getting cancer on the other side. In those women, we certainly would want to consider a bilateral mastectomy and reconstruct both breasts at the same time. There are other women that have undergone many years of surveillance of their breast, multiple biopsies and would rather not have to worry about the diagnosis of breast cancer in the future. So when they’re treating the one breast, we’ll often to the other side in order give them symmetry. More recently we’ve discovered now the BRCA gene, which is a gene that tells patients that they have a higher chance of getting breast cancer in the future due to genetic reasons. These patients will often do bilateral mastectomies preventatively and reconstruction at the same time.
Melanie: Now, there’s been quite a bit in the media about these preventive mastectomies if you find out that you’re positive for the BRCA gene. What do you advise women when they do not know what to do in that situation?
Dr. Hyans: Again, we work closely as a team with our geneticists, our medical oncologists, and our breast surgeons, and formulate a plan. In most of those cases, the patients do elect bilateral mastectomy to lessen the chance of them getting breast cancer in the future, and we’ll often do a mastectomy procedure where we can spare the nipple or save the nipple so it does not have to be removed, to give the patient a more natural result. And again, the reconstruction to recreate the breast is performed at the same time as the mastectomy procedure.
Melanie: So tell us about recreating the breast now. What kinds of implants are you using in reconstruction? Is this something that is permanent? How does it look afterwards?
Dr. Hyans: There are various procedures that are available today for reconstruction. As I’ve mentioned, today, most all reconstruction is done immediately at the time of mastectomy and no longer is it done on a delayed basis, months or years after a patient has done a mastectomy. So that patient, when they wake up from the operation to have their breast removed, a significant portion of their reconstruction is well underway to lessen the need for additional surgeries and the psychological trauma of losing their breast. There are various procedures that we use today. Some of those, as you touched on, involve an implant reconstruction. Other procedures that we use involve using the patient’s own tissue, which could be tissue from the back or, most commonly, the belly and other areas such as the inner thigh or buttock area. Some of those procedures are done by transferring the tissue, keeping it attached, and others are done under the microscope. Reconstruction options today are much more so than they have ever been, and it is much more common to get a very natural-looking result after this type of surgery.
Melanie: If you use your own body tissue, obviously, the recovery would be just a little bit longer because now you have another area that’s been slightly traumatized during the surgery.
Dr. Hyans: That’s true. However, we try to individualize the procedure for the patient. Younger patients are maybe apt to want to use their own tissue where an older patient, with the recovery period, she has limited time to recover because of other medical conditions, then an implant surgery might be the easiest option. In general, I would say that implant reconstruction, usually, these patients will be in the hospital overnight. They’ll be back to work within three weeks and most normal activities in four to six weeks, whereas you’re using the patient’s own tissues such as the belly, the patients may require an additional night in the hospital, and they’ll be back at work probably about four to six weeks after surgery and back at all physical activities at about two months’ period of time.
Melanie: Dr. Hyans, if a woman is considering breast reconstruction after mastectomy, does radiation play a role? After a mastectomy, sometimes they might want to still radiate the area.
Dr. Hyans: That’s an excellent question. When we see the patient for their original consultation, there are many factors that go into our recommendations. One will be the patient’s height, weight, breast size, how much the breast droops, what the patient’s other medial situations are, whether they’re going to require a post-operative chemotherapy and radiation. So if we know a patient is going to need radiation, we might modify the recommendations in terms of which procedures to do. But having radiation does not preclude the patient from undergoing reconstructive surgery.
Melanie: Wow. That’s very good to hear. Now, what about the emotional effects of all of this? Because they’ve gotten the diagnosis no woman wants to hear, they are about to feel that maybe part of what defines them as a woman is about to go away. What do you say to give them that hope and reassure them that they’re going to come back and look beautiful afterwards?
Dr. Hyans: Well, that’s the beauty of breast reconstruction. The procedures today really will give a very natural result, and many women will feel very feminine and very normal after having reconstruction, and especially if this procedure is done immediately at the time of mastectomy. We will often show the patient examples in the office of photos of other women—with their permission, of course—that have had a reconstructive surgery. Just by seeing those other women that have had to undergone the same thing that they’re going to have to undergo and how natural and normal they look, it really is very reassuring to patients contemplating this type of surgery.
Melanie: And I suppose that while you’re in support groups for your cancer anyway, that’s something that women probably discuss.
Dr. Hyans: Absolutely. We often have people referred by the other women in their support groups that will compare their results or who show off the results and discuss their treatment options. So it’s very important for all women that are considering just to talk with their friends and colleagues that have had this type of surgery to get feedback.
Melanie: And so, in the last 30 seconds or so, Dr. Hyans, will you just wrap it up for us? Give us your best advice for women considering breast reconstruction following mastectomy.
Dr. Hyans: Breast reconstruction surgeries today have really advanced. It can really provide the woman that is contemplating a mastectomy with a very natural result. This surgery is usually performed at the time of mastectomy or could be even done after a lumpectomy if the patient had some asymmetries. The result should be very natural-looking and make the patient really feel good and confident in their appearance after having to deal with a very difficult diagnosis.
Melanie: Thank you Dr. Hyans, you are listening to SMG Radio.
Breast Reconstruction After Mastectomies
Melanie Cole (Host): Breast reconstruction is a surgery to rebuild a breast after the breast has been removed for treatment of cancer, a mastectomy. My guest is Dr. Peter Hyans. He’s the medical director of plastic surgery center at Summit Medical Group. Welcome to the show, Dr. Hyans. Tell us about the reasons that a woman would need breast reconstruction surgery.
Dr. Peter Hyans (Guest): Hello, Melanie. Thank you for having me. Breast reconstruction surgery is a procedure that is performed on women to try to recreate the natural appearance of their breast that they lost in most cases due to cancer. This is usually done in patents that have had a lumpectomy or most commonly in patients that have had to require a mastectomy.
Melanie: Okay. So a woman gets the diagnosis of cancer. She goes through treatment. She decides what the best options are for her, and then if she chooses mastectomy, does she come and see you before she actually goes through with that? Do you do it all at the same time, the reconstruction and the mastectomy? How does the timeline work?
Dr. Hyans: That’s correct. What we like to do is we work very closely with our breast surgeons here at the Summit Medical Group. Once the diagnosis of cancer is made, the patient is then referred to our office, and then we will be involved as a team to design a plan for the patient in terms of their cancer treatment and their reconstruction. Most of the reconstructive procedures that we’ve performed are performed at the time of mastectomy. So the patient is going to require a mastectomy. We will discuss the various options in terms of breast cancer reconstruction. This may involve the use of an implant or their own tissue to recreate the breast. We will also discuss the options of doing another reconstruction or mastectomies and reconstructions on both breasts or any other procedure that maybe necessary on the other side in order to give the patient symmetry.
Melanie: So giving the woman symmetry, that is important. Is there a medical reason to do both at the same time?
Dr. Hyans: Bilateral mastectomies have become more common. Some of the reasons are due to medical reasons. Because now we have more information, we know which women are at higher risk for getting cancer on the other side. In those women, we certainly would want to consider a bilateral mastectomy and reconstruct both breasts at the same time. There are other women that have undergone many years of surveillance of their breast, multiple biopsies and would rather not have to worry about the diagnosis of breast cancer in the future. So when they’re treating the one breast, we’ll often to the other side in order give them symmetry. More recently we’ve discovered now the BRCA gene, which is a gene that tells patients that they have a higher chance of getting breast cancer in the future due to genetic reasons. These patients will often do bilateral mastectomies preventatively and reconstruction at the same time.
Melanie: Now, there’s been quite a bit in the media about these preventive mastectomies if you find out that you’re positive for the BRCA gene. What do you advise women when they do not know what to do in that situation?
Dr. Hyans: Again, we work closely as a team with our geneticists, our medical oncologists, and our breast surgeons, and formulate a plan. In most of those cases, the patients do elect bilateral mastectomy to lessen the chance of them getting breast cancer in the future, and we’ll often do a mastectomy procedure where we can spare the nipple or save the nipple so it does not have to be removed, to give the patient a more natural result. And again, the reconstruction to recreate the breast is performed at the same time as the mastectomy procedure.
Melanie: So tell us about recreating the breast now. What kinds of implants are you using in reconstruction? Is this something that is permanent? How does it look afterwards?
Dr. Hyans: There are various procedures that are available today for reconstruction. As I’ve mentioned, today, most all reconstruction is done immediately at the time of mastectomy and no longer is it done on a delayed basis, months or years after a patient has done a mastectomy. So that patient, when they wake up from the operation to have their breast removed, a significant portion of their reconstruction is well underway to lessen the need for additional surgeries and the psychological trauma of losing their breast. There are various procedures that we use today. Some of those, as you touched on, involve an implant reconstruction. Other procedures that we use involve using the patient’s own tissue, which could be tissue from the back or, most commonly, the belly and other areas such as the inner thigh or buttock area. Some of those procedures are done by transferring the tissue, keeping it attached, and others are done under the microscope. Reconstruction options today are much more so than they have ever been, and it is much more common to get a very natural-looking result after this type of surgery.
Melanie: If you use your own body tissue, obviously, the recovery would be just a little bit longer because now you have another area that’s been slightly traumatized during the surgery.
Dr. Hyans: That’s true. However, we try to individualize the procedure for the patient. Younger patients are maybe apt to want to use their own tissue where an older patient, with the recovery period, she has limited time to recover because of other medical conditions, then an implant surgery might be the easiest option. In general, I would say that implant reconstruction, usually, these patients will be in the hospital overnight. They’ll be back to work within three weeks and most normal activities in four to six weeks, whereas you’re using the patient’s own tissues such as the belly, the patients may require an additional night in the hospital, and they’ll be back at work probably about four to six weeks after surgery and back at all physical activities at about two months’ period of time.
Melanie: Dr. Hyans, if a woman is considering breast reconstruction after mastectomy, does radiation play a role? After a mastectomy, sometimes they might want to still radiate the area.
Dr. Hyans: That’s an excellent question. When we see the patient for their original consultation, there are many factors that go into our recommendations. One will be the patient’s height, weight, breast size, how much the breast droops, what the patient’s other medial situations are, whether they’re going to require a post-operative chemotherapy and radiation. So if we know a patient is going to need radiation, we might modify the recommendations in terms of which procedures to do. But having radiation does not preclude the patient from undergoing reconstructive surgery.
Melanie: Wow. That’s very good to hear. Now, what about the emotional effects of all of this? Because they’ve gotten the diagnosis no woman wants to hear, they are about to feel that maybe part of what defines them as a woman is about to go away. What do you say to give them that hope and reassure them that they’re going to come back and look beautiful afterwards?
Dr. Hyans: Well, that’s the beauty of breast reconstruction. The procedures today really will give a very natural result, and many women will feel very feminine and very normal after having reconstruction, and especially if this procedure is done immediately at the time of mastectomy. We will often show the patient examples in the office of photos of other women—with their permission, of course—that have had a reconstructive surgery. Just by seeing those other women that have had to undergone the same thing that they’re going to have to undergo and how natural and normal they look, it really is very reassuring to patients contemplating this type of surgery.
Melanie: And I suppose that while you’re in support groups for your cancer anyway, that’s something that women probably discuss.
Dr. Hyans: Absolutely. We often have people referred by the other women in their support groups that will compare their results or who show off the results and discuss their treatment options. So it’s very important for all women that are considering just to talk with their friends and colleagues that have had this type of surgery to get feedback.
Melanie: And so, in the last 30 seconds or so, Dr. Hyans, will you just wrap it up for us? Give us your best advice for women considering breast reconstruction following mastectomy.
Dr. Hyans: Breast reconstruction surgeries today have really advanced. It can really provide the woman that is contemplating a mastectomy with a very natural result. This surgery is usually performed at the time of mastectomy or could be even done after a lumpectomy if the patient had some asymmetries. The result should be very natural-looking and make the patient really feel good and confident in their appearance after having to deal with a very difficult diagnosis.
Melanie: Thank you Dr. Hyans, you are listening to SMG Radio.