February 13, 2020

Options in Breast Reconstruction

Written by
Dr. Kristen Yee
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Recently I had the opportunity to help a dear friend of mine, who is an MD Anderson-trained breast cancer surgeon, with breast reconstruction in her practice at Kaiser in addition to my core practice.

With the patient base there, the volume of breast reconstruction was tremendous and I really enjoyed having days focused on this aspect of plastic surgery.  The corporate management dictated, among other things, that as part of being sensitive and respectful to all patients we should avoid humor – I guess I didn’t follow that very well, as one of my patients wrote in a very kind note: “Thank you for being a kind, compassionate, and funny doctor.  You have made this very difficulty journey seem more pleasant and for that we are grateful.  Although we are SAD to see you go we wish you nothing but the VERY Best!”

Receiving a diagnosis of breast cancer can be very overwhelming, in part because of all the different aspects of treatment: surgery, chemotherapy, radiation therapy.  Not all of them will be recommended but all are considered.  I enjoy being part of a team (including the patient) as we work on the best option for each person.  I like to think that I deserve the praise above because of my approach, but honestly I think that many of my patients enjoy our visits more because I am focusing on the future, and restoring their appearance, and it’s not really about the cancer.

I realized in that group practice as well, that other plastic surgeons just tell patients what kind of implants are best for them.  There are several decision points in breast reconstruction that require medical/surgical input mainly.  However, I include the patient in the choice of final implants because they will be living with the aesthetic consequences of it.

Most surgeons are recommending round cohesive (gummy bear) silicone implants for their patients.  These can be a great option for many women.  If they rupture, the silicone inside is engineered to stay in one piece, so there is less concern for silicone leak or creating other issues.  These implants have been in the US for around 6 years.

I always mention saline implants; even though these can look less natural without the overlying breast tissue to camouflage the edges, and the more “liquid” feel, some patients want to know when their implants rupture for the safety concern.  The saline we use is the same saline that is used for intravenous injection, so it’s biocompatible and your body just absorbs it-corresponding to a loss in volume, sometimes in a matter of hours or days!

The conventional silicone implant has been around for 50+ years.  They tend to feel and look more natural due to the thickness of the material and some patients like that there is a long track record.

We look forward to being part of your breast cancer treatment team!

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