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Study Shows That Most Women Do Not Choose Immediate Post-Mastectomy Breast Reconstruction

Despite the benefits of immediate post-mastectomy breast reconstruction, only a small minority of women, regardless of age, choose this option, a new study indicates. Research has shown that compared with a delayed procedure, immediate post-mastectomy reconstruction improves psychological well-being and quality of life. The new study, headed by Dawn Hershman, M.D., associate professor of medicine and epidemiology at Columbia University Medical Center, indicates that only about one-third of women opt for the procedure, according to the American Association for Cancer Research.
Source: cosmeticsurgerytimes.modernmedicine.com/
cosmeticsurgerytimes/article/articleDetail.jsp?id=751765

Immediate breast reconstruction does lead to better results in patients with early stage breast cancer. That is a pretty much well known fact. This statistic of less than a third of women seeking this type of reconstruction in this light seems kinda sad, but keep reading: Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Study Hopes To Help Those Seeking Breast Reconstruction Surgery

Jeffrey A. Ascherman, MD, FACS

Jeffrey A. Ascherman, MD, FACS

After the jubilation of beating cancer, many women who seek breast reconstruction have another journey to complete. Before they can receive a permanent breast implant, they must first undergo a process to create the space to house the new implant – a process which can be uncomfortable at times and may take many months.

“Traditionally, women undergoing breast reconstruction have had to endure a long process of inconvenient and sometimes uncomfortable saline injections every 2 to 3 weeks to create a pocket for the permanent implant following a mastectomy,” said Jeffrey Ascherman, MD, Site Chief, Division of Plastic Surgery, NewYork-Presbyterian/Columbia. According to some women, this process can also involve a significant time burden, since they must visit their doctor’s office every few weeks for an average of four to six months.

Dr. Ascherman is now the first physician in the United States to be enrolling patients in a study of a new, Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Potential Alternative For Breast Reconstruction Following A Mastectomy

Though mastectomies are often a necessary and even welcome intervention to save the lives of women suffering from breast cancer, they also may contribute to the overall physical and emotional trauma facing the patients. In order to alleviate some of these problems, surgeons have developed breast reconstruction procedures that usually entail restoring the mound by implanting a silicone sac filled with salt solution (saline) or gel under the skin and pectoral muscles. The traditional process to prepare for implantation of the sac may be long and sometimes painful because it involves weekly bolus saline injections (sometimes up to 22 weeks) in order to create a pocket of sufficient size.

A potential alternative solution is being developed by AirXpanders, a med tech start-up in Palo Alto that focuses on tissue expansion for breast reconstruction following cancer. Their system, known as AeroForm, just recently Read more »

*This blog post was originally published at Medgadget*

Breast Reconstruction After Mastectomy: Are Patients Making Good Decisions?

An outcomes article in the January 2011 issue of the Journal of Plastic and Reconstructive Surgery asks the question: “Are patients making high-quality decisions about breast reconstruction after mastectomy?”

The objective of the study was to “measure women’s knowledge about reconstruction and to evaluate the degree to which treatments reflected patients’ goals and preferences.” Their conclusion (bold emphasis is mine):

Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients’ goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making.

Granted the study was small, but it left me wondering if we the medical community fails to educate these women.  

The study involved a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. Only 84 patients participated (59 percent response rate). Participants answered only 37.9 percent of knowledge questions correctly. Read more »

*This blog post was originally published at Suture for a Living*

Breast Implants Under Local Anesthesia?

Reader question:

A surgeon I’m thinking about seeing said on his website that breast implants were able to be done under local + intravenous anesthetic (like twilight). Can this really be done? I always thought it was too invasive for just twilight, especially if it is under the muscle. Is there an advantage to using twilight? After looking it up, there are lots of differing opinions out there, but I think that this may just be a way for the surgeon to cut costs. What is the cosmetic surgery truth here, Dr. D?

I am not a fan of local anesthesia or twilight sleep for breast implant surgery except in rare cases (simple redos and such). The reasons are patient comfort and practicality. I place most of my breast implants under the pectoral muscles, and these muscles need to be relaxed for this to work out. That relaxation is suboptimal under less than a general anesthetic. Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

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