Breast Reconstruction Clubhouse Discussion

This past week, I was fortunate to have Roberta Albany and Dr. Minas Chrysopoulo join me as moderators for a breast reconstruction clubhouse discussion.

Clubhouse is a fairly new app for iPhone users. The sessions generally last an hour in length. Think of it as a casual phone conversation with the members who join. It is not recorded, or at least does not have that feature yet. There are moderators who can invite those who “raise their hand” using an icon on the app to come “up to the stage”. They are invited to speak by a moderator when they raise their hand. Once invited to speak, they unmute their microphone to begin their question, comment, or thoughts.

The topic I chose was “Breast Reconstruction Concerns and Questions Answered”. The discussion and information provided by Roberta and Dr. C was both enlightening and informative. I want to provide some of the concerns presented by patients, questions answered, but more importantly, provide the resources that may further provide insight for the readers of this blog who may have similar breast reconstruction concerns.

Breast Reconstruction Recovery and Pain Management

DIEP flap breast reconstruction involves incisions at the abdominal area to harvest the flap to create a new breast after mastectomy. With incisions at the breast and tummy patients are often concerned about length of stay in hospital, recovery, and pain management. It is a valid and understandable fear. Dr. C spoke at length about ERAS (Enhanced Recovery After Surgery) protocol. Roberta and I both shared that we did not have this protocol in place at the time of our DIEP flap and how much difference we see in patient recovery and length of time in hospital compared to now and patients who experience the advantages of ERAS. Key take away provided by Dr. C: Change is driven by patients so please mention ERAS to your plastic surgeon at your breast reconstruction consult. I will provide links to resources where you can watch and read more:

Real patient stories who had ERAS protocol.

Episode 75: Diastasis Recti and Why to Repair it During DIEP Flap – DiepCJourney Podcast

This interview is another resource provided by DiepCFoundation.org specifically providing access to care for those affected by breast cancer. The slide presentation and interview are available on the Foundation educational channel for our listeners and followers who would like to access it at DiepCFoundation YouTube channel. We are discussing a topic that is often discussed in my community so I reached out to my guest to share her expertise on the repair of diastasis and recognizing what a hernia or bulge might look like after autologous breast reconstruction, specifically DIEP flaps. My guest is Dr. Kelsey McClure who practices with a team of other microsurgeons at Southwest Breast and Aesthetics in Phoenix, AZ. She is a board-certified plastic surgeon and holds certification with The American Board of Plastic Surgery. She is an active member of: The American Society for Reconstructive Microsurgery (ASRM) The American Society of Plastic Surgery (ASPS) Mountain West Society of Plastic Surgeons (MWSPS) AND the Arizona Society of Plastic Surgeons She has authored several research publications. Dr. McClure believes that shared decision- making is necessary to tailor a comprehensive aesthetic and reconstructive plan. We reference a PRS Global Open paper published by Dr. Arvind Gowda who has been a guest on a previous episode of the DiepCJourney podcast. The paper can be accessed through this open-source Journal here: Approach to DIEP Flap Pedicle Dissection via a Midline Fascial Incision Connect with Dr. Kelsey and her team across these platforms: Instagram: https://www.instagram.com/southwestbreast/ Facebook: https://www.facebook.com/SWBreast

Breast Reconstruction Wound Healing and Seromas

Patients present with a variety of medical history and prior surgeries that can compromise or make wound healing more challenging for some. One participant shares her experience with prior seromas and healing after being brought to the stage. Dr. C listens carefully to the details and advises her accordingly. Resources discussing these to concerns can be found in the links below for further information and details.

Blog discussing breast reconstruction wounds and management can be found in this link.

Breast Reconstruction Clubhouse Discussion on Sensation

Unfortunately, women are not always aware or told their breasts will have numbness after mastectomy. There is hope restoring some of the sensation lost during mastectomy. If a woman is considering autologous reconstruction sensation can be performed with or without the use of a nerve graft. Resources to understand this process further are provided in the links below:

Sensory Nerve Reconstruction During DIEP flap Breast Reconstruction

Nerve Graft and Restoring Sensation to the Breast

Sensation can also be restored during implant-based reconstruction. Dr. C mentioned the two surgeons who pioneered this work, Drs. Anne Peled and Ziv Peled. You can listen to the podcast and watch the video interviews with these two surgeons in the links below:

Breast Reconstruction and Breast Sensation with the DiepCJourney Podcast in this blog.

Nipple Sparing Mastectomy in Breast Reconstruction

There was also a detailed discussion about nipple sparing mastectomy and why or why not women chose this at the time of breast surgery or breast reconstruction based on choice and oncologic safety. More details are in the links below. Thank you to PRMA for providing the link to the video.

From Nipple Sparing Mastectomy to DIEP flap Breast Reconstruction

Breast Reconstruction Clubhouse

I was grateful to those who participated and joined us that evening. There is a “Club” on Clubhouse titled, “Breast Reconstruction” I set up with the intention of having further discussions for interested participants. I encourage you to give Clubhouse a try and follow me by searching Terri Coutee and my moderators by searching Roberta Albany and Minas Chrysopoulo. I hope you will join me for the next breast reconstruction Clubhouse discussion.

Disclaimer

References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website. The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.