It is a remarkable patient experience from the clinical consult for breast reconstruction to the day the plastic surgeon begins the process of rebuilding a patient’s breasts. Whether you have breast cancer or are having a prophylactic mastectomy to reduce your risk of getting breast cancer, breast reconstruction begins the day of your initial clinic visit. It culminates the day of surgery, on the canvas, the skin and tissue your plastic surgeon has to work with.
The Journey from the Clinic to the Canvas
A plastic surgeon begins to look at all aspects of the canvas. They work with different coloration from pale white to the deepest hues of browns and everything in between. Is the canvas rough, smooth, or does it have its own unique characteristics; previous scars, moles, stretch marks? What is the suppleness of the skin, the canvas? The surgeon might be working with young, taut skin, still unaffected by childbirth. The skin may be a thicker, softer canvas because of weight gain that sometimes occurs with age. Are there deep ridges and folds of skin or unevenness in the regularity across the lines of symmetry the sternum and the spine?
There are times when the surgeon has the original breasts to work with. Other times, the breast area can be flat from mastectomy. Scar lines can vary from the work done by the breast surgeon for delayed DIEP flap surgery. There may be folds of skin if a patient presents with a skin sparing, nipple sparing mastectomy performed. This was my experience because I had delayed DIEP flap reconstruction. Thickness of the skin will determine the amount of expansion and size of implant used if the patient chooses to have implant reconstruction. The canvas might be thicker because of previous radiation. All of these considerations must be carefully assessed by the reconstructive surgeon.
Discuss Your Desired Breast Reconstruction Aesthetic Outcomes
At the initial consult, these elements are observed, measured, and recorded for planning the work the day of surgery. Discussing the aesthetic outcomes of your breast reconstruction with your plastic surgeon is an important part of the consult. Talk about your anticipated surgical outcomes. Your desired expectations should be clearly stated with your plastic surgeon. Your surgeon will guide you on how closely those expectations can be met. Remember, the original canvas is now going to change, be rearranged, and yield a different look.
The Work on the Canvas Begins
The origin of the word plastic is from the Greek, plastikos. Used as a verb it means moldable. When the patient is draped and lying on the gurney in the operating room, the artist, the plastic surgeon, begins to design and mold the breasts. The plastic surgeon works with the canvas of your torso from the top of your breasts to just above your pubic bone. They begin to dissect tissue from the tummy to achieve new, sculpted breasts. Carefully the tissue is transferred from the bottom of the canvas to the top for DIEP flap breast reconstruction.
The artist views his canvas as he creates the work of art. Meticulousness strokes of surgical instruments guide the hands of the plastic surgeon to create a final product pleasing to the eye. This requires grit, patience, and stamina, all characteristics of an accomplished plastic surgeon.
I hear many women refer to their plastic surgeon as a true artist. The first time I saw the hands of my own plastic reconstructive surgeon, I thought to myself, these are the hands of an artist. It goes beyond that to have a true sense of what the owner of the canvas desires. The lines, curves, and symmetry of the final product are in the hands of the plastic surgeon.
What can you tell me about your breast reconstruction surgery from the clinic to the canvas? How do you admire the work of your plastic surgeon? You were courageous to lend your plastic surgeon the canvas of your body to recreate your beasts after mastectomy. Your plastic surgeon possesses a great deal of courage as well.
Creativity takes Courage ~ Henri Matisse
