Breast Reconstruction: Seromas Evaluation and Treatment

We looked at the pre and post-operative assessment of seromas after breast reconstruction in a previous blog and video. Here, Drs. Minas Chrysopoulo and Ramon Garza III of PRMA in San Antonio explain to the viewer how to evaluate and treat a seroma if it occurs after breast reconstruction. Seromas form because of your body’s natural healing processes. Think of a wound you get on the outside of your body. The body produces fluid as part of the healing process. You see fluid as with a scraped knee or a burn. Imagine the wound on the inside of your body that forms because of surgery. Your body is going to produce fluid internally due to the trauma of surgery. This fluid must be managed. Dr. C, as his patients refer to him, explains a seroma can happen anywhere someone has surgery. In breast reconstruction this can be in the breast Continue Reading →

Breast Reconstruction: Seromas Pre and Post-Operative Assessment

Breast Reconstruction: Seromas Pre and Post-Operative Assessment Breast reconstruction complications are possible as is the case with any surgery. A possible complication in breast reconstruction is the development of a seroma. Here we look at the pre and post-operative assessment of seromas after autologous or implant-based breast reconstruction. I speak to two ASPS board certified plastic surgeons from PRMA in San Antonio, Dr. Ramon Garza III and Dr. Minas Chrysopoulo. I feel fortunate to share this information with the reader. The video in the blog will give a detailed explanation of pre and post-operative assessment of seromas. You can subscribe to DiepCFoundation YouTube channel after watching the video for a variety of educational topics on breast reconstruction. Dr. Garza begins the discussion by explaining who might be more prone than others to complications such as seromas after breast reconstruction. It is important to point out that their practice at PRMA Continue Reading →

What Do Breast Cancer and BRCA Friends Share in Common?

I know that Heather Barnard and I share a lot in common! We are both educators. Breast cancer has affected Heather and me. Heather and I have had a mastectomy. Heather and I had breast reconstruction. We both write blogs about our breast reconstruction experience. Finally, and most coincidentally, we had the same plastic surgeon perform our breast reconstruction. What makes our friendship unique? We have never met in person. Heather and I live over 9,000 miles apart. Our shared commonalities, however, have bridged those miles and made us friends. Her Twitter handle says it all, @expattravelmom. She teaches in Singapore and in her off time travels extensively with her husband and three great children. I had my DIEP flap breast reconstruction in December of 2014. Heather had a prophylactic mastectomy with immediate implant breast reconstruction in June of 2015. Dr. Chrysopoulo was our connection. Heather would message me asking Continue Reading →

Nipple Reconstruction after Mastectomy

I am often asked about the process of nipple reconstruction after mastectomy at the time of breast reconstruction. I am grateful to Drs. Minas Chrysopoulo and Ramon Garza III of PRMA in San Antonio who took time to make the video. It can be viewed from this blog explaining the procedure. My own experience during my DIEP flap breast reconstruction was a skin sparring, nipple sparring mastectomy. My breast surgeon clearly explained how she was going to make every attempt to save my nipples during my mastectomy. She also was very forthright in telling me, based on tumor size and location, she may not be able to save my nipples. I felt fortunate she successfully saved my nipples at the time of my double mastectomy. This is not always the case for every woman or man who has a mastectomy. There are reasons nipples cannot be saved. There are also patients Continue Reading →

Surgical Loupes Used in Breast Reconstruction

Sometimes we like to have fun at DiepCFoundation. This video about the surgical loupes used in breast reconstruction was one of those moments. Dr. Ramon Garza of PRMA in San Antonio was kind enough to bring his surgical loupes for me to try on. Dr. Minas Chrysopoulo, his team member at PRMA, looked on with amusement when I tried to focus while maneuvering my hands to appreciate the magnification. What I noticed most was adjusting to the depth perception while I had the surgical loupes on. Dr. Garza verified it takes a lot of training and hours spent in the operating room learning how to use the surgical loupes and the technical aspects of the surgery. He states the following: Good optics allow micro-surgeons to do what they do. The surgical loupes help to see very tiny, delicate structures. Function always overrides form in microsurgical breast reconstruction. The surgical loupes help Continue Reading →

How Breast Reconstruction Changed Me

How breast reconstruction changed me is one survivor’s story. It is the topic of a recent video that was added to the DiepCFounation.org YouTube video channel. It was such an honor to meet and talk to Jan about her thoughts after being diagnosed with breast cancer and how choosing DIEP flap breast reconstruction allowed her to “conquer cancer”. Jan and I were Facebook friends for a while but never met in person. We finally had the opportunity after attending a fundraiser with other breast cancer survivors. We decided to spend the following day together getting to know each other. We met for coffee and the conversation began as it does with so many other women I meet who have been diagnosed with breast cancer. She spoke about her fears after being diagnosed and the impact it had on her life. We shared our stories and the conversation flowed easily. Jan Continue Reading →

ERAS Protocol Breast Reconstruction

A little over a year ago I learned about ERAS protocol as it pertains to breast reconstruction from the plastic surgeon who performed my DIEP flap. ERAS, Enhanced Recovery after Surgery, protocol was not in place at the time I had breast reconstruction in December of 2014.  I wrote a blog about our conversation and what I learned. I have been reading several social media posts about ERAS and the benefits to patients. One study shared recently on Twitter states in the conclusion of the study: Conclusion: Enhanced recovery pathway program implementation should be considered as the standard approach for perioperative care in autologous tissue-based breast reconstruction because it does not affect morbidity and is associated with accelerated recovery with reduced postoperative opiate use and decreased length of hospital stay, leading to downstream health care cost savings.  ~ Journal of the American Society of Plastic Surgeons ERAS Protocol Benefits Observed I Continue Reading →

The Value of a 2nd Opinion for Breast Reconstruction

The value of a 2nd opinion for breast reconstruction is fortunately something that has the potential to give women hope if they have been turned down at an initial consult for autologous breast reconstruction. I had the fortune to talk with two board certified microsurgeons, Dr. David Song of MedStar Georgetown and Dr. Minas Chrysopoulo of PRMA in San Antonio. Both plastic surgeons successfully and routinely perform a variety of autologous flap surgeries with great success. What is autologous breast reconstruction? Autologous breast reconstruction is using another area of the patient’s body using the tissue and underlying blood vessels to create a soft, warm, new breast after a mastectomy. Why are women sometimes turned down by plastic surgeons or told they are not good candidates for autologous breast reconstruction? Here are some of the reasons Dr. Song and Dr. Chrysopoulo mention in the video: Well trained colleagues in plastic surgery Continue Reading →

Patient Advocacy: Shared Decision Making in Breast Reconstruction

When does your voice matter in patient advocacy in the shared decision-making conversation of breast reconstruction? The sum of events helps me answer this question in my work as a patient advocate. I have a voice, true. However, my voice only becomes amplified by the support, connections, and personal interaction I make through social media with those interested in this topic; plastic surgeons and patients who have lived the experience. Shared decision making in breast reconstruction after mastectomy means a process the patient and plastic surgeon engage in, resulting in the choice the patient believes is in their best interest. It includes but is not limited to the suggestions made by the plastic surgeon based on skill and years of expertise, being given all options for breast reconstruction, discussing risks and complications, and listening to and respecting the voice of the patient and what they bring to the conversation. This Continue Reading →

Waiting for Authorization for Breast Reconstruction

Waiting for Authorization for Breast Reconstruction It can take enormous patience for breast cancer patients who are waiting for authorization for their breast reconstruction procedure. I was once there. Now I am an advocate for all options of breast reconstruction after mastectomy. I interact with patients daily. Many times, their questions are a catalyst for topics to write a blog. Amplifying our voices to educate is part of patient advocacy responsibility. I recently received an email from a patient who was denied coverage for a revision phase of her reconstruction. Her plastic surgeon even wrote an appeal, but it was still denied. She reached out to me for help and suggestions about what to do. I take a deep breath when I get these emails and step out of my breast cancer survivor role and put on my patient advocate hat. I don’t want to offer false hope, but I Continue Reading →