Category: Evidence Based Research

Who is Responsible? Aesthetic Outcomes of Breast Reconstruction Surgery

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It is an important topic to discuss. Who is responsible for the aesthetic outcomes of breast reconstruction surgery? The headline in the September 6, 2018, online article from Cosmopolitan reads: These Cancer Patients Wanted to Get Rid of Their Breasts for Good. Their Doctors Had Other Ideas. It is an emotionally filled article from women who chose to go flat. These women woke up after surgery with results that left them angered, saddened, disappointed, and fighting a battle to find out how to change things. In fact, on September 8, 2018, the article mentioned: … she’s organizing the first Not Putting On a Shirt Nationwide Walk in Cleveland, Ohio, in which women will join her to march topless and raise awareness around the issue. A sister march will be held in Los Angeles in the same day. The article speaks of women who chose to remain flat after their mastectomy Continue Reading →

Breast Cancer: Why We Choose to Be Patient Advocates

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I recently took part in an online meeting with two friends and fellow patient advocates. We met through the Project LEAD Institute program in July of 2017. Why did we apply for scholarship and attend this intensive week of the study of breast cancer biology? We all want further training to improve our advocacy knowledge base, so we could better serve our communities. The focus of our discussion at our online meeting; “Why do we choose to be patient advocates”? Kirstin, Jennifer, and I remain close friends. We talk frequently via phone chats, texts, and emails and ask each other for advice. We seek resources when we cannot find them for our community who might be in need. Opportunities for new learning, conferences to attend, and sharing new studies are just a few of the advocacy tools we share with each other to stay on top of our game. Our Continue Reading →

1900 Patients Share Stories About Breast Reconstruction

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Three short years ago in the summer of 2015, I opened a Facebook page dedicated to serve the breast reconstruction community. The Facebook page, https://www.facebook.com/groups/diepcjourney/ grew organically by word of mouth. We started out small, as so many new social media sites do. It is growing daily and now 1900 Patients Share Stories About Breast Reconstruction. What Do We Share? Think about this. You have just been diagnosed with breast cancer. Now you face the tsunami of information about to flood your brain; lab reports and waiting on results, treatment options, surgery, lumpectomy, mastectomy. Some days you feel overwhelmed, depressed, anxious, or even jubilant. Who will understand all these feelings? Who do I talk to who has been on this Journey? Think about this. You are told your best treatment option is to have a mastectomy. Perhaps, for peace of mind, you decide to have a prophylactic mastectomy because you Continue Reading →

Breast Reconstruction: Seromas Evaluation and Treatment

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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

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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 →

Nipple Reconstruction after Mastectomy

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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

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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 →

ERAS Protocol Breast Reconstruction

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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 →

Patient Reported Outcome Measurement in Plastic Surgery & Breast Reconstruction

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Patient Reported Outcome Measurement (P.R.O.M.s) are a way to improve plastic surgery and breast reconstruction. Dr. Roy Kim, San Francisco Plastic Surgery, points out that with the development of P.R.O.M.s in the future, the hope is that a broader audience of participants including a more diverse female group both in ethnicity and socio-economic levels, will be included. By engaging both patient advocacy groups and breast reconstruction practices, better data could evolve to be more statistically valid information and help more patients. How and Why are P.R.O.M.s done? Patients do surveys of their plastic surgery and breast reconstruction results/experience. Data is collected and saved. The data becomes statistically significant The data helps with various procedures in breast surgery, plastic surgery, and various breast reconstruction. P.R.O.M.s started with an on-line group to measure patient outcomes. Academic Centers will want to collect this data for future research and journal articles. Private practice plastic surgery Continue Reading →

Sensory Nerve Reconstruction During DIEP Flap after a Mastectomy

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DiepCFoundation interviews Dr. Minas Chrysopoulo from PRMA in San Antonio about sensory nerve reconstruction during DIEP flap after mastectomy to restore sensation to the breasts. The procedure is called microneurorrhaphy (micro-ner-ar-o-fee) A real mouth full! Dr. C points out that this is a complex topic to describe at a consult. A plastic surgeon may say that your breasts will “feel” more natural but “to whom”? The reality is that the patient will not feel the same that they did before mastectomy. I am the Founder and Director of DiepCFoundation and was fortunate to have this interview with Dr. Chrysopoulo. I am also a patient who has had successful sensory nerve repair performed by Dr. C. It is truly better than the alternative, which is NO sensation in the breasts at all. I’m quite used to this “new” sensation now and I like it. I feel very fortunate to have found Continue Reading →