Category: Plastic Surgery

What are the Surgical Stages of Breast Reconstruction?

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A question frequently asked in the breast reconstruction community for those planning any type of breast reconstruction is, what are the surgical stages of breast reconstruction? I reached out to the experts to do a video. Dr. Minas Chrysopoulo of PRMA answers the question. I summarize the conversation with Dr. C in this blog. You can watch the entirety of the conversation in the at the end. Dr. C begins with a very important statement, “Breast reconstruction should really be considered a process rather than as one procedure. For most people it is going to take more than one surgery to get the best results.” Breast Reconstruction: Stage 1 It is preferable to have both the mastectomy and reconstruction done at the same time, known as immediate reconstruction. This often yields better results because there is less scarring and looks more natural. Sometimes, because of the diagnosis, stage of the Continue Reading →

Learning Together During the Coronavirus

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I am an educator by profession. Although I switched from classroom teaching to becoming a patient advocate after a second breast cancer diagnosis and successful DIEP flap breast reconstruction, I am always energized when I can learn something new. Living through the global pandemic of 2020 has been one adjustment after the other for everyone across the world. It has been downright frustrating for me some days. This week, I felt uplifted. Some new tools and ideas opened up for me. I am grateful a world pandemic can also result in learning together during the coronavirus. Using Instagram LIVE During the Coronavirus Instagram has been a busy platform during the past few weeks. Those little circles at the top of your Instagram feed have been highlighted in red more than I have ever noticed. Notifications of IG LIVE have been frequently lighting up my phone. What is up? I turned Continue Reading →

Nerve Graft: Restoring Sensation to the Breast

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Sensation to the breast is important to most women. Nerves in the breast provide this sensation. This feeling provides protection from heat and cold temperatures. The breast is an erogenous zone for several women providing sexual sensation, especially in the nipple and areola area. Nerves are cut at the time of mastectomy when cancerous tissue is removed leaving numbness to the chest. During breast reconstruction, some surgeons perform a procedure using a nerve graft restoring sensation to the breast. Location of the Nerves Restoring Sensation to the Breast The breast is comprised of an intricate web of nerves running through the breast tissue. Surgeons tend to speak about the two sides of the breast looking at it from the front. Draw an imaginary line from the arm pit area running down the side. This is the area of the chest referred to as the lateral area. The area at the Continue Reading →

The Aesthetics of the Donor Site: DIEP Flap Breast Reconstruction

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At the 2019 annual conference of the American Society of Plastic Surgeons, I interviewed Dr. Minas Chrysopoulo of PRMA in San Antonio.  Dr. C points out we often talk about the results of the breast in breast reconstruction. After all, it is why the patient is having the procedure, to replace the breasts affected by breast cancer. I agree with his statement, “The conversation about the belly is well overdue.” This blog will focus on the aesthetics of the donor site in DIEP flap breast reconstruction. As microsurgeons, skill and technique are often discussed in published papers and at medical conferences. Plastic surgery, of any kind, is about form and function. The donor site for DIEP flap, the belly, is as important to the patient. What it is going to feel and look like after surgery is essential to the physical and psychological healing for the patient. Dr. Chrysopoulo says, Continue Reading →

The Woman Behind the Mask: Coronavirus

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This is the third week I am writing my weekly blog on the topic of the coronavirus. The rapidly evolving events of this global pandemic have caused staggering changes in statistics. We seem to grapple daily with how to deal with the spread of the virus. Wearing a face mask was the most visible symbol coming out of Wuhan, China where the coronavirus began in late December. At the beginning of March here in America, the consensus was not to wear a mask in public. Now in the first days of April, a month later, we are seeing a flood of masks being worn in America. A movement has begun to make homemade masks. This blog is dedicated to a friend, the woman behind the mask, and why she began making them during the coronavirus. Why We Transitioned from No Mask to Wearing Masks During the Coronovirus The growth of Continue Reading →

DiepCJourney Celebrating Five Years in Unprecedented Times

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Five years ago, on March 17, 2015, I published my first blog for DiepCJourney.com. I felt excited and anxious. Today, on March 17, 2020, those feelings, excitement and being anxious manifest themselves in a completely different way. We are at the tip of the iceberg in the United States as we grapple with how to deal with a global pandemic, the worldwide Coronavirus outbreak. This blog will be marked as a time capsule. I had no idea DiepCJourney would be celebrating five years in unprecedented times. I had an idea what I might write in this blog as 2020 rolled around knowing it was the fifth anniversary year. But now things have changed. I want to share my concerns and gratitude to all of the amazing readers over the past five years. My Concerns for Readers of DiepCJourney at this Unprecedented Time The blog continues to grow and evolve. What Continue Reading →

Can Sensation be Restored to the Breast after Mastectomy?

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At a meeting of the American Society for Reconstructive Microsurgery (ASRM), I had the opportunity to interview Dr. James Craigie from the Center for Natural Breast Reconstruction in Charleston, S.C. for this important discussion on restoring sensation to the breast after mastectomy. This is done during breast reconstruction surgery. Women undergoing DIEP flap breast reconstruction frequently ask me, “Can sensation be restored to the breast after mastectomy?” The short answer is yes, it can. However, not all plastic surgeons perform this procedure. In fact, it is done by surgeons trained in a sub-specialty of plastic surgery called microsurgery. Microsurgery requires advanced skills involving the art and science of connecting nerves and blood vessels under high powered microscopes. It takes the trained eye of a microsurgeon to perform nerve reconstruction. What Type of Breast Reconstruction Can Restore Sensation? Dr. Craigie explains that “natural breast reconstruction” involves using the patients own tissue. Continue Reading →

Are All DIEP Flaps the Same?

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It is a fair question to ask don’t you think?  It is even a better question to discuss at your initial consult when you want to use your tummy tissue to reconstruct your breasts. If you have been affected by breast cancer and are facing a mastectomy, I think you should ask your plastic surgeon, “Are all DIEP flaps the same? The video embedded in the blog will give you talking points for a discussion with your plastic surgeon. I was fortunate to interview Drs. Pankaj Tiwari and Ergun Kocak of Midwest Breast in Ohio to help the reader understand the nuances and differences in tummy flap breast reconstruction. What are the Differences in Flap Procedures using the Tummy? These surgeons point out the scar on the outside looks similar to a tummy tuck scar. But what happens on the inside as Dr. Kocak says, “it’s entirely different”. Let’s take Continue Reading →

Microsurgery in Breast Reconstruction after Mastectomy

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I had the opportunity to attend the American Society of Reconstructive Microsurgeons meeting recently. As a patient advocate attending, I was particularly focused on microsurgery in breast reconstruction after mastectomy. It gave me the chance to have in depth conversations with plastic surgeons who dedicate intense hours of training to become microsurgeons.  The conference attendees included medical students interested in this specialty, plastic surgeons who are currently in fellowship training for microsurgery, and those seasoned veterans sharing the latest techniques and methods of surgical skills to achieve optimal outcomes for patients. The ASRM conference took place at a hotel with all of the sessions easily accessible. This conference felt comfortable, informal, and intimate to me. These microsurgeons reflected the feeling, this group is like a small tribe who understand the rigors of microsurgical training and how it can positively change the lives of patients. Why Should you Find a Microsurgeon Continue Reading →

Why I Can’t Wait for the New Decade in Breast Reconstruction

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We have sent best wishes for the New Year to our social media friends. This year ushered in a new decade. Many of us wonder how things will change in the next ten years. This blog may be my time capsule for the upcoming decade. I would like to check back in 2030 to see what items in this blog will change and improve and why I can’t wait for the new decade in Breast Reconstruction. A New Decade of Shared Decision Making in Breast Reconstruction The topic of shared decision-making is at the top of my list. The practice of shared decision-making with the plastic surgeon who performed my DIEP flap is what made my breast reconstruction so successful. I see progress! Dr. Chrysopoulo developed a decision making tool, the Breast Advocate app, this past decade to give patients a voice in their decision making with their health care Continue Reading →