Tag: plastic surgery

I Had DIEP Flap. Do You Know What That Is?

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I Had DIEP Flap. Do You Know What That Is? Picture this scenario. You walk into a physician or health care provider’s office after having DIEP flap breast reconstruction. They ask you to discuss your current health and why you came into the office for a visit. A standard question, right?  You are in a gown sitting on the exam table with only your underwear on under the gown. You know they are going to do a full exam and ask you to open the gown. Before they begin the exam, you say, “I had DIEP flap. Do you know what that is?” The answer is often one of two replies, “Oh yes, I see. You had a TRAM Flap.” Or, “No, I have no idea what a DIEP flap is.” This is when the education begins. The physician says, “Well, let’s take a look.” I open my gown and Continue Reading →

Breast Reconstruction. Taking Control Despite the Risks and Complications

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Patients who chose breast reconstruction often feel they are taking control despite the risks and complications associated with the surgery. I hear comments from patients after having breast reconstruction who have encountered complications including, seromas, wound healing issues, hernias, multiple surgeries, and yet, are very happy with their decision to reconstruct their breasts. Many feel it gave them control. Why? It gave them the opportunity to rebuild a body part lost after being diagnosed with breast cancer or deciding on prophylactic surgery due to a genetic mutation. An article in the New York Times reported on complications after various types of breast reconstruction surgeries including both implants and numerous forms of autologous (using your own tissue) reconstruction. A multicenter cohort study referenced in the article in JAMA stated: Reconstruction may be associated with a high risk for complications, but successful reconstruction may still be achieved in most patients. Women electing 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 →

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 →

Aesthetic Questions to Ask If Going Flat After Mastectomy

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Have you decided to go flat after having a mastectomy? This blog and video discuss aesthetic questions to ask if going flat after mastectomy. When a woman or man loses their breast to breast cancer they have choices whether to rebuild their breast or not. They can choose to go flat, or they can choose breast reconstruction. I had a mastectomy in May of 2014 and remained flat for seven months prior to having DIEP flap breast reconstruction. But there are many women and men who choose to remain flat after a mastectomy. I had the privilege of speaking to Drs. Minas Chrysopoulo of PRMA in San Antonio about this topic. They are both plastic surgeons who perform various kinds of plastic surgery, primarily autologous based breast reconstruction. The information they explain in this video and have personally done themselves, is achieving optimal aesthetic outcomes for patients who choose to 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 Advocacy: Shared Decision Making in Breast Reconstruction

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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

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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 →

A 3-year Anniversary: Blogging About Breast Reconstruction

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I am celebrating a 3-year anniversary blogging about breast reconstruction on March 17, 2018. When Did I Begin Blogging About Breast Reconstruction? It began as a cathartic experience after having successful DIEP flap surgery in early December of 2014. While I was at home healing, the events and challenges I faced the year after a second breast cancer diagnosis began to flood my thoughts daily. I put my M.Ed. program on hold to focus on my health. I met with a friend and artist in early January, 2015. We sat down together and planned two things; the artistic backdrop and platform for my blog on WordPress and an opening date, March 17, 2015. We are both Irish and it was a good goal. We met many times afterward to hammer out details. We hit our target date and celebrated together over a pint of Guinness. Why Did I Begin Blogging 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 →