Physical and emotional scars can heal with breast reconstructive surgery

Dr. Karen Powers

Dr. Karen Powers

Few things are more frightening for a woman than receiving a breast cancer diagnosis. The nightmare doesn’t end quickly. Often, women must undergo a mastectomy or lumpectomy in addition to chemotherapy or radiation. Although these procedures can be life saving, they’re also potentially devastating to a woman’s self-esteem and sense of femininity. It can be an isolating, depressing experience.

In years past, women who underwent mastectomies had no choice but to wear breast prostheses to look “normal” in clothing. Removing the prostheses while dressing and undressing often triggers anxiety and stress. Today, the emotional and physical results after surgery are much more positive. New insight about breast cancer, new treatments and improved reconstructive surgery options mean that women need not feel disfigured or less attractive after surgery.

“Women are often disheartened after their surgery,” says Dr. Karen Powers, a plastic surgeon at UTMB. “I specialize in breast reconstruction and I see almost every patient after she receives her diagnosis. Women are very disheartened when they know they’re facing a mastectomy or lumpectomy, so I begin seeing them even before their surgery.”

The UTMB Breast Health and Imaging Center at Victory Lakes offers state-of-the-art breast screening, multidisciplinary evaluation and a complete range of services and treatments related to breast health and breast cancer, including breast reconstruction.

Dr. Powers says that with some patients, the reconstruction process can begin immediately—sometimes even while they’re still asleep from their surgery. “There are two ways to do reconstructive implants,” she explains. “We can do silicone or saline implants, which are very safe and don’t increase the patient’s chance for a cancer recurrence, nor does it impede finding cancer if it returns. Or, if it’s possible, we can use tissue from the woman’s own body to reconstruct the breast.” If the woman has enough extra tissue on her lower belly, upper back, or buttocks, she could be a candidate to use her own tissue.

Once a woman has consulted with her team and chosen the best option for her breast reconstruction, Dr. Powers says the next step is to begin the tissue expansion phase of treatment. “It can be compared to a temporary implant,” she says. “I stretch the space under the pectoral muscle, which saves the space to be filled later with the implant or the tissue. During this time, the breast tissue that was surgically removed is being analyzed so that we can determine whether the patient requires chemotherapy or radiation. Other specialists will consult with one another and with the patient to determine the best course of action.” The tissue expansion process, which lasts at least two months, occurs at outpatient clinic visits until the patient has the size breasts that she desires.

Dr. Powers adds that there’s more good news for women coping with a breast cancer diagnosis. “In 1998, a federal law was passed that mandates all insurance companies must pay for breast reconstruction surgery in cancer patients. That includes a ‘symmetry’ procedure—meaning that the ‘non-cancer’ breast might not match the newly reconstructed breast, giving a lopsided appearance. Insurance must cover the procedure to correct this.”

Some women who had their mastectomy years ago may not realize that they are still candidates for reconstructive surgery. “It doesn’t matter if you had your surgery decades ago, you can still have a breast reconstruction, and insurance still has to cover it,” Dr. Powers explains. “Women don’t have to fear life without one or both breasts.”

“While some women may choose not to reconstruct their breasts, all women should be informed of their options and have the opportunity to work with their physician to develop a treatment plan that’s right for them,” Dr. Powers adds. “Here at UTMB, each woman has the benefit of being treated by an integrated team of doctors, including separate oncologists who specialize in surgery and radiation, as well as others. “The best news for women is that here at UTMB, our team of specialists will create a complete game plan for that patient so she can begin the process of treatment and reconstruction right away.”

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