Why Breast Implants with a Breast Lift?

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“Often when I ask a patient what it is about her breasts that bothers her, she will tell me that her breasts are droopy. Yet, when I examine her breasts, they are not droopy at all. Instead, they lack or have lost fullness in the upper part of the breasts,” explains Charles Slack, MD.

For Plastic Surgeons, droopiness, also referred to as ptosis, is when part of the lower portion of the breast hangs below the natural breast fold. A breast lift is designed to remove the extra skin that allows the breast to hang down below the fold and to elevate the nipple to a higher, more youthful position. Unfortunately, breast lifts usually don’t restore upper breast fullness to the degree most patients desire. To achieve better upper breast fullness, an implant is often needed. Another misconception is that breast implants alone will lift breasts. In certain instances where the nipple is above the fold and there is only a small amount of droopiness, an implant can create the “appearance” of lifting the breast, but it really does not lift the breast. These two procedures are often performed together to create the look that a patient wants. Another benefit of combing a breast lift procedure with breast augmentation, is that it will save you money as well as time in surgery and recovery.

Savings on Natrelle® silicone breast implants can be found on our new SPECIALS page!

Your first step is to schedule a cosmetic consultation with board-certified plastic surgeon, Dr. Charles Slack. He will discuss with you if a breast lift with augmentation is your best option based on the results you desire. He will need to know your medical history, including any medications or supplements you are taking, past surgeries or medical conditions, and your overall health.  Dr. Charles Slack, voted one of the best plastic surgeons in Dallas and Collin County by D Magazine, will help you achieve a natural look that is long lasting.

WHY BREAST LIFT WITH AUGMENTATION?

Breast tissue changes over time just like everything else in life. Loss of elasticity can cause the breasts to take on a deflated, uneven, or sagging look due to:

  • Pregnancy
  • Breastfeeding
  • Aging
  • Weight changes
  • Gravity
  • Heredity

Breast lift with augmentation can restore the youthful appearance of your breast tissue while providing you needed volume. Your results will be firmer, fuller, lifted breasts with more symmetry.

By having both procedures performed during one cosmetic surgery, you will also save on the cost of anesthesia and reduce your downtime, which means fewer days away from work.

There are numerous types and sizes of breast implants to consider. Natrelle®, Ideal Implants®, Sientra, and Mentor are all options that Dr. Slack offers to his patients.

Now through August 31, 2020, Dr. Slack is offering savings on Natrelle® silicone breast implants! After breast augmentation surgery using Natrelle® silicone breast implants, you will receive $250 in credit toward Botox Cosmetic®, Juvederm® or other skin treatments. As an additional bonus, you will receive 25 units of Botox Cosmetic® treatment.

The best way to consider how you can look your best is to schedule a private consultation with Dr. Slack. He will discuss your concerns and goals in detail. Patients find Dr. Slack to be the kind of surgeon whose wisdom and compassion make him easy to talk to about the sensitive topic of breast surgery. Contact Dr. Slack today to schedule a consultation.

What happens during Breast Implant surgery?

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Breast implant surgery is performed to add volume, restore firmness and add fullness to the breasts. Breast augmentation can also subtly lift the breast but not enough to correct significant droopiness. Dr. Charles Slack, voted one of the best plastic surgeons in Dallas and Collin County by D Magazine, helps women achieve a natural look that is long lasting.

After pregnancy, breastfeeding, and/or weight loss, breasts can lose volume and fullness. On the other hand, sometimes you are just not happy with the size of your breasts. A breast augmentation procedure is obviously intended to enlarge the breasts. However, a great surgical outcome involves much more than simply deciding on the cup size you want to be. It is important to choose a board-certified plastic surgeon who has extensive experience in cosmetic surgery. Also important is to be in good physical and mental health and have realistic expectations. In a cosmetic consultation, Dr. Charles Slack can guide you in achieving your desired look.

There are numerous types and sizes of breast implants to consider. Natrelle®, Ideal Implants®, Sientra, and Mentor are all options that Dr. Slack offers to his patients. Choosing the appropriate implant for your breast is a critical part of the process to help you achieve the breast augmentation results you are looking for. The factors considered in determining the right implant for you include:

  • breast shape
  • breast width
  • desired height of fullness
  • natural or rounded look
  • body type
  • desired increase in size
  • your lifestyle
  • Dr. Slack’s surgical judgment and recommendations

Now through August 31, 2020, Dr. Slack is offering savings on Natrelle® silicone breast implants! After breast augmentation surgery using Natrelle® silicone breast implants, you will receive $250 in credit toward Botox Cosmetic®, Juvederm® or other skin treatments. As an added bonus, you will receive 25 units of Botox Cosmetic® treatment. The best way to consider how you can look amazing is to schedule a private consultation with Dr. Slack. He will discuss your concerns and goals in detail with an explanation of what can and cannot be achieved for you with breast augmentation. Patients find Dr. Slack to be the kind of surgeon whose wisdom and compassion make him easy to talk to about the sensitive topic of breast surgery. Contact Dr. Slack today to schedule a consultation.

What You Should Know About Plastic Surgery Videos on YouTube

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Everyday people watch more than a billion hours of YouTube. Increasingly, those hours include some time searching for health information and watching plastic surgery related videos in particular. Unfortunately, many of these videos are low quality and should be watched with caution, says new research published in the journal Plastic and Reconstructive Surgery.

Researchers graded over 500 videos on subjects like breast augmentation, breast lift, breast reduction, eyelid surgery, face lift, and tummy tuck. The videos analyzed came from a variety of sources, mainly physicians, patients, and product companies.

The videos were rated using the EQIP (Ensuring Quality Information for Patients) scale, scoring on a wide variety of criteria including:

  • Quality and accuracy of information presented
  • Clarity of video sponsorship or funding
  • Disclosure of risks, potential complications, and alternative treatments

With the average video scoring 13 out of 27 on the EQIP, the results of the study were not encouraging.

“Patients should be aware that the information contained in aesthetic surgery videos could be of low-quality and has the potential to be inaccurate,” said Ash Patel, MBChB, senior author of the study in this press release. “It involves a little research from the viewer, but they should check if the video is produced by a board-certified plastic surgeon.”

YouTube is a social media and entertainment platform, never intended as a gatekeeper for high quality medical information. Nonetheless it is a place where people seek this kind of information, and what they find often influences their health care making decisions.

That is why we urge all our patients to use a critical eye whenever viewing plastic surgery information on social media platforms like YouTube. Here are some questions to ask yourself the next time you view one of these kinds of videos:

Who produced the video?

Anyone can upload a video to YouTube and say nearly anything they want, but, according to the study, videos created by physicians tended to be of higher quality. Make sure the video you are watching is produced by a legitimate medical center, government entity, plastic surgery society, or board certified plastic surgeon. Look for logos and links to websites for verification.

Is the language general or product specific?

No one product, medication, or surgical procedure is perfect for everyone. Watch out for videos that appear biased toward one brand, as they are likely sponsored and created primarily to sell you a specific product. Language should be clear with limited use of jargon, and products should be presented using generic names. Not all sponsored videos are bad, but this information should be clearly disclosed.

Are risks, complications, or alternative treatments mentioned?

A well trained board-certified plastic surgeon is trained to put the patient first, and sometimes this means saying no to certain procedures. A careful balance of risks versus benefits should be part of every treatment decision. Pre-existing medical conditions and lifestyle choices are among the many considerations that come into play. A high quality video will address issues like risks, complications, and treatment alternatives to some degree.

Here, at North Texas Plastic and Reconstructive Surgery, we encourage you to do your homework when it comes to medical procedures and choosing a plastic surgeon. The internet, YouTube, and other social media can be terrific sources of information, as long as you use a critical eye. Always back up any information you learn there by talking to an actual board-certified plastic surgeon who knows you specifically, like Dr. Slack. And be on the look out for Dr. Slack’s new YouTube channel coming soon.

If you have questions about something you’ve seen on the internet, contact our Allen, TX office. You can make an appointment for a consultation today. 

Will Breast Density Limit My Plastic Surgery Options?

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Getting good news about breast density and plastic surgery options

The last time you got your mammogram results, did you notice a little note about your breast density? If you are like 40 percent of women, it might have said something like, “Your breasts are heterogeneously dense, which may obscure small masses and may put you at greater risk of developing breast cancer in the future.” Though this may sound a bit scary, it’s actually a normal reading.

Normal breast density exists on a spectrum from not dense at all to extremely dense. Knowing this information is important; it helps women and their doctors decide which breast screening methods are best, and how often they should get them. According to the American Cancer Society, whether a woman has dense breasts or not, regular screenings (mammograms in particular) are still the best way to find cancer early.

Because of the relationship between breast density and cancer risk, it is now the law in many states that breast density information be conveyed to each woman who has a mammogram. You may have seen talk of this newer legislation on the news.

What this means is that more women than ever before know that breast density matters, and many can tell you just how dense their own breasts are. Knowing this has also left some women wondering if their breast density will affect their options when it comes to cosmetic breast surgery.

To help answer this question, it will help if we first explain what doctors mean when they talk about breast density.

Breast density is a radiologic (mammogram) finding that has nothing to do with how breasts look or feel from the outside. The classification of density has to do with the ratio of fat (not a dense tissue) to everything else that makes up the breast, including glandular and fibrous tissue. On a mammogram, the fat shows up dark and the other stuff shows up white. The more white seen on a mammogram, the more dense the breast classification. The breast density classifications that may be assigned are – from least dense to most dense – the following:

  1. Fatty
  2. Scattered Fibroglandular
  3. Heterogeneously Dense
  4. Extremely Dense

Only about 10 percent of women are categorized as having extremely dense breast tissue. You can learn more about these breast density types, and see images too, at the American Cancer Society.

Here at North Texas Plastic and Reconstructive Surgery, Dr. Slack performs a wide range of cosmetic breast procedures including breast implants, liposuction, breast lifts, and breast reductions. In some cases, he may perform a combination of one or more of these procedures, depending on the goals of the patient. Here is how breast density may come into play with each of these procedures:

Augmentation

Breast implants are placed underneath the breast tissue not within in. This means that the breast tissue itself, no matter how dense, sits on top of the implant and therefore has little bearing on whether a breast implant is possible.

Liposuction

Liposuction alone is sometimes an option for women who are looking for a mild reduction in breast size. It is possible that a woman with extremely dense breasts, which means they have a lower ratio of fat to other tissue, may have a limit as to how much fat can be successfully removed using this method.

Breast Reduction or Lift

A breast reduction or lift sometimes includes liposuction, and the limitation just mentioned may come in to play to some degree. However, because these procedures also include an open surgical component, the goal of the reduction usually isn’t limited by breast density.

Here is the big takeaway: None of these procedures are off limits to a woman simply because she has higher breast density.

There are many factors that will limit a person’s plastic surgery options, including poor health, weight instability, and a bad smoking habit, but breast density usually isn’t one of them. That said, every person who walks into our clinic has their own unique anatomical identity, and that includes breast density. Dr. Slack takes all of this (and more) into consideration when advising each patient and planning their surgery.

If you have more questions about breast density and which breast procedures might be right for you, call our office today and schedule a consultation with Dr. Slack.

Is There an Age Limit for Breast Reconstruction After Cancer?

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“Seventy is the new fifty.” That’s not just a saying, it’s an actual statistic from a recent survey on age perception, conducted by TD Ameritrade. They found more than 70 percent of women believe this age adjustment is true. Times have certainly changed, considering that a child born in 1900 was only expected to live to be about 50-years old. Today women are not only living longer, they are living with more vitality, throwing out old edicts to dress and act “their age.”

Much of this is thanks to incredible advances in medicine, and breast cancer survival is a germane example. A once deadly killer now has survival rates upward of 90 percent. This leaves more women than ever before deciding how they want to live their lives following mastectomy. For many this means choosing breast reconstruction. According to this government report, in the last decade breast reconstruction has increased among all age groups but “disproportionately so for women aged 65 years and older.”

All this has led researchers (and many women) to ask the question: Is breast reconstruction more dangerous for older women than it is for those who are younger? An analysis published this month (June 2019) in the journal Breast Cancer Research and Treatment specifically asked the question “Is immediate breast reconstruction safe in women over 70?”

The researchers reviewed data collected between 2005 and 2016 in the United States on how women in this age group fared in the 30 days after breast reconstruction and compared that to those 18-69 years old. All women (older and younger) in the study had been diagnosed either with breast cancer that was in situ (contained within the breast) or invasive (also spread to another part of the body).

Most of the women in the study (28,000 of them) had undergone an implant-based reconstruction, while others (9,000 of them) underwent autologous reconstruction. Here is the difference between these two types of breast reconstruction, commonly performed following mastectomy of one or both breasts:

Implant-based breast reconstruction
A breast mound is constructed using breast implants. These may be filled with silicone gel, saline, or a combination of the two. Implants may allow for larger breasts, but they may not look and feel as much like a woman’s natural breasts.

Autologous breast reconstruction
A breast mound is constructed using tissue taken from the patient’s own body. Tissue may be taken from the patient’s thigh, back, buttocks, or abdomen. Autologous reconstruction may result in softer more natural looking breasts, but a second surgical site is needed for harvesting the graft tissue.

Dr. Slack performs both of these types of procedures and while more women choose implant-based reconstruction (as they did in the research study), the choice is personal and should be made with the help of a qualified plastic surgeon experienced with breast reconstruction.

In total, nearly 40,000 women were included in the study, nearly 2,500 of those were women 70-years and older. In other words, significantly more younger women underwent reconstruction than did older women (not surprising since this surgical option has only recently been open to older women). Nonetheless, the scientists were able to compare complication and death rates between the two groups during the 30 days following their procedures.

Their analysis took into account the fact that the older women in the study were more likely to have what are called co-morbidities. These include age-related and other health issues like high blood pressure, diabetes, or heart disease, that are not due to a diagnosis of breast cancer. After accounting for these issues, the researchers found complications were more or less equal between groups, and death within 30 days of breast surgery was rare in either group.

Here is the take-away: Any increased risk for a woman age 70 and above has more to do with her health than her age.

If you have read our blog much, you will likely know that Dr. Slack puts a big priority on health screening before any kind of plastic surgery. He encourages all his patients to do as much as they can to boost their health through diet and lifestyle, smoking cessation, and weight management before and after surgery. This helps ensure fewer complications and a better outcome— this goes for women (and men) of any age.

If you are considering breast reconstruction following mastectomy and have concerns about your age, make an appointment today to talk to Dr. Slack. He will give you an honest and carefully considered answer.

I ❤️ My New Breasts: The Role of Tattooing in Breast Reconstruction

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It used to be tattoos brought to mind far away cultures or sailors on shore leave. Not so much anymore. From rock stars to soccer moms, tattoos are everywhere now, and in terms of their sophistication and artistry… well, they’ve come a long way since “I ❤️mom.” In the past decade, tattooing for some women has even become integral to their recovery from breast cancer. We’re talking about nipple tattoos, some of which are remarkable in their anatomical detail, color matching, and 3D shading.

For years Dr. Slack has believed that tattooing is a viable option for women after breast reconstruction (as long as they have fully healed). It can be done instead of nipple reconstruction or in addition to the procedure. For women who are undergoing breast reconstruction following mastectomy, the cost of nipple tattooing is often covered by insurance.

To understand where tattooing and breast reconstruction come together, you first need a little background on how breast reconstruction is typically done.

It is sometimes possible to spare a woman’s nipple when performing a mastectomy, however, most of the time the darker, sensitive skin of the nipple and areola is removed entirely. When the breast is then reconstructed, the first stage is to create a breast mound (without nipple), using grafted tissue from her own body or a breast implant. Depending on the extent of the cancer and the degree of tissue removed during the mastectomy, this may require more than one surgical procedure.

Once the breast mound is complete and fully healed, the question of the nipple can be addressed. There are several options here: no nipple, surgically reconstructed nipple with or without tattooing, or 3D nipple tattooing.

Some women choose to go without a nipple (reconstructed or otherwise), being most concerned with their breast appearance under clothes. You can see some before and after images of this in our breast reconstruction gallery. Prosthetic (or stick-on) nipples are an option for these women.

A nipple and areola can also be recreated surgically, using grafted tissue from the woman’s own body. Typically with reconstruction, the new nipple does not have the same color characteristics that the woman had before. For those who want a more natural looking nipple, Dr. Slack offers tattooing in his office. He has a specially trained cosmetic tattooist who can ink in the missing color, usually darker for the nipple and lighter for the areola. This is typically done about six weeks after surgery, to ensure all incisions are well healed.

For women who want the appearance of nipples, but don’t want surgery, 3D nipple/areola tattooing is a good option. For this, Dr. Slack refers his patients out to medical tattoo artists. He has several in the Dallas area that he trusts who do remarkable work. You can also find a listing or artists online at Pink Ink Project, 3D Nipple Areola Tattooing. They recommend taking a look at the tattooist’s before and after photos before making a choice.

Even though 3D tattooed nipples are actually flat and lack dimension, many women say they look as good as the real thing. According to a study published in the journal Plastic and Reconstructive Surgery, professional nipple tattooing can result “in a more realistic and three-dimensional reconstruction that can appear better than surgical methods. The application of three-dimensional techniques or ‘realism’ in tattoo artistry has significant potential to improve the aesthetic outcomes of reconstructive surgery.”

If you want to learn more about breast reconstruction and whether tattooing may play a role for you, schedule a consultation with Dr. Slack today.

Listening to Your Concerns about Breast Implants

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It’s a unique kind of double-punch to be told something is “all in your head,” especially when it comes to your health. When this happens you still have the problem you came in with, and now you have the pain of feeling unheard. The FDA recently did something to remedy this for a group of women who have concerns about the safety and relative risks of breast implants—they listened.

In late March the FDA held a public hearing to address concerns about breast implant safety. Women who have had breast implants, physicians, and manufacturers were allowed to speak openly before a panel of experts over the course of two days. “We do not feel we have been effectively and appropriately informed,” said one of the women at the FDA hearing. Attendees asked for increased transparency by manufacturers and improved patient access to information on risks associated with breast implants.

Two primary health and safety issues were raised, one of which was the subject of our recent blog post, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). BIA-ALCL is a rare complication associated with some textured implants that was identified in 2017. At the time of discovery the FDA issued a warning, and we also wrote a post to help our patients understand BIA-ALCL.

The other issue is also rare. It is a difficult to describe condition called Breast Implant Illness. The problem, which includes a variety of vague symptoms like joint pain and fatigue, has often been dismissed by doctors and manufacturers. This is largely because the condition is poorly understood, and no definitive cause is known. Some research has suggested that the symptoms may be associated with an autoimmune reaction, but the authors of these studies concede that their findings show association but not causation.

Breast implants are not the only thing associated with these kinds of symptoms. The FDA recently released a statement warning that a small number of patients may have similar biological reactions to a wide array of implantable devices. As with breast implants this is also in need of much more study.

“Although there is no scientific evidence to date to support diseases/illness being caused by breast implants,” says Dr. Slack. “I don’t think it is unreasonable to believe that there are some people whose immune systems react strongly to having a breast implant or an implanted device in place. This is a very small number and is certainly not a common occurrence; nonetheless, it should be discussed when considering breast augmentation along with the other potential risks of breast augmentation surgery.”

A big takeaway here is that if you have had any adverse reaction to a surgical implant or have a history of an autoimmune disorder or allergies, it is important to discuss this with your surgeon. It is also important to follow your surgeon’s instructions regarding long term follow up after getting breast implants.

Despite the risks, the news at the FDA hearing wasn’t all bad. Decades of research has also shown breast implants to be safe for most women, and complications are rare. One cancer survivor relayed how her breast implants hadn’t been problematic and were, in fact, integral to her recovery after a double mastectomy. She hopes implants can remain an option for future patients like her.

“The meetings concluded with the panel recommending that the FDA require manufacturers to provide simpler and clearer health warnings to all patients,” according to this Atlantic article “but stopped short of encouraging a ban on any particular type of implants.”

The FDA hearing underscores the notion that good medicine requires a careful and well informed balance of risk and reward. In addition to finding a physician who is highly qualified, you also need one who is up to date and can adequately explain the risks of any procedure or treatment. On top of that, you need someone you can really talk to. Someone who knows that hearing what you have to say is an integral part of the equation.

If you are considering breast implants and want to know more about these issues, make an appointment with Dr. Slack today. He will be glad to give you the answers you need, and if you have concerns, he’s ready to listen.

Breast Implant Associated Cancer (BIA-ALCL) in the News Again

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woman thinking about BIA-ALCL

Most of our life choices carry a certain amount of risk. Each time we get behind the wheel of the car or sign a form allowing our child to participate in sports, we accept a basic level of risk.  We do this because we feel the reward outweighs the potential downside. When choosing to have a plastic surgery procedure, we do the same thing. All surgeries carry the risk of complications, but we choose the path that makes the most sense based on our goals, lifestyle, and comfort with risk.

Most of the more common complications associated with cosmetic procedures are relatively mild and can be avoided with proper preparation before surgery and care after surgery. But occasionally a rare complication arises that has more serious repercussions. In the case of breast implants, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is one of those rare complications.

BIA-ALCL has predominantly occurred in patients who have, or at one time had, textured breast implants. Reports of the disease developing in patients who have only had smooth implants lack adequate patient history for confirmation, but even so, the unconfirmed reports make up a tiny fraction of the cases.

This unusual cancer is a cancer of the immune system (called a lymphoma) not a cancer of breast tissue itself. It occurs in people without implants but is exceedingly rare. Why it can develop around a breast implant not clear, but it is thought to be related to how a person’s immune system reacts to the implant surface, specifically a textured-surface implant. It typically occurs within the natural scar tissue (capsule) that forms around the implant but can develop as a mass within the breast.

According to the FDA, BIA-ALCL has been reported 457 times in association with breast implants since 2010, but it appears that some of these reports are duplicates. Either way it is quite a rare complication. In fact, the risk of developing the disease for women with textured implants is somewhere from 1 in 3,817 to 1 in 30,000. For perspective, the overall risk of developing breast cancer due to all causes is one in nine. Even though the numbers are small, the association with breast implants is clear. Most cases are caught early and cured with the removal of the implant and the scar tissue surrounding it. Three-year disease survival is reported to be 93 percent. More advanced cases with cancer spread have been reported, and these cases do require chemotherapy. The nine reported deaths in the US from the disease occurred in patents who did not receive these recommended treatments.

We first updated you on BIA-ALCL in 2017, when the FDA announced the association between breast implants and the cancer had been identified. More recently, the FDA has addressed primary care physicians about the issue. As most women don’t see a plastic surgeon for routine health care, it is more likely to be a primary care physician (PCP) who will detect a lump or other change in the breast. This means PCPs must be aware of the special attention a woman with breast implants requires when providing her ongoing care.

As a patient, it pays to be proactive as you think about potential complications of breast implants. Below you will find concrete actions you can take that will give peace of mind about choosing a procedure and living with the results for years to come.

  1. Prior to surgery, discuss all possible complications with your plastic surgeon, including the possibility of BIA-ALCL. Compare the risks and benefits of different types of surgeries and implants to make the decision that is right for you. If your surgeon isn’t up front about potential risks, he or she is not the right surgeon for you.
  2. Do everything your surgeon recommends to prepare for a successful surgery – quit smoking, exercise, eat a well-balanced diet, and limit your alcohol intake.
  3. After surgery, strictly follow the post-operative instructions your surgeon provides for you.
  4. Have a frank discussion with your PCP about your breast implants and ask them to brush up on the latest research on BIA-ALCL. You might even share the FDA letter with them to be sure you are on the same page. Follow-up with them as recommended so they are able to detect any changes over time.
  5. The most common symptoms of BIA-ALCL are the development of fluid (seroma) around the implant several years after surgery, lumps, swelling or pain within the breasts. If you have any concerns at all about your breast implants, always contact your surgeon. He or she is in the best position to evaluate any symptoms that are bothering you.

If you are thinking about getting breast implants or have concerns about the implants you already have, Dr. Slack is your best local resource. Not only is he a member of the American Society of Plastic Surgeons, he completed a fellowship in breast surgery at Georgetown University Hospital in Washington D.C. He would like to discuss your questions with you and help provide a clear view of the risks and benefits of any procedure you choose. Contact our Collin County office to schedule a consultation.

Timing Your Breast Reconstruction After Mastectomy

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Breast reconstruction isn’t for everyone. Tig Notaro, for example.

After her double mastectomy without reconstruction, the dry-witted comedian embraced her new body and performed topless (for a full 20 minutes!) in her 2015 HBO special Boyish Girl Interrupted. If you aren’t as willing to accept a new life without breasts, reconstruction may be an easy choice for you. Even if you aren’t 100 percent sure whether you will want a breast reconstruction, do your due diligence now because timing matters if you want to achieve optimal results.

Here’s what the American Cancer Society has to say about that:

“If you are thinking about having reconstructive surgery, it is best to talk about it with your surgeon and a plastic surgeon experienced in breast reconstruction before you have surgery to remove the tumor or breast. This lets the surgical teams plan the best treatment for you, even if you decide to wait and have reconstructive surgery later.”

Breast reconstruction is most often performed at the same time as mastectomy (immediate reconstruction), but it can also be done years later (delayed reconstruction). In other words, though you shouldn’t wait to get informed, you don’t have to decide whether to have the surgery right away. With everything you have to think about before a mastectomy, it can be overwhelming to have to make a decision about reconstruction too. Your doctors may also recommend you wait if you are continuing with radiation treatment.

Here are some other reasons to delay reconstruction.

You are a smoker

Cigarettes and other tobacco products contain hundreds of toxic chemicals, including nicotine, hydrogen cyanide, and carbon monoxide. They leave your body with an overall shortage of oxygen and make it harder to heal. Smokers are more likely to suffer from complications, like an infection or blood clot, during or after surgery.

While claims have been made that e-cigarettes are a healthier alternative, this does not make them safe. Toxic metals like lead, chromium, manganese and nickel have been detected in their vapor. Read more about vaping and plastic surgery in this post.

Most plastic surgeons will require that you quit smoking at least four weeks before surgery.

You have other health problems

Cancer may not be the only health problem you are dealing with. Conditions such as obesity, diabetes, heart disease, stroke, high blood pressure, sleep apnea, or other breathing problems can impair your body’s ability to withstand the stresses of another surgery.

Your plastic surgeon will likely require that conditions like these be managed and well under control before undergoing breast reconstruction.

You haven’t found the right plastic surgeon

Your oncologist or surgeon will likely be able to refer you to a qualified plastic surgeon before your mastectomy. Take the opportunity to meet with them as soon as possible. You want to do your homework to make sure the surgeon is right for you. Your plastic surgeon should be board certified and have hospital privileges at a reputable facility you have access to.

Breast reconstruction is complicated and no two surgeries will be the same. You will need someone (like Dr. Slack) who has specific training and experience in breast reconstruction surgery and is able to discuss the options available to you.

Whether and when to have breast reconstruction after mastectomy is a very personal decision. One that you need to make with your healthcare team, including a plastic surgeon. Maybe, like Tig and many other women, you will decide to go flat, or maybe reconstruction is a no brainer for you. As long as you are informed, there is no wrong choice. You do you—shirt off, or on, or somewhere in between.

If you have any questions or want to learn more about breast reconstruction, contact our office today.