Receiving the diagnosis of breast cancer can be a very emotional experience. Being told that a mastectomy is part of the treatment regimen either through the patient's choice or the recommendation of the cancer surgeon may add further to the burden of choices. Dr. Lucas feels strongly that every effort should be made to provide early education and counseling regarding treatment options if a mastectomy is being contemplated.
Fortunately, there are several options for patients with regard to breast reconstruction. If possible, immediate reconstruction can be initiated if the circumstances are appropriate. Women who choose initially not to undergo breast reconstruction or wish to defer until the cancer treatment was completed are similar candidates for most procedures.
Creating a breast or breasts that feel and look natural is our goal. The emotional benefit of feeling whole again is an important component in the recovery from breast cancer. One choice, if appropriate, is the use of the body's own material of fat and skin from another region of the body with an associated blood supply. This can be in the form of part of the abdomen such as the TRAM flap, or the back muscle (latissimus muscle with or without skin). These are larger operations but have a very natural look and feel. In cases requiring the harvesting of the back muscle, Dr. Lucas can utilize an endoscopic approach to minimize incision and thus scarring on the back.
Another option for women who are not candidates for autologous reconstruction is through the use of implants. In most instances, there is a deficiency in skin and muscle coverage of the implants which requires a technique of tissue expansion to stretch the skin and muscle to accommodate an appropriate breast implant. Many times, if a unilateral reconstruction is necessary, the opposite breast needs modification to match the reconstructed side. Most of this work can be performed as outpatient surgery. Dr. Lucas is a co-investigator in the FDA approved Silicone Gel Implant study. Therefore, he is able to offer his patients the option for silicone gel implants which are a superior product for women seeking implant reconstruction of a mastectomy site.
Another service Dr. Lucas provides to the breast cancer survivor community is revision surgery. Many patients might be unhappy with their reconstruction results and Dr. Lucas is a well know surgeon in the area to provide second opinions and possible revisions to alleviate patient’s dissatisfaction with their outcomes.
Techniques such as biologic modification of implant reconstruction with the use of autologous micro-fat grafting, and the use of Alloderm (acellular dermal matrix graft) to improve contour deformities and volume expand the skin flaps covering the implant. Dr. Lucas has considerable experience in these procedures and he is typically consulted by the areas medical oncologists for revision procedures for their patients.
Common problems patients have with their reconstruction either stem from incorrect size or placement of implants, asymmetries with the opposite breast, contour defects of the reconstruction, and tightness of the scar pocket around the implants. Dr. Lucas will perform a thorough evaluation during your consultation to determine the exact problems and come up with an appropriate treatment plan to alleviate the problems with your existing reconstruction.
Click for a Breast Reconstruction Animation video.
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