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Author: Breast Reconstruction Associates

Breast cancer awareness and prevention tips for 2024

How Common is Breast Cancer? Updated for 2024

Written by Breast Reconstruction Associates on . Posted in Breast Cancer, Womens Health. No Comments on How Common is Breast Cancer? Updated for 2024

Breast cancer is the most common malignancy affecting American women, with one in eight women diagnosed during their lifetime (12.5% risk). There are several risk factors that can affect a woman’s risk, some of which are modifiable while others are out of our control.

Modifiable Risk Factors

  • Body Mass Index (BMI): Weight can significantly increase a woman’s risk for developing breast cancer as adipose (fat) tissue stores estrogen. Being overweight or obese increases estrogen exposure and cancer risk. Maintaining a healthy BMI is essential not only to lower your breast cancer risk but also to decrease the risk of recurrence if you are a breast cancer survivor. A balanced, nutritious diet and avoiding processed foods play crucial roles in achieving this.
  • Alcohol Consumption: The more alcohol you consume, the higher the risk of developing breast cancer. Limiting your intake to less than 3 to 4 drinks per week is recommended.
  • Tobacco Use: Nicotine use increases breast cancer risk and inhibits wound healing. It’s crucial to quit all nicotine products before undergoing surgical management.
  • Physical Activity: A sedentary lifestyle can increase your risk for breast cancer. Aim to engage in at least 150 minutes of exercise per week, though ideally, you should aim for 300 minutes for optimal risk reduction.
  • Hormone Replacement Therapy (HRT): Combination HRT (estrogen/progesterone) increases breast cancer risk. Most women must stop these medications once diagnosed. It’s especially important to perform routine self-breast exams and screening mammograms while taking HRT.

Non-Modifiable Risk Factors

  • Age: Breast cancer is predominantly diagnosed in women over the age of 50.
  • Gender: While women are overwhelmingly more affected by breast cancer than men, men constitute 2% of all breast cancer diagnoses each year. Men should also be aware of this risk and practice breast awareness.
  • Genetics & Family History: Certain genetic mutations like BRCA1 and BRCA2 can increase the risk of developing breast cancer. Other genes include CHEK2, PALB2, and ATM. Even if genetic testing is negative, a family history of breast cancer can still place you at higher risk.
  • Lifetime Estrogen Exposure: Early menstruation (before age 12), late menopause, delaying childbirth after age 30, or not having children at all increases estrogen exposure and breast cancer risk.
  • Atypical Breast Cells: Not every breast biopsy is malignant; many are benign like fibroadenomas or cysts. However, some biopsies reveal high-risk lesions like atypical ductal and lobular hyperplasia and lobular carcinoma in situ.

While breast cancer rates have been increasing, more women are surviving this diagnosis thanks to increased awareness, early detection, and improved treatment options. If you have been diagnosed with breast cancer or a genetic mutation and are considering breast reconstruction surgery, reach out to us at our Fort Worth, Austin, Bozeman, or Oklahoma City offices. At Breast Reconstruction Associates, we are committed to our patients’ overall health and reconstructive goals.

Learn more about breast cancer prevention and modifiable risk factors to take proactive steps in reducing your risk.

For more information and personalized advice, book a call with one of our specialists today!

When Should You See A Breast Reconstruction Surgeon? | DIEP Flap TX

When Should You See A Breast Reconstruction Surgeon?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

The timing of breast reconstruction is often determined by the stage of cancer and the oncologic treatment recommendations. However, in general, we refer to the timing as immediate or delayed.

Immediate breast reconstruction

Refers to reconstruction occurring at the same time as the mastectomy. There is a two-fold benefit of immediate reconstruction. The first, it provides a breast mound and avoids a flat chest wall. The second, the skin envelope can be utilized via a skin-sparing mastectomy, thus allowing for a potentially better aesthetic outcome.

Delayed breast reconstruction

Refers to reconstruction that is performed at another time following the mastectomy. A mastectomy without reconstruction is frequently performed when a woman has advanced cancer, requires radiation therapy, or has multiple medical comorbidities.

In general, it is best to see a breast reconstruction surgeon soon after your diagnosis. Many factors contribute to the timing of reconstruction, and involving the plastic surgeon early in this decision making will help to provide the best outcome. This is true regardless of your type of cancer or expected treatments.

Lastly, if you have already had a mastectomy and have completed the recommended adjuvant treatments, you are still a candidate for reconstruction. We are happy to assist you with your reconstructive needs at any point along your journey. If you would like to get in touch with a plastic surgeon regarding the best timing for your reconstructive breast surgery, please contact us in Fort Worth, Austin, Oklahoma City, or Bozeman.

Common Plastic Surgery Risks | Breast Reconstruction Associates

Secondary Flaps: PAP and SGAP

Written by Breast Reconstruction Associates on . Posted in DIEP Flap Reconstruction.

Some patients may not be a candidate for the DIEP flap reconstruction. These patients may have a history of previous abdominal surgery that may have affected the DIEP vasculature. Examples of such procedures could be a prior abdominoplasty (aka tummy tuck) or liposuction. Other patients may have more volume at the other donor sites of the buttocks or thighs when compared to the abdomen. 

In these instances, patients may be candidates for autologous reconstruction from a secondary site.  Our commonly preferred secondary sites include the PAP (inner thigh) and SGAP (upper gluteal region) flaps.  Just as is performed with the DIEP procedure, both the PAP and SGAP flaps involve harvesting the skin and fat from these various regions along with their respective blood supply to reconstruct a more natural-appearing breast.

Various factors can influence a patient’s candidacy for these secondary flaps, which include having an adequate volume from the donor site.  In some instances, you may benefit from a combination implant and autologous reconstruction with a secondary flap.  While the incisions can be hidden in clothing, patient acceptance of scar patterns is important for all autologous reconstructive cases.

At Breast Reconstruction Associates, we would be happy to discuss your reconstructive needs and design the best plan using a secondary flap if the DIEP flap is not an option for you.  Please call your local Forth Worth, Austin, or Oklahoma City office to schedule a consultation today.

How Do You Make a Nipple?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Nipple reconstruction is usually a part of the final stage of breast reconstruction. A nipple reconstruction can be done as an office procedure, but sometimes is incorporated with revision of the reconstruction in the operating room. In our practice we perform the nipple reconstruction, and then tattooing of the areola as a separate procedure.

In simple terms, the nipple is made from elevating skin and folding it in a way that leaves a ‘nub’ of skin that looks like a nipple. In medical terms we refer to the skin elevation as “elevating a flap”, and the flaps described for nipple reconstruction are numerous. We may use a different flap design based on the needed size, width, or projection – either to match the other side (for one–sided reconstruction) or based on the patient’s goals (for two–sided reconstruction). Importantly, though the final product may strongly resemble an actual nipple, the reconstructed nipple does not have sensation or ability to change with temperature changes, and lacks erogenous sensation.

You can also watch the following 9 min video to see the specific steps involved in a nipple reconstruction done in the office.

Oncoplastics Breast Surgery | Breast Reconstruction Associates

Oncoplastic Breast Surgery: What Is It? Am I a Candidate?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, Womens Health.

Oncoplastic breast surgery is a surgical approach that integrates breast cancer surgery with plastic surgery techniques. Historically, breast conservation therapy, or the combination of a lumpectomy and radiation therapy, was performed to preserve a portion of the breast and still offer patients equivalent survival rates as a mastectomy. However, a traditional lumpectomy often leads to deformity of the breast; this is why combining lumpectomy with a plastic surgery technique has potential benefit for patients. The goal of oncoplastic breast surgery is to improve aesthetic outcomes without compromising the resection and treatment of breast cancer.

In general, ideal candidates for breast conservation are those who have a small tumor relative to total breast size. Oncoplastic breast surgery can be integrated with any lumpectomy procedure, but patients with large breasts or breasts with a fair degree of ptosis (or “droop”) are the optimal candidates. In these cases, the tumor can be safely removed using standard breast reduction or breast lift techniques while also improving the overall appearance of the breast. A balancing breast lift or reduction of the other breast is typically performed simultaneously for symmetry purposes.

Oncoplastic breast surgery can also be a good strategy for women who are wanting mastectomies and reconstruction but also would require post-mastectomy radiation (usually for an advanced cancer or cancer in the lymph nodes). In order to prevent radiating a total breast reconstruction, oncoplastic surgery is followed by radiation. Completion mastectomies and total breast reconstruction can then be performed at a later time after the patient has recovered from radiation therapy.

The Advantages of Having a Mastectomy | Breast Reconstruction Associates | Dallas Forth Worth

The Advantages of Having a Mastectomy

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Breast cancer is one of the most common types of cancer among American women — nearly one in eight women develop it in the course of their lifetime. Treatment of breast cancer involves a multidisciplinary approach and therapies are selected based on biology, size, and location of the tumor. In most cases, surgical intervention is recommended, and patients are faced with the decision to undergo lumpectomy followed by radiation (known as breast conservation therapy) or mastectomy.

A mastectomy is the complete surgical removal of breast tissue. This surgical approach is appropriate for patients with breast cancer that does not meet the criteria for breast conservation therapy, patients who prefer mastectomy over BCT, or for prevention of breast cancer in high risk patients.

Historically, mastectomies included the removal of the overlying breast skin. Strategies to preserve the breast skin have now been developed that have significantly improved the cosmetic outcome of immediate breast reconstruction following a mastectomy. Patients who have a mastectomy followed by breast reconstruction can now have equivalent or superior cosmetic outcomes compared to breast conservation therapy.

There are other advantages of having a mastectomy over breast conservation. By choosing a mastectomy, patients have the potential to avoid the need for radiation therapy. This allows women to forgo the skin changes and other effects caused by radiation. Patients also no longer require regular mammograms following a mastectomy. And lastly, while research has demonstrated equivalent survival outcomes between mastectomy and breast conservation therapy, the risk of local recurrence is lower in patients who undergo mastectomy.

The decision to choose a mastectomy over other surgical treatment approaches is difficult and includes many variables. To determine the best plan for you, talk to your breast surgeon in Fort Worth.

Breast Reconstruction Associates – North Austin Area

Breast Reconstruction Associates – Austin TX

I’ve Had a Lumpectomy and Radiation Previously but Now I Need a Mastectomy. What Should I Know? | DIEP Flap Texas

I’ve Had a Lumpectomy and Radiation Previously but Now I Need a Mastectomy. What Should I Know?

Written by Breast Reconstruction Associates on . Posted in Mastectomy Radiation.

Lumpectomy and radiation, also known as Breast Conservation Therapy (BCT), is an increasingly common way to treat breast cancer, especially in women with larger breasts and smaller tumors. Although BCT has similar survival rates compared to women who undergo mastectomy and reconstruction (usually without radiation), there is a higher local recurrence rate for breast cancer in the same breast after BCT.

For women who have had BCT previously but now have a new breast cancer in the same breast, another lumpectomy with radiation is not possible. For this reason, women are best counseled to treat their new cancer with mastectomy. Although hormornal or chemotherapy may be indicated, radiation is usually not able to be given a second time.

For women undergoing mastectomy in this scenario, reconstruction with an expander or implant has a much higher rate of infection and reconstruction failure compared to women who undergo microsurgical breast reconstruction using their own tissues. For this reason, we strongly counsel women to consider free flap breast reconstruction. Depending on the previous scars present and the tissue quality, skin sparing mastectomy might still be possible.

Preparing for Diep Flap Breast Reconstruction | Breast Reconstruction Associates

Preparing for DIEP Flap Breast Reconstruction

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, DIEP Flap Reconstruction.

Patients who have opted for mastectomy with DIEP flap reconstruction often ask what they can do to best prepare for the recovery process. The amount of time between deciding on the right surgery for you and the surgery date varies from patient to patient. Some patients have only a few weeks between their diagnosis and surgery; others have months to years depending on other treatments or life circumstances. In either situation, the following recommendations apply.  

1. Maintain a healthy diet

Eating a balanced diet of protein, healthy fats, fruits and vegetables will help you get the proper macronutritents, vitamins and minerals needed for healing and recovery after surgery. Try to minimize your intake of sugar, foods with added sugar, or highly processed foods. These foods can be pro-inflammatory and are unlikely to be nutrient-rich sources of food. Most patients do not need any type of supplements prior to surgery

2. Optimize cardiovascular status

Exercise in the form of aerobic activities (i.e. walking, jogging, biking, etc.) strengthens your cardiopulmonary system to better tolerate surgery and anesthesia, helps control blood pressure, and contributes to a faster post-operative recovery. Some patients have high blood pressure, coronary artery disease or other cardiac issues. It’s important to optimize the management of these issues with your cardiologist prior to surgery. If you have a history of heart problems or are not currently physically active, check with your doctor before beginning exercise routines.

3. Minimize risk factors of surgical complications

Many patient factors that contribute to surgical complications, such as poor wound healing and infection, are modifiable. If you are an active smoker, the best thing you can do for your recovery would be to completely eliminate nicotine use. If you are overweight or have diabetes, it’s also extremely beneficial to lose weight and/or control your blood sugar as much as possible prior to surgery. Talk to your doctor about strategies to reduce risk factors of surgical complications before surgery.

4. Mental preparation

Undergoing breast reconstruction surgery can be stressful mentally and emotionally, especially if you are also processing a new breast cancer or gene mutation diagnosis. Having emotional and spiritual support systems in place in the form of family and friends is also important. You may also find it helpful to have some personal coping mechanisms in place prior to surgery such as journaling, meditation, support groups or prayer. Lastly, it’s important for you to have a positive relationship with your surgeon. Open communication about the surgery, recovery and expectations will help you feel comfortable and confident with your decision to undergo breast reconstruction surgery.

Nipple Reconstruction and 3D Nipple Tattoos | Breast Reconstruction Associates

Nipple Reconstruction and 3D Nipple Tattoos

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, DIEP Flap Reconstruction.

Breast reconstruction surgery is designed to restore the volume and shape of the breast after mastectomy. Some women may be candidates for nipple-sparing mastectomy but in many cases, this part of the breast must be removed. To complete the reconstruction and restore the aesthetic unit of the nipple and areola, women have the option to choose from 3D nipple and areola tattoos vs nipple reconstruction followed by tattooing of the areola pigment.

3D nipple and areola tattoos are done by a professional tattoo artist that specializes in this trade. ‘Before’ photos are reviewed, and careful consideration is given to the color selection, size and placement of the nipple and areola. The pigment is then applied in the form of a tattoo with additional shading techniques to create the appearance of a 3D nipple. This means that in the mirror, the visual aesthetic unit of a nipple is present, but to the touch, the breast is smooth and flat.

Nipple reconstruction followed by NAC tattoos involves a minor procedure of nipple reconstruction that can be done at the time of breast reconstruction, in combination with a second stage revision, or alone as an office procedure. The procedure involves cutting and suturing a small amount of skin into the shape of a nipple with proper placement and symmetry on the breast mound. After this reconstructed nipple has healed, tattoo pigment can be applied to restore the color and shape of the areola. This results in restoration of the visual aesthetic unit of the nipple and areola, as well as the physical projection of a nipple. It is important to note that a nipple reconstruction does not have sensation and will always remain erect.

These procedures are not mandatory but encouraged to achieve the most optimal and the most natural aesthetic result. If you have questions, please consult your breast reconstruction experts of Austin, North Texas and Oklahoma at Breast Reconstruction Associates. You may also find it helpful to review some of our before and after photos. The surgery and completion details are indicated for each photo.

Pain After Breast Reconstruction | Breast Reconstruction Associates

Pain After Breast Reconstruction

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, Womens Health.

Most surgical interventions come with some degree of postoperative pain or discomfort. This can be a source of fear and anxiety for many patients facing mastectomy and breast reconstruction surgery. At Breast Reconstruction Associates, we use a specific pain control protocol that has proven efficacy, and we work together with patients to achieve the optimal degree of pain control. Most of our patients have been pleasantly surprised that their pain was less than expected. Here is some insight into the way we approach pain control.

While it is not feasible to guarantee a pain score of 0/10, even with adequate pain medications, we are committed to helping you remain as comfortable as is safely possible after surgery. Our goals are to reduce your discomfort to a degree that is tolerable so regular activities of daily living can be performed, to avoid over-sedation, and to avoid adverse medication side effects.

There are many different types of pain that are experienced after mastectomy and breast reconstruction—general post-operative pain of incision sites, neuropathy (nerve-related pain) and musculoskeletal pain. In our pain control protocol, we prescribe medications that target each type of pain to yield better overall pain control.

The post-operative pain medication regimen used at Breast Reconstruction Associates is aligned with the ERAS (Enhanced Recovery After Surgery) protocol.  This protocol was developed to be a perioperative strategy that promotes quicker recovery after surgery and helps patients avoid opioid-based pain medications. The medication regimen associated with this protocol is supported by evidence-based research and is used worldwide.  Our practice takes a patient-centered approach to the use of this regimen and we have had great success with our patients’ post-operative recovery.

Our patients are our priority. Your post-operative comfort and care are important to us. If you are considering DIEP flap breast reconstruction and have questions about post-operative pain, reach out to our plastic surgeons at Breast Reconstruction Associates.