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Common Plastic Surgery Risks | Breast Reconstruction Dallas Forth Worth, Austin & Oklahoma City, OK

Surgical Risks of Breast Surgery and Reconstruction

Written by info@wildmonkeybrand.com on . Posted in Breast Cancer, Breast Reconstruction, Womens Health.

Making the decision to undergo surgery, regardless of the operation, can be overwhelming. At Breast Reconstruction Associates, we understand that discussing the surgical details in plain English as well as reviewing the potential risks involved imparts the needed information that leaves patients feeling informed and confident.

A few of the general risks associated with any surgery are bleeding, infection of the surgical site, blood clots, and adverse reactions to general anesthesia. During your consultation with your plastic surgeon, you will review these general risks as well as the risks specific to breast surgery and/or reconstruction in detail. Although most women do not experience the following complications, here is a brief preview of the risks that will be covered in your discussion:

Fluid collections

Fluid or blood (seroma or hematoma) may accumulate between the skin and underlying tissues following surgery. Drains may be left in place after surgery to prevent this accumulation. Should this problem occur after drain removal, it may require additional procedures for drainage of the fluid.

Changes in sensation

The surgery will alter the sensation to the nipple, areola and surrounding breast skin. It’s important to discuss the possible extent of these changes with your surgeon, as it will depend on what type of surgery has been recommended for you.

Potential loss of the nipple-areola complex

If you are having a procedure that spares the nipple and areola, there is a risk of decreased vascular supply to these structures which can lead to necrosis (or death). This can either be self-limiting or require intervention.

Mastectomy flap necrosis

The breast skin remaining after mastectomy can have trouble healing from a lack of blood supply. When the blood supply is low enough, breast skin can die.  This is more common in larger breasted women.  Tobacco use and previous radiation history can also increase the risk of mastectomy flap necrosis.

Delayed wound healing

Wounds may separate after surgery. This may require daily home wound care or further surgery to correct the defect.

Microvascular thrombosis

Autologous breast reconstruction is associated with the risk of clot formation within the artery or vein providing circulation to the flap. This most commonly occurs during surgery but can happen afterwards, usually within the first 24-48 hours after surgery. This requires a second operation to attempt salvage of the tissue. The risk of this occurring is low and will be discussed in further detail with your surgeon.

Failure of the reconstruction –

Regardless of the method selected (implants, DIEP flap, or other flap), the reconstruction can fail which leaves the patient with a flat chest wall.  Alternative methods would be considered if the patient elects to proceed with secondary reconstruction. In general, in properly selected patients, failure is uncommon.

At Breast Reconstruction Associates, we are committed to helping you navigate your surgical options, weigh the risks and benefits of surgery, and make the best decision specific to your care.  Reach out to our plastic surgery office in Fort Worth, Austin or Oklahoma City if you have questions. We are here as a resource for you.

Breast Surgery for Older Women | Breast Reconstruction Associates

Breast Surgery for Older Women

Written by info@wildmonkeybrand.com on . Posted in Breast Cancer, Breast Reconstruction, Womens Health.

Breast cancer is the most common malignancy affecting American women with 1 in 8 women diagnosed during their lifetime.  There are several risk factors involved in the development of breast cancer, some of which are modifiable (weight/BMI, hormone use, smoking and alcohol use) while others cannot be changed or controlled (age, genetics).  Increasing age is considered the most significant risk factor for this diagnosis, and it may contribute to the treatment decisions as chronologically advanced women may have other co-morbidities that must be considered.

As we age, our organs experience various changes that can affect surgical healing.  For example, the skin becomes thinner and has less connective tissue like collagen and elastin, all of which can lead to delayed healing.  While we cannot reverse this physiologic process, we can control other components like smoking. All nicotine products cause vasoconstriction, which makes it more difficult for the arteries to deliver necessary oxygen and nutrients to all organs and tissue.  Smoking and the use of nicotine products exponentially increases the risks of surgery and can sometimes disqualify a patient from reconstructive surgery.  We prefer that any patient undergoing reconstructive surgery be off all nicotine products for at least 6 weeks.

General anesthesia is required during breast reconstructive surgery whether using implants or autologous aka tissue-based reconstruction.  At Breast Reconstruction Associates, we use a two-surgeon team on all autologous cases to minimize the length of surgery and therefore the amount of anesthesia, which directly correlates to quicker recovery times.  Age is a consideration for these surgeries as there are increased risks of post-operative delirium and post-operative cognitive dysfunction in patients aged 65 and older.  These patients are at higher risk if they have an established diagnosis of any form of cognitive impairment.

At Breast Reconstruction Associates, we offer various reconstructive options for our patients and always involve the patients in this discussion and decision process.  Each patient is unique due to their age, medical and family history, and tumor profile among many other considerations.  We want to work with you and your breast cancer team to determine the best possible outcome, so please contact us today to set up a consultation.

Sources:
“Preparing for Surgery – Age Risks,” American Society of Anesthesiologists, https://www.asahq.org/whensecondscount/preparing-for-surgery/risks/age/.

How Common is Breast Cancer? | Breast Reconstruction Associates

How Common is Breast Cancer?

Written by info@wildmonkeybrand.com on . Posted in Breast Cancer, Breast Implants, Breast Reconstruction.

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 aka fat tissue stores estrogen. Being overweight or obese increases estrogen exposure as well as cancer risk. It is important to maintain a healthy BMI to not only lower your breast cancer risk, but also decrease the risk of cancer recurrence if you are a breast cancer survivor. Your diet plays into this as well so it is important to eat a balanced, nutritious diet and avoid processed foods.
  • Alcohol consumption – This is an exponential risk factor in that the more alcohol you consume, the higher the risk of developing breast cancer. You should limit your intake to less than 3 to 4 drinks per week.
  • Tobacco use – As with most malignancies, nicotine use increases breast cancer risk. It also inhibits wound healing, so it is important to quit all nicotine products before undergoing surgical management.
  • Physical Activity – A sedentary lifestyle can increase your risk for breast cancer as well. Ideally, you should increase your exercise routine to 300 minutes per week, but risk reduction is observed at 150 minutes per week.
  • Hormone Replacement Therapy – Combination HRT (estrogen/ progesterone) increases breast cancer risk. Most women must stop these medications once diagnosed. It is especially important to perform routine self-breast exams and screening mammograms while taking HRT.

Non-modifiable Risk Factors:

  • Age – Breast cancer is an aging woman’s disease with a majority of cases diagnosed after the age of 50.
  • Gender – Women are overwhelmingly more affected by breast cancer than men, but men constitute 2% of all breast cancer diagnoses each year so it is important for men to practice breast awareness as well.
  • Genetics & Family History– Certain genetic mutations can increase a woman or man’s risk of developing breast cancer. Most people are aware of the BRCA1 and BRCA2 genes, but there are several other genes that increase this risk as well (CHEK2, PALB2, ATM to name a few). Even if genetic testing is negative for these mutations, patients are still considered to be at a higher risk than the general population if they have a family history of breast cancer.
  • Lifetime Estrogen Exposure – Starting menstruation before the age of 12, menopause at a later age, and delaying childbearing after the age of 30 or not having any children all lead to increased estrogen exposure and ultimately breast cancer risk.
  • Atypical breast cells – Not every breast biopsy is malignant; many are benign like fibroadenomas or cysts. There are some biopsies considered high risk lesions like atypical ductal and lobular hyperplasia and lobular carcinoma in situ.

While breast cancer rates have been increasing over the years, the good news is that more and more women are surviving this diagnosis. This is largely due to increased patient awareness and early detection as well as improved and increasing 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 or Oklahoma City offices. At Breast Reconstruction Associates, we are committed to our patients’ overall health and reconstructive goals.