Special to Tallahassee, FL women

October is Breast Cancer Awareness Month, and it serves as a good reminder of a disease that claims far too many women. Last year, more than 210,000 women in the United States were diagnosed with breast cancer and about 41,000 will die from the disease this year.

While the numbers are staggering, the better news is that today there are more than two million women living in the United States who have been treated for breast cancer. Fortunately, the death rates are declining too, which has resulted from earlier detection and improved treatments.

There’s encouraging news about the progress being made in breast cancer care and reconstruction. Working hand in hand with cancer surgeons, plastic surgeons are giving breast cancer patients the most natural-looking breast possible, often making a diagnosis of breast cancer easier to bear. About 85,000 breast reconstruction=2 0procedures are performed each year, giving women new hope and comfort.

Local plastic surgeons Ben J. Kirbo, M.D., and Laurence Rosenberg, M.D., from Southeastern Plastic Surgery, P.A., shared information about some of the new options in breast reconstruction.

“We’ve come a long way in breast cancer treatment,” according to Dr. Kirbo. A mastectomy began as surgery where everything in the breast area was surgically removed, later more muscle was left, now more skin is left so that patients have more choices.”

Most women who have had a mastectomy can undergo reconstruction. More and more women with breast cancer are choosing surgery that removes less breast tissue. Some women who have had a lumpectomy may not even need reconstruction.

Women considering reconstruction should talk with their physician and plastic surgeon prior to the mastectomy. It allows the doctors to plan the treatment that is best for the individual. Some women may decide to have reconstruction at a later time.

Dr. Rosenberg said, “Reconstruction of a breast that has been removed due to cancer is one of the most rewarding surgical procedures available today.”

“New medical techniques and devices have made it possible for the surgeon to create a breast that can come close in form and appearance to matching a natural breast,” Dr. Kirbo added. “Frequently, reconstruction is possible immediate follow breast removal, so you wake up with a breast already in place.”

Among the types of procedures available for breast reconstruction are:

Tissue Expansion

The most common technique combines Tissue Expansion and subsequent insertion of an implant. Following mastectomy, the surgeon will insert a balloon expander beneath the skin and chest muscle. Through a tiny valve mechanism buried beneath the skin, we inject a salt-water solution to gradually fill the expander over several weeks or months.

After the skin over the breast area has stretched enough, the expander may be removed in a second operation and a more permanent implant will be inserted. Some expanders are designed to be left in place as the final implant. The nipple and the dark skin surrounding it are reconstructed in a subsequent procedure.

Tissue Flap Reconstruction

An alternative approach to implant reconstruction involves creation of a skin flap using tissue taken from other parts of the body, such as the back or abdomen. Here the tissue remains attached to its original site, retaining its blood supply. The flap, consisting of the skin, fat and muscle with its blood supply, are tunneled beneath the skin to the chest, creating a pocket for an implant or, in some cases, creating the breast mound itself, without need for an implant.

Dr. Rosenberg said that most breast reconstruction involves a series of procedures that occur over time. Usually, the initial reconstructive operation is the most complex. Follow-up surgery may be required to replace a tissue expander with an implant or to reconstruct the nipple and surrounding area.

Other considerations include deciding whether or not to have immediate reconstruction or delayed reconstruction at a later time.

Your physician also will consider your overall health, the stage of your breast cancer, the size of the natural breast, amount of tissue available and whether or not you are interested in matching the way the other breast looks.

“Women who are given a breast cancer diagnosis often are overwhelmed,” said Dr. Kirbo. “We work very hard to schedule same day appointments for consultation to help set them at ease and present all options.”

For additional information about breast cancer reconstruction options, or to schedule an appointment, call Southeastern Plastic Surgery, at (850) 219-2000 or visit www.se-plasticsurgery.com

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