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>>>Dr. Jay K. Harness: A woman who is facing a mastectomy and who has decided to undergo
reconstruction, they will ask me the question, Gee Dr. Harness, is it better to begin the
reconstruction or the first stage at the time of the mastectomy, or should we do it on the
delayed basis?
I have a very strong feeling and a philosophy about this and that is that beginning the
first stage reconstruction with a tissue expander at the time of mastectomy, makes the patient
feel more whole. It is part of what I call beginning the process of emotional reconstruction.
Now, if a patient is having a reconstruction done with a flap, then again that can be done
immediately or on a delayed basis. With flap reconstruction, most of the plastic surgeons
that I know, want to do it on a delayed basis if the patient is going to have radiation
therapy as part of the treatment of the mastectomy site itself.
And then letting that mastectomy site heal up usually a good four to six months after
the end of the radiation therapy, before swinging a flap in from the abdomen or from the back,
or whatever. This allows the tissue in the area to recover. Also it helps with not having
any potential radiation therapy damage to the flap itself.
So the answer to the question is again somewhat complicated. If it is really straight forward
- patient is going to eventually have lets say a saline or silicon implant, that generally
the first stage reconstruction is the placement of a tissue expander.
I think all of us prefer to do that at the time of mastectomy thats called first stage.
The second stage reconstruction then is the placement of the permanent implant. Dealers
choice here - silicon, saline… discuss these options with your plastic surgeon.
On the other hand, if you are going to have radiation therapy but not going to have a
flap reconstruction, then putting in a tissue expander in at the time of the mastectomy,
subsequently and then following up if you need chemotherapy and then radiation therapy,
waiting again a good four months or more after the end of the radiation therapy, then the
permanent implant can be placed.
It is a complicated answer. Hopefully it answers your questions and just keep those questions
coming. We want to keep the answers coming to you here at Breast Cancer Answers.
*****
Hi, I am Dr. Jay Harness and I want to share with you an important information that I believe
that every newly diagnosed patient with breast cancer needs to know.
Susan Denver: “I am a breast cancer survivor.”
Katherine Stockton: “I am a breast cancer survivor.”
Coree: “I am a breast cancer survivor…”
Susan Denver: “…and I want every woman to know…”
Katherine Stockton: “…about personalized breast cancer treatment…”
Susan Denver: “…and the Genomic Test.”
Coree: “A test that helps guide a woman and her doctor…”
Katherine Stockton: “…to the best treatment options for her.”
Susan Denver: “Pass it on!”
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Transcribed at Divine Mercy Transcription http://www.divinemt.com