UCHealth/Courtesy photo
Breast reconstruction surgery post breast cancer continues to evolve, from the availability of more stable implants to techniques to preserve natural breast shape.
Since July 2020, Dr. Aaron Frye, a plastic and reconstructive surgeon at UCHealth Yampa Valley Medical Center and in Fort Collins, has performed about two breast reconstruction surgeries each month in Steamboat Springs.
Frye said approximately 56% of breast cancer patients opt for some form of breast reconstruction, such as autologous tissue transfer, implant-based reconstruction or oncoplastic closures following lumpectomy that preserves breast shape by limiting contour deformities.
Of the women who are diagnosed with breast cancer and also want to proceed with reconstruction, 80% of those women visiting Frye’s practice opt for implant-based reconstruction, noted Kathryn Wick, a certified physician associate at UCHealth Plastic and Reconstructive Surgery Clinic in Fort Collins.
“We primarily perform implant-based reconstruction. We do this either immediately at the time of cancer removal surgery or any time after that, which is known as delayed reconstruction,” Frye explained.
In autologous reconstruction, the surgeon uses the patient’s own abdominal tissues or muscle, fat and skin from the abdomen to reconstruct the breast.
If the breast cancer is more advanced, the reconstruction surgery usually is more complex, said Frye, who has performed more than 500 breast reconstruction surgeries in the past nine years. When a patient is anticipating radiation treatment, for example, Fyre can use the latissimus dorsi, a large muscle of the back, to assist in reconstruction to allow for more adequate blood flow and better healing properties.
Frye said having surgery locally may lead to better outcomes.
“Some of the advantages include having your support system nearby, a more comfortable recovery at home versus at a hotel, less travel time that minimizes risk of blood clot or other serious complications immediately following surgery, closer proximity to medical care in case of post-operative complications and consistency and ease of care, which allow a patient a less stressful healing experience leading to more positive surgical outcomes,” Frye said.
Breast implants are “consistently changing as manufacturers are attempting to make them more and more safe and realistic,” Frye said. Current breast implants are increasingly stable and sturdy, with more of a “gummy bear” type of inner consistency that more closely resembles a natural breast and are difficult to break. Modern implants can last a lifetime, Frye said.
“Implants used cosmetically are the same as those used for reconstructive purposes,” Wick explained. “There is no need for replacement of these unless certain complications arise, such as capsular contracture (a capsule of scar tissue around an implant), discomfort, symptomatic rupture of the implant or patient preference.”
Patients have the option to have silicone or saline implants, but saline-filled breast implants include a silicone outer shell. Most patients prefer silicone implants as they have a more realistic feel, Wick said.
Patients who opt for breast reconstruction are able to save a step when the first surgery is a tandem surgery. Reconstruction initiated at the time of the initial breast cancer removal during lumpectomy, partial mastectomy or mastectomy allows a plastic surgeon and general surgeon to coordinate and work together, Frye said.
“Usually, this route is easier on the patient and means less surgery overall for them. This also helps the patient to reach their final outcome sooner, which is an added benefit,” Frye said.
The American Cancer Society advises breast cancer patients who are considering breast reconstruction to ask many questions and fully understand what to expect in order to make the best decisions about options. For example, many mastectomy patients lose sensitivity in nipples, so another route could be to opt for a 3D tattoo to mimic the appearance of nipples.
Some patients in the active culture of Colorado chose to have no reconstruction or to delay reconstruction for years as a trial, Frye said. Many women and doctors call no reconstruction “going flat,” according to BreastCancer.org.
Each patient visits the surgeon’s office for an initial consultation focused on education, not scheduling a surgery, Wick said.
“We set aside extra time during this visit to get to know our patients and have the ability to answer any and all of their questions as well as listen to their concerns,” she said.
Frye said breast cancer treatment is a collaborative, teamwide approach involving a general surgeon, plastic surgeon, oncologist, radiologist, nurse navigator and others.
“The most difficult yet most rewarding aspect of what I do is being a part of a patient’s cancer battle,” Frye said. “Although it is painful to watch someone battle a cancer diagnosis, it is incredible to be a part of their recovery and a gift to be able to encourage and support them through it.”
To reach Suzie Romig, call 970-871-4205 or email sromig@SteamboatPilot.com.
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Women have options through breast reconstruction surgery - Steamboat Pilot & Today
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