Dr Adamson, Inflammatory Breast Cancer, Dr Lo Giudice discussed on Saturday Spotlight


We Take the access tissue, usually at the mid or lower portion of the abdomen. And even if it's a one sided reconstruction, we still take an equal amount of tissue on both sides of the abdomen so that the patient gets a good contour. So a lot of folks look at it favorably. From not only the perspective of getting a breast reconstruction, but they also look at it as improving the contour their abdomen and are there certain types of patients who are undergoing therapy for breast cancer who might be a better candidate for That type of reconstruction with the deep flat versus an implant, for example, so patients that have, um no plans for radiation immediately after the mastectomy. Are are usually good candidates for using their own tissue. We try not to transfer the tissue or do an autologous flap. At the time of mastectomy. If we know that they're going to get radiation afterwards because the radiation can have ill effects on the reconstruction. In terms of other things that we consider if the patient is very large breasted. We still don't have great success with Implant based reconstruction due to the limitations of the implants that are available, and so oftentimes we steer those patients to autologous reconstruction as well. And if they have tissue, for instance, in their belly despair Again. They oftentimes don't mind having it harvested and is the recovery from that sort of reconstruction with their own tissue. Is it a more difficult recovery? I mean, I'm assuming they're more scars, of course, because they have the abdominal scar. But do patients tend to recover as well as with an implanted as quickly or is it a little bit of a longer recovery? In general. We tell patients that there's a lot more work up front for them versus an implant based reconstruction because they do have to heal what we call the donor site or the site that we harvest the tissue from And so we usually impose some form of restrictions for approximately six weeks after we harvest, for instance, from the abdominal donor site. Those restrictions include lifting restrictions. Usually in the 10 to £15 range. In addition, we don't want them sleeping on their on their breasts. When it when it's all said and done. It might mean that for another two or three weeks, they have more restrictions than an implant based reconstruction. But Overall, they don't need any, um significant recovery afterwards because most the reconstruction is completed at the time of that initial procedure versus Implant based reconstruction, where it may need to be staged, and Dr Adamson win it when the implant based Reconstructionist stage What's usually the timeline? You had mentioned the tissue expanders to ultimately the implant it Zob Vesely a longer timeline than Dr Lo Giudice said, alluded to for the flap reconstruction. So what is that timeline, usually for women? So usually we will exchange the expander for the implant after about 3 to 4 months, But if the patient is having chemotherapy and definitely if they're having radiation therapy, then we wait to exchange to the permanent implant until after that treatment is complete. And the skin has recovered. And finally in our last couple minutes, Dr Dorian is it Do people have to have for example, if they decide that they just want to have their breast cancer surgery and not have any reconstruction at the same time. Is that an option? Can they come back at a later date and have the reconstruction or you'd do typically try to recommend it in a close Interval of time from when they have their breast cancer surgery. It certainly is an option how to reconstruction at any time. So what we call it is immediate or delayed reconstruction. So some woman will opt to have the reconstructive process started at the time of their mastectomy, which is called an immediate reconstruction, even though they're often several operations still to follow in the following months. Delayed reconstruction is when a woman chooses not have reconstruction up front or sometimes their oncologist recommends not every construction in front because they may have an aggressive cancer, such as something called inflammatory breast cancer, in which case they can come back year two years later and have the reconstruction. And can they have the imp imp in plant based or the tissue reconstruction? Like Dr Adamson and duck shirt the Judas mentioned or their one over the other? That's a good question. So if you've had a mastectomy and then been treated with radiation afterwards, it's not possible to re expand your skin and haven't implant alone Reconstruction. So in that case, you would be requiring an autologous or using some form of your own tissue. Okay, Great. Well, thank you all so much for everything you do for our patients at M C W and join us shortly for an excitement. New.

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