During The Breast of Everything podcast, Comprehensive Breast Care Surgeon Eric Brown, MD; talked with Plastic Surgeon William Stefani, MD; about reconstructive surgery after breast surgery, and what women should know. Dr. Stefani is a board certified plastic surgeon who also completed a fellowship in aesthetic surgery. He has been voted “Top Doctor” many times by Hour Detroit magazine, Consumer Guide and Castle Connolly (an organization that helps consumers find top doctors and the best health care in America), and practices at some of Michigan’s top ranked hospitals.
Many years ago, women underwent a radical mastectomy with massive reconstruction of the chest wall with back flaps. Fortunately, this archaic technique has taken a revolutionary turn and has been replaced with a new procedure that truly has changed a woman’s appearance … and her life.
Today, surgeons will do everything in their power, not only to remove all of the cancer, but also to restore a woman’s natural-looking breasts so she will have a cosmetic outcome that makes her feel and look great again.
In many cases, a woman can have one reconstructive implant surgery, Dr. Stefani reports.
The second option involves surgically implanting a tissue expander after the mastectomy, followed by a permanent implant at a later time. During the tissue expander surgery, the plastic surgeon expands the breast skin and muscle using a temporary tissue expander (an inflatable breast implant). A few months later, during the second surgery, the expander is removed and replaced by a breast implant.
Dr. Stefani chooses the best option for his patients based on what he calls “mapping” of the breast to see what the tissue looks like after surgery, and to determine which procedure provides the safest and best results.
During the podcast, Dr. Stefani also talked about animation deformity in breast reconstruction. To alleviate this problem, he performs a pre-pectoral reconstruction on top of the muscle instead of under it. This holds the implant in position better, there is no risk of the implant extruding through the incision and the outcome is “beautiful,” he reports. The breast looks natural, softer and it alleviates what he calls “animatory movement.”
Dr. Stefani and Dr. Brown also discussed the importance of breast cancer patients quitting smoking at least six weeks prior to breast surgery. Smoking causes a tightening of the blood vessels that delays and decreases wound healing capabilities.
The controversy regarding breast implant-associated anaplastic large cell lymphoma (BI-ALCL) also was a topic of discussion. Social media has created an unnecessarily alarming concern for women with breast implants, the doctors find. BI-ALCL is very rare, generally very slow-moving, and affects only a small number of women who primarily have received textured implants, which Dr. Stefani does not use. Fewer than 10 patients a year are diagnosed with BI-ALCL, while there are more than 10 million women globally who have breast implants.
The doctors also talked about breast implant-associated illness. This term describes a wide range of mostly mild and easily treatable symptoms that can develop from implants.
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