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Oncoplasty & Reconstructive Breast Surgery: November 7, 2011

When it comes to breast cancer surgery, the fields of general surgery and plastic surgery are increasingly being stitched together. Dr. Melvin Silverstein is a professor of surgery at the University of Southern California.

“Old-fashioned breast surgery training; didn’t care what the breast looked like it only cared that you got the tumor out. New training, the way I train my fellows, are that the cosmetic result at the end matters. It’s not more important than the cancer but it’s important,” says Dr. Silverstein. 

The new frontier of breast cancer surgery is the oncoplasty. Where a mastectomy removes the entire breast, the oncoplastic procedure is a form of lumpectomy.

“That removes the breast tumor using a plastic surgical operation such as a reduction operation. So you can take a large tumor out of a large breast and reduce it to a small round breast,” says Dr. Silverstein.

Even women who have had a mastectomy has options, with reconstructive surgery playing a part in the healing process.

In southwest Florida, plastic surgeon William Wittenborn often plays an active role during the cancer surgery.

“We do a combined surgery with the general surgeon so at the time of the mastectomy of the initial phase of the reconstruction would begin at that surgery,” says Dr. Wittenborn.

At the time of surgery, the patient starts implant reconstruction with the use of an expander to prepare her body.

“The expander is then placed underneath one of the chest muscles and its then covered over and we can put some volume into the expanders. So that when the woman wakes up from surgery there’s some volume there. There’s not a concavity in the chest,” says Dr. Wittenborn.

Conserving or reconstructing the breast is proving to have healthy benefits all around.

“For the majority of women that have breast cancer, its pretty well been shown that reconstruction does not hinder the ability to deliver the cancer treatment. It doesn’t hinder the ability to detect recurrences, and it doesn’t impact their overall survival,” says Dr. Wittenborn.

“Most likely they will be more satisfied. A woman who preserves her breast is usually happier and feels better about it,” says Dr. Silverstein.

Preserving not just life, but quality of life being the end goal.