Elevate Your Health Colorado Breast reconstruction restores confidence

When Barbara Svik, 48, was diagnosed with early stage breast cancer in March 2008, she had several questions: “Will I survive this?” “Can we remove the cancer quickly?” and “If I survive, will I lose my breasts?” The answer to each was “yes.”

Svik’s concerns are some of the most common among breast cancer patients. Diagnosing, staging, and treating the cancer are foremost, but there’s another important part of the conversation: breast reconstructive surgery that can help a woman feel more like herself again.

It’s also a discussion Mark Kiehn, MD, a plastic surgeon with Kaiser Permanente Colorado, is having with more women these days. About 70 percent of his practice is now dedicated to breast reconstructive surgery.

“When confronted with breast cancer, the most important thing to women is getting rid of the cancer,” says Dr. Kiehn. “But many women also think about the impact it will have on their body and their lifestyle.”

Reconstructive surgery options

When a woman is diagnosed with breast cancer, she will undergo either a lumpectomy or mastectomy to surgically remove the tumor and as much of the breast as needed. In either case, plastic surgeons can rebuild the breast to its former size and shape or, more often, to one the patient likes even more.

Breast cancer reconstruction surgery involves using breast implants or the patient’s own tissue to rebuild the breast. If a patient decides on breast implants, surgeons place tissue expanders behind the chest wall muscles at the time of mastectomy to make room for the new breast. After the tissue has expanded (4-6 months), the expanders are removed and saline or silicone implants are placed.  In some cases patients cans skip the expansion phase and have the final implants placed at the time of mastectomy.  Although implants may require replacement or adjustment over time, the initial surgery and recovery time are typically shorter than using patients own tissue. 

If a woman decides to use her own tissues, surgeons use skin, fat, and muscle tissue from the patient’s abdomen, back, buttocks or thighs to rebuild the breast. By using their own tissue, women tend to have more natural looking breasts, but typically face a greater recovery and may experience some additional difficulties at the site from which the tissues were obtained. Many women, however, see an unexpected benefit from this approach. The use of abdominal tissue results in an ‘tummy-tuck’ type improvement. This is yet another way that plastic surgeons put a silver lining on breast cancer treatment.

Although undergoing breast reconstruction is a patient’s personal choice, factors such as the patient’s anatomy, stage of the cancer, and lifestyle dictate what types of reconstructions can be offered and when they can be performed.

Care from the experts

Following Svik’s breast cancer diagnosis, a team of oncologists, nurses and surgeons quickly established a treatment plan. Before Dr. Kiehn even met Barbara, he collaborated with her general surgeon to better understand her case.

“I felt really comfortable that Dr. Kiehn and my general surgeon were on the same page,” Svik says. “I felt like my care team gathered as much information for me as they possibly could before I had surgery.”

In May 2008, Svik underwent a bilateral mastectomy, followed immediately by breast reconstruction surgery with tissue expanders and breast implants. Although recovery was a long, 11-month process, she’s reached the point where breast cancer is no longer her first waking thought. 

Restoring body and mind

For breast cancer patients like Svik, breast reconstruction surgery is more about achieving a sense of normalcy. “The emotional component of breast reconstruction cannot be ignored,” Dr. Kiehn states. “Much of what reconstruction does is restore a woman’s confidence and peace of mind.”

Svik admits she never thought about appearances at the onset of her diagnosis. “I wanted the cancer out,” she says. “I had a bilateral mastectomy to make sure of it, but now I still have a sense of the person I was before breast cancer.”

“This is life saving surgery. Maybe not in the life or death sense, but I am helping to get women to a position where they can look beyond their cancer,” Dr. Kiehn says. “Breast reconstruction takes patients from a feeling of despair to feeling good about their body again.”

Get more facts on the benefits and risks of breast reconstructive surgery at kp.org.