Prophylactic Mastectomy and Breast Reconstruction
Dr. DellaCroce: When they’re making a decision for preventive or prophylactic mastectomy, that’s a high-stakes event. They’re afraid if they make a decision to reduce that risk, that there will be a lasting deformity or disfigurement; that they’ll lose their femininity in whole or in part.
Lorell: The idea of losing my breasts was daunting; it really was. I believe that I have the right to be whole the way that I was before. This is how I was before; I have the right to be like that afterward.
Kerry: It’s okay to still feel like this is part of you that you’re losing, and you have to be, you know, that it’s okay to grieve that.
Mandy: As a 27-year-old single, it was it wasn’t something that I thought I would be going through at 27, but it was definitely something I needed.
Dr. Sullivan: This is a tough decision to go forward and have a prophylactic mastectomy, with a concern that they’re gonna be disfigured, there won’t be a woman, they’ll lose their self-worth and self-esteem. I think they need hope; they need guidance; they need assurance; they need a feeling of self-worth. That’s where the reconstruction really comes in.
Dr. DellaCroce: In terms of options, when you’re considering prophylactic mastectomy with breast reconstruction, you can choose to use an implant or your own tissue. For implant reconstruction, after the breast tissue is removed, a breast implant is inserted through the mastectomy incision and placed beneath the pectoralis major muscle. The implant is supported below by a collagen sheathing, known as dermal matrix material. The incision is then closed. In a DIEP flap reconstruction, an incision is made from just below your belly button down to your panty line. A portion of skin, fat, and blood vessels is taken and inserted through the open mastectomy incision. The blood vessels in the flap tissue are attached to the blood vessels on the chest wall. The flap is then formed into a breast shape, and the incision is sewn shut. In an S gap reconstruction, a section of skin, fat, and blood vessels is taken from the top of your buttocks and moved up to your chest. Then the blood vessels are attached, the flap is then formed into a breast shape, and the incision is closed. There are also additional options for breast reconstruction available to women today.
Kerry: Just being able to, if you’re put in this position to know that there are options out there, to go through this and to not feel like you’re losing a part of yourself; you’re whole.
Dr. DellaCroce: Yeah, that’s where it comes full circle for us. To know that we’re able to deliver a service to you, to allow you to live a long, happy life and to look fabulous along with it. And then to have you look back and if there’s nothing you would change, that means we did a good job.
Mandy: At such a young age, it was like, what am I getting into? How is this all gonna end up? But it’s ended up beautiful.
Lorell: So, I would guess it was about six months, where I was healing, and I wasn’t so inflamed or swollen, and I looked and said, “I think I can really do this.” This is not going to be bad at all. You look really good with clothes on; this is really kind of cool. Let me look at me; I’ve got a flat tummy; I have beautiful breasts; this is going to be okay. It’s gonna be alright.
Frank DellaCroce, M.D., F.A.C.S., and Scott Sullivan, M.D., F.A.C.S. of the Center for Restorative Breast Surgery explain how breast reconstruction can help restore a feeling of wholeness after prophylactic mastectomy. Dr. DellaCroce walks us through three commonly performed reconstruction techniques: implant, DIEP flap, and SGAP flap surgeries. Lorell, Kerry, and Mandi share their feelings about how reconstruction helped them regain a sense of confidence.