Our Summary

This study looked at the trends in breast reconstruction surgery in the US over the past two decades. The researchers were interested in seeing if plastic surgeons were doing more of these procedures than general surgeons. They examined data from two large healthcare databases, focusing on three types of breast reconstruction: free flap (using tissue from elsewhere in the body), alloplastic (using an implant), and oncoplastic (combining cancer surgery with plastic surgery).

Their findings showed that plastic surgeons did the majority of these procedures. They also found that over time, plastic surgeons did more immediate oncoplastic procedures, such as breast reduction and mastopexy (breast lift) after a cancer-related lumpectomy. However, there were no significant changes in the proportion of delayed oncoplastic, alloplastic, or free flap procedures done by plastic surgeons.

The study also showed that plastic surgeons were more likely to use a material called acellular dermal matrix (ADM) in their procedures, which can improve the outcome of the surgery.

The researchers conclude that plastic surgeons have been doing more of these procedures over the past two decades, without taking away from the other types of breast reconstruction surgeries they normally do. They suggest that plastic surgeons should keep working closely with breast cancer surgeons to provide the best care for breast cancer patients.

FAQs

  1. What types of breast reconstruction were examined in this study?
  2. Has the proportion of different types of breast reconstruction surgeries performed by plastic surgeons changed significantly over the past two decades?
  3. What is acellular dermal matrix (ADM) and how does it improve the outcome of breast reconstruction surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about reconstructive surgery is to make sure to discuss all options with their plastic surgeon and breast cancer surgeon to determine the best approach for their individual case. It is important to have open communication and ask any questions or concerns they may have before undergoing the procedure. Additionally, following post-operative care instructions and attending follow-up appointments are crucial for a successful recovery and optimal outcome.

Suitable For

Patients who are typically recommended for reconstructive surgery include those who have undergone a mastectomy or lumpectomy for breast cancer, as well as individuals who have experienced trauma or injury that has affected the appearance or function of a body part. Additionally, patients with congenital abnormalities, such as cleft lip and palate, may also benefit from reconstructive surgery. It is important for patients to consult with a plastic surgeon to discuss their specific needs and determine the best course of action for their individual situation.

Timeline

Before reconstructive surgery:

  • Patient receives a diagnosis of breast cancer and discusses treatment options with their healthcare team
  • Patient decides to undergo a mastectomy or lumpectomy to remove the cancerous tissue
  • Patient discusses reconstructive surgery options with their healthcare team, including the type of reconstruction (free flap, alloplastic, oncoplastic) and timing of the surgery (immediate or delayed)
  • Patient undergoes the initial cancer surgery

After reconstructive surgery:

  • Patient undergoes the reconstructive surgery, either immediately following the cancer surgery or at a later date
  • Patient may experience pain, swelling, and discomfort in the days and weeks following the surgery
  • Patient attends follow-up appointments with their healthcare team to monitor their recovery and ensure proper healing
  • Patient may undergo additional procedures or revisions to achieve the desired outcome
  • Patient continues to receive support from their healthcare team and may undergo additional treatments such as radiation therapy or chemotherapy
  • Patient continues to follow up with their healthcare team for long-term monitoring and care.

What to Ask Your Doctor

Some questions a patient should ask their doctor about reconstructive surgery include:

  1. What are the different types of reconstructive surgery options available to me?
  2. What are the potential risks and complications associated with the procedure?
  3. How long is the recovery process and what can I expect during this time?
  4. Will I need multiple surgeries to achieve the desired result?
  5. What are the expected outcomes of the surgery and what kind of results can I realistically expect?
  6. Are there any alternative treatments or procedures that I should consider?
  7. How experienced are you in performing this specific type of reconstructive surgery?
  8. What is the cost associated with the procedure and will my insurance cover it?
  9. Can you show me before and after photos of previous patients who have undergone similar reconstructive surgery?
  10. What kind of post-operative care will be required and how often will I need to follow up with you after the surgery?

Reference

Authors: Rochlin DH, Matros E, Shamsunder MG, Rubenstein R, Nelson JA, Sheckter CC. Journal: J Surg Oncol. 2023 Dec;128(7):1064-1071. doi: 10.1002/jso.27398. Epub 2023 Jul 13. PMID: 37439094