Thinking about tomorrow’s National BRA Day, or Breast Reconstruction Awareness Day, I am reminded that most Plastic Surgeons unfortunately do not offer all the available techniques of breast reconstruction.  In fact, many Plastic Surgeons do not offer reconstructive surgery as part of their practice.

As a woman and a Plastic Surgeon who entered this profession to help others, I found early on in my training that I connected well with other women, particularly breast cancer patients.

Although I do not have a history of breast cancer in my family, many of my family members also care for breast cancer patients in their own way.  My father is a nearly-retired Surgical Oncologist who specialized for thirty years in breast cancer surgery.  My sister Ingrid is a Genetic Counselor in Toronto who sees many women with a history of breast cancer in their family, or who are wondering whether they carry the BRCA gene.

And I have developed a significant part of my private practice in San Francisco to breast cancer reconstruction, using advanced techniques that are not always offered to women who require breast cancer surgical treatment.

State-of-the-art options for breast reconstruction include:

• Single-stage implant reconstruction – achieving the final result in often a single surgery, without the use of Alloderm (dead people skin) and without putting implants under the muscle
• Nipple-sparing mastectomy (NSM) – saving the entire ‘envelope’ of the breast, which helps to create the most aesthetic reconstruction and eliminates the need for additional surgeries in many cases
• DIEP flap or SIEA flap reconstruction – using Microsurgery to transplant skin and fat from the lower abdomen to build a new breast
• TUG (inner thigh) flap reconstruction – Microsurgical transplantation of upper inner thigh skin and fat for breast reconstruction
• Reconstruction by local tissue rearrangement – breast lift or reduction following lumpectomy and radiation
• Revision breast surgery – improving the appearance of previously reconstructed breasts, to achieve the best possible symmetry and a beautiful, natural result

Click on my downloadable Advanced Breast Reconstruction handout to learn more about each of these techniques, and visit the breast reconstruction overview section of my website!

Happy BRA Day 2013!

Karen M. Horton, M.D., M.Sc., F.A.C.S., F.R.C.S.C.