Breast Reconstruction Surgery

00:00:06.707 --> 00:00:08.130 I do a lot of breast reconstruction. 00:00:08.200 --> 00:00:11.410 It probably makes up, I do not know, 40 to 50% of my practice. 00:00:11.480 --> 00:00:15.760 Sometimes the percentage changes, but I have several breast surgeons 00:00:15.826 --> 00:00:17.918 who refer cancer patients to me. 00:00:17.985 --> 00:00:21.530 Types of reconstruction, I think that I do. 00:00:21.600 --> 00:00:23.890 I will just give you the basics. 00:00:23.960 --> 00:00:29.596 I do implant-based reconstruction and flap or autologous tissue-based reconstruction. 00:00:29.663 --> 00:00:33.490 I also do, sometimes for lumpectomies, I'll do an oncoplastic reduction. 00:00:33.934 --> 00:00:38.370 Knowing how to do all forms of a breast reduction is very important 00:00:38.440 --> 00:00:40.520 because the cancer could be anywhere. 00:00:40.600 --> 00:00:43.920 Whenever you're doing a reduction around that, you're doing essentially 00:00:43.986 --> 00:00:46.130 a reduction around a lumpectomy. 00:00:46.200 --> 00:00:52.553 If a patient is having a lumpectomy, you have to know how to preserve the rest 00:00:52.619 --> 00:00:56.450 of the breast and move it and do a good reduction. 00:00:56.957 --> 00:01:01.370 Then you typically do a matching reduction on the other side for symmetry. 00:01:01.440 --> 00:01:04.530 Once the breast tissue is taken away, how are we going to fill the breast? 00:01:04.600 --> 00:01:06.166 What are we going to fill it with? 00:01:06.233 --> 00:01:08.035 The options are an implant, 00:01:08.101 --> 00:01:09.730 sometimes you may start off with a tissue expander. 00:01:09.800 --> 00:01:14.007 I'd say almost all the time we do start off with a tissue expander, 00:01:14.074 --> 00:01:16.610 and then come back later and put an implant in. 00:01:17.080 --> 00:01:19.736 The other option is to use some of your own tissue, 00:01:19.936 --> 00:01:21.715 and that is called a flap. 00:01:21.782 --> 00:01:26.130 Once it is there, it is there forever, and it looks good. 00:01:26.887 --> 00:01:29.256 It behaves and looks like breast tissue. 00:01:29.323 --> 00:01:33.360 You can often hide it under the mastectomy skin. 00:01:34.061 --> 00:01:36.563 I tend to do more flaps than I do implants. 00:01:36.630 --> 00:01:39.050 Either way, whether it is an implant or a flap, 00:01:39.120 --> 00:01:42.236 I think I tend to get high-yield outcomes, 00:01:42.302 --> 00:01:45.290 and I think my breast cancer surgeons know that. 00:01:45.360 --> 00:01:47.130 I do a lot of that in my practice. 00:01:47.200 --> 00:01:48.890 It's something I'm very passionate about. 00:01:48.960 --> 00:01:53.610 I also think that the reconstruction part makes me a better cosmetic surgeon. 00:01:53.680 --> 00:01:57.410 I think being a good cosmetic surgeon makes me a better reconstructive surgeon. 00:01:57.480 --> 00:02:00.320 I do think that those really interplay.