With all due respect, please stop using the term "immediate" breast reconstruction.
Please consider changing this term to one that does not mislead your patient. One that does not encourage an abundance of misinterpretation. One that does not give a previvor/survivor a false sense of hope.
How about "primary reconstruction" or "principle reconstruction" or "advanced reconstruction"?
The term "immediate reconstruction" is tossed around the breast reconstruction community without any thought given to the affect it may have on a vulnerable patient.
Is there really such a thing as "immediate reconstruction"?
First lets define "Immediate"
im·me·di·ate
iˈmēdēət/
adjective
Can someone please explain to me what is instant about breast reconstruction?
The fat grafting is not instant.
The nipple tattooing is not instant
The nipple reconstruction is not instant
The fine tuning and adjustments are not instant
The healing of the scars are not instant
Do plastic surgeons tell their patients the real story? Do they give them a realistic idea of when the ordeal might come to an end?
Do they tell their patients that following the mastectomy with "immediate" reconstruction, there may be YEARS of fine tuning, adjustments and then nipple tattooing and reconstruction if desired?
And that is if the first technique used is successful!
What if the surgeon has to start over, using a different technique, or a different type of reconstruction?
Do surgeons tell their patients the real probability of this happening, and that if it does happen, it may extend the entire ordeal up to 5 years or more? For example; in Ontario, Canada, once you have had the mastectomy and a first attempt at reconstruction, you are then pushed to the bottom of all wait lists if you need to change plastic surgeons to try another technique. You are not considered an urgent case as there is no longer active cancer. Your wait for a second attempt at reconstruction will be 2-5 years.
Are patients advised to seek psychotherapy to assist with the stress, anxiety and depression that stems from not having breasts for years following a mastectomy?
Are patients given a true realistic idea of what they may be looking at in the mirror every day, following a mastectomy for perhaps years until the project is complete? Are they shown photos of worse case scenarios?
Do they tell their patients that following the mastectomy with "immediate" reconstruction, there may be YEARS of fine tuning, adjustments and then nipple tattooing and reconstruction if desired?
And that is if the first technique used is successful!
What if the surgeon has to start over, using a different technique, or a different type of reconstruction?
Do surgeons tell their patients the real probability of this happening, and that if it does happen, it may extend the entire ordeal up to 5 years or more? For example; in Ontario, Canada, once you have had the mastectomy and a first attempt at reconstruction, you are then pushed to the bottom of all wait lists if you need to change plastic surgeons to try another technique. You are not considered an urgent case as there is no longer active cancer. Your wait for a second attempt at reconstruction will be 2-5 years.
Are patients advised to seek psychotherapy to assist with the stress, anxiety and depression that stems from not having breasts for years following a mastectomy?
Are patients given a true realistic idea of what they may be looking at in the mirror every day, following a mastectomy for perhaps years until the project is complete? Are they shown photos of worse case scenarios?
I doubt it.
This needs to change, and needs to change fast.
Plastic Surgeons, I implore you to be brutally honest with your patients. Give your patient's the worse case scenario. Talk to your patients about your failures, not just your successes. Tell your patient's what you have learned from your failures.
Show your patients photos of "not so great" results, and results that are in progress. And when you do show success photos, share statistics and facts such as how long it took to get to that result, and was the patient happy, what was the age, weight, height of the patient, did they have issues prior such as tubular breasts, or excess tissue or sagging, or radiation?
Show your patients photos of "not so great" results, and results that are in progress. And when you do show success photos, share statistics and facts such as how long it took to get to that result, and was the patient happy, what was the age, weight, height of the patient, did they have issues prior such as tubular breasts, or excess tissue or sagging, or radiation?
Plastic Surgeons, I implore you to take the time to discuss all of this information with your patients well in advance of a surgery date. Discuss post-op care well in advance of a surgery date as well.
Allow your patients to make arrangements for childcare or employment commitments based on realistic expectations. Will there be follow up appointments? How many, how often? Will there be a need for massage, physiotherapy, exercise, counselling? How often, and where?
Allow your patients to make arrangements for childcare or employment commitments based on realistic expectations. Will there be follow up appointments? How many, how often? Will there be a need for massage, physiotherapy, exercise, counselling? How often, and where?
I underwent a bilateral mastectomy with immediate reconstruction over 3 years ago and we are nowhere near finished! And to think, I was under the impression that I was going to wake up in the recovery room and look down at my newly reconstructed cancer free foobs. I am an intelligent person, and yet I feel like the most ignorant patient.
I truly don't know how I will survive another 2 years of procedures. But I don't exactly have a choice do I?
