The Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery

by Steligo, Kathy

• ISBN13: 9781421407203
• ISBN10: 1421407205
• Edition: 3rd
• Format: Paperback
• Copyright: 2012-11-01
• Publisher: JOHNS HOPKINS UNIV PRESS

Summary

For a decade The Breast Reconstruction Guidebook has been the best resource on this topic for women who have had a mastectomy. Equal parts science and support, it is filled with stories that illustrate the emotional and physical components of breast reconstruction. Readers will find advice about choosing a doctor and a procedure, insurance and payment issues, how to prepare for surgery, and what to expect during recovery. Expert commentary by physicians and insights from patients inform this book, as does the exhaustive research by the author, a two-time breast cancer survivor who has twice had reconstructive surgery. New in this edition are discussions of- the pros and cons of saline and silicone implants - solutions for post-lumpectomy cosmetic problems- new immediate-delayed reconstruction when post-mastectomy radiation may be required- the benefits and limitations of nipple-sparing mastectomy- considerations for direct-to-implant reconstruction- newly developed tissue flap procedures - who can best apply nipple and areola tattoos and why tattoos may not last- enriching fat with stem cells so it stays in the breast- patient-controlled tissue expansion - how insurance and health care reform affect reconstruction

Author Biography

Kathy Steligo is a freelance writer specializing in business and health topics and is coauthor of Confronting Hereditary Breast and Ovarian Cancer, also published by Johns Hopkins. She is a two-time breast cancer survivor who has twice had reconstructive surgery.

Table of Contents

Foreword	p. xi
Acknowledgments	p. xiii
Introduction	p. 1
Decision: Mastectomy
Why Mastectomy?	p. 7
Inside the Breast	p. 8
Surgical Treatments	p. 10
Do You Really Need a Mastectomy?	p. 13
Mastectomy without Reconstruction	p. 15
What to Expect	p. 15
The Prosthesis Alternative	p. 17
Paying for Mastectomy and Prostheses	p. 19
Breast Reconstruction Basics	p. 22
Sorting through the Options	p. 23
Timing Your Reconstruction	p. 26
Health Matters	p. 29
Coordinating Reconstruction with Treatment	p. 31
How Mastectomy Affects Reconstruction	p. 37
Mastectomy: Cause and Effect	p. 37
Skin-Sparing Procedures	p. 40
Saving Your Nipple and Areola	p. 41
Considering Prophylactic Mastectomy	p. 47
Should You Have Genetic Testing?	p. 48
How Real Is Your Risk?	p. 49
Removing Your Breasts to Reduce Your Risk	p. 50
Paying for Preventive High-Risk Services	p. 53
Reconstructive Procedures
Breast Implants	p. 57
Defining Your New Breasts	p. 57
Are They Safe?	p. 61
Tissue Expander-to-Implant Reconstruction	p. 63
Direct-to-Implant Reconstruction	p. 64
Recovery	p. 67
Potential Problems	p. 68
The Expander Experience	p. 75
Getting Your Fill	p. 75
Minimizing Your Discomfort	p. 76
Living in Limbo	p. 78
Exchange Surgery	p. 79
Potential Problems	p. 81
Tummy Tuck Flaps	p. 82
Tissue Flap Basics	p. 82
Borrowing from the Abdomen	p. 85
TRAM Flap Procedures	p. 86
DIEP and SIEA Flaps	p. 90
Potential Problems	p. 94
Other Flap Methods	p. 96
The Latissimus Dorsi Flap	p. 96
GAP Flaps	p. 100
Using Fat from the Thighs	p. 103
Using Fat from the Hips	p. 106
Altering the Opposite Breast	p. 107
Breast Augmentation	p. 108
Breast Reduction	p. 110
Breast Lift	p. 112
Final Touches: Creating Your Nipple and Areola	p. 115
Icing on the Cake	p. 115
Building the Nipple	p. 117
A Colorful Finish	p. 119
Problems and Solutions	p. 121
Non-surgical Alternatives	p. 123
Prep, Post-Op, Recovery, and Beyond
Preparing for Your Surgery	p. 127
Countdown: Four Weeks to Surgery	p. 127
Two Weeks before Surgery	p. 129
One Week to Go	p. 132
The Day before Surgery	p. 135
It's Reconstruction Day	p. 137
What to Expect in the Hospital	p. 139
Admitting and Pre-op	p. 139
Showtime in the OR	p. 141
A Peek into Post-op	p. 142
Your First Day after Surgery	p. 143
The Rest of Your Hospital Stay	p. 145
Back Home	p. 147
A Timetable for Healing	p. 147
Managing Medication	p. 153
Dealing with Drains	p. 154
Tips for an Easier Recovery	p. 156
Seeing Your New Breasts for the First Time	p. 160
Dealing with Problems	p. 162
Inherent Surgical Risks	p. 162
Lingering Pain	p. 166
Lymphedema	p. 167
Cosmetic Do-Overs	p. 168
Fixes with Fat	p. 170
Improving Scars	p. 172
Life after Reconstruction	p. 175
Adjusting to the New You	p. 175
Back to Work	p. 179
Dating, Intimacy, and Sex	p. 179
Surveillance after Mastectomy	p. 182
Finding Answers, Making Decisions
Searching for Dr. Right	p. 187
Shopping for a Surgeon	p. 187
Five Characteristics of an Ideal Plastic Surgeon	p. 188
Your Pre-appointment Footwork	p. 190
Making the Most of Your Consultation	p. 191
The Value of a Second (or Third) Opinion	p. 194
Tips for Travelers	p. 195
Paying for Your Reconstruction	p. 197
Are You Covered?	p. 198
Appealing When the Answer Is No	p. 201
When All Else Fails	p. 205
Other Types of Insurance	p. 207
Making Difficult Decisions	p. 208
Ten Steps in the Right Direction	p. 208
Other Sources of Information and Inspiration	p. 212
Information for Family and Friends	p. 215
Hints for Family Members	p. 215
Food for Thought for Partners and Spouses	p. 216
Issues for Caregivers	p. 218
Dos and DonÆts for Friends	p. 219
Closing Thoughts	p. 222
Notes	p. 225
Glossary	p. 231
Resources	p. 239
Index	p. 243
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