PREVIVOR: A person who is not diagnosed with cancer, but has survived the predisposition, or higher risk, of cancer due to a genetic mutation and/or strong family history. After being armed with this information, a previvor can make informed choices prior to a cancer diagnosis.

Tuesday, February 11, 2014

Guest Post

Every now and then I'm contacted by someone who has seen my blog and wants to contribute content they think would be beneficial to my readers. Below is a contribution from Dr. Sheryl Pilcher, a plastic surgeon in San Antonio. Even if you're not near the San Antonio area, its a good comprehensive overview of the tissue expansion process. Enjoy!!

What Breast Reconstruction Patients Can Expect During Tissue Expansion

If you have undergone, or plan to undergo, a mastectomy, your plastic surgeon, Dr. Sheryl Pilcher, will begin your breast reconstruction with tissue expansion. She will start the process during your mastectomy or can begin after a wait period of several weeks, if your oncologist recommends additional treatment. Before she can rebuild your breast, she must first insert a tissue expander under your breast muscle to make room for your final reconstruction.

What Is Tissue Expansion?

Tissue expansion is a technique used by a wide variety of plastic surgeons. For breast reconstruction, it begins with the surgical placement of a tissue expander, which your plastic surgeon will manually fill over time. The slow expansion of the device stretches your skin, but it is not simply a stretching mechanism. This also signals your body to develop additional skin tissue to accommodate the growth within your body. Expansion provides the extra skin needed to reconstruct breasts, either with implants or tissue from your own body, after a mastectomy.  

The Procedure

Either during or after your mastectomy, Dr. Pilcher will surgically insert a silicone balloon beneath your skin and breast muscle. The expander is built with a port through which Dr. Pilcher can place saline solution to fill the expander. The expander also includes a catheter and drainage tubes. Your plastic surgeon will use the catheter to administer local anesthetic, while the drainage tubes remove excess fluids. You may feel some pressure during the saline injection, but your surgeon will closely monitor your sensations to ensure minimal discomfort. You will need recovery time after the procedure, such as avoiding heavy lifting for approximately six weeks. However, you will not require recovery time after your weekly fill appointments. While you may return to your daily activities, if discomfort occurs, you may treat it with ibuprofen. Your expansion process will last up to six months, or until your surgeon determines you are ready for the next step in reconstruction.

What Types of Sensations Can I Expect?

Every patient responds differently to tissue expansion, so there is no one set of potential sensations or treatment period. Following stretching exercises provided to you by Dr. Pilcher will help improve your comfort. However, consider the following common effects of tissue expansion, so you feel informed and know that your sensation is normal:

·         You may experience discomfort within the first few days after your saline expansion

·         Your chest may feel tight – this sensation typically goes away with time

·         Shoulders may feel stiff

·         You may experience mild pain in your back

·         Skin may become dry – apply a gentle moisturizer, avoiding your incision

However, if you experience any addition swelling, bruising, redness, fever, or unyielding pain, contact your plastic surgeon immediately.

About Sheryl Pilcher, M.D.

Dr. Sheryl Pilcher, your board-certified, female plastic surgeon, has practiced plastic surgery in San Antonio for over 15 years. An honors graduate of Temple University, Dr. Pilcher trained in Plastic and Reconstructive Surgery under internationally renowned teachers at the University of Virginia, and focuses her services on breast surgery, body contouring, and facial rejuvenation techniques.