Cancer

Currently alone 30% of pectus cancer patients are informed of their pectus reconstruction options earlier mastectomy or lumpectomy.

New legislation is beingness proposed inward Texas that aims to significantly improve that abysmal statistic for pectus cancer patients. Texas House Bill 669 would mandate that doctors inform all pectus cancer patients almost their pectus reconstruction options BEFORE having surgical physical care for for pectus cancer. The pecker was drafted based on similar legislation inward the patch of New York.

PRMA Plastic Surgery is proud to denote that a sometime patient, Tammy Carrington, is the squad leader behind this Bill.  She proactively sought out her patch representative, James White, to start out drafting proposals.  The Bill was drafted in addition to submitted Jan 14, 2011.  If approved, this statute volition accept resultant the next year.

Tammy Carrington knows firsthand what it’s similar to live diagnosed alongside pectus cancer in addition to have express handling options.  After beingness diagnosed inward June of 2009, Tammy was given 2 options: a lumpectomy alongside radiations or a unilateral mastectomy.  Tammy didn’t desire either.

Tammy wanted to decrease the gamble of pectus cancer inward the futurity inward the other pectus too. After intensely researching her options on her ain she learned she could stimulate got bilateral mastectomies in addition to immediate reconstruction. Ultimately she traveled to PRMA inward San Antonio in addition to underwent bilateral mastectomies alongside immediate DIEP flap pectus reconstruction using her ain abdominal tissue.  All the procedures were covered past times her wellness insurance.

Not surprisingly, Tammy feels really strongly almost this Bill since she then easily could stimulate got chosen something she feels would stimulate got been the incorrect selection for her.

"My nature is to interrogation things completely then that I tin give the sack brand informed decisions. I am the mom to a severely encephalon injured lilliputian boy… I’ve spent lots of fourth dimension over the years looking for data on how to aid him boot the bucket better… After getting over the stupor of hearing the 'C' word,... I went into interrogation mode”, Tammy recalls.

“HB 669 isn’t mandating whatever detail treatment. It's non mandating whatever surgery. It's simply mandating education. Women stimulate got the correct to live told almost their options then they tin give the sack brand really informed decisions almost their ain health. Unfortunately, correct directly alone 30% are fifty-fifty told pectus reconstruction is an option”, she says.

PRMA Plastic Surgery is proud to back upward HB 669 in addition to is calling on pectus cancer patients, physicians, in addition to all those touched past times pectus cancer throughout the patch of Texas to offering their back upward past times calling their representatives.

Please telephone phone your State Legislator in addition to urge them to co-author HB 669. Your patch representative’s contact data tin give the sack live works life HERE.

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PRMA Plastic Surgery inward San Antonio, Texas, specializes inward advanced breast reconstruction using the patient's ain tissue. Procedures offered include the DIEP flap, SIEA flap, GAP flap, in addition to TUG flap. We are In-Network for most USA insurance plans. Patients are routinely welcomed from across Texas, out-of-state, every bit good every bit from exterior the USA. Connect alongside other pectus cancer reconstruction patients at www.facebook.com/PRMAplasticsurgery

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Alarmingly, 70% of American women facing surgical operation for pectus cancer are non told virtually the selection of pectus reconstruction.

Perhaps i of the best things virtually pectus reconstruction is that it tin dismiss live performed at whatever time….  you tin dismiss never “miss the boat” so to speak. Regardless of the timing of the procedure, pectus reconstruction enables women to experience whole again, non simply physically but likewise emotionally.

There are several reconstructive options ranging from pectus implants to using the patient’s ain tissue. Tissue (or “flap”) procedures recreate a “natural”, warm, soft pectus in addition to are associated amongst fewer complications than pectus implants.

Breast reconstruction tin dismiss live performed at the same fourth dimension every bit the mastectomy ("immediate reconstruction") or whatever fourth dimension subsequently mastectomy ("delayed reconstruction"). 
When the mastectomy in addition to reconstruction are performed at the same time, a skin-sparing mastectomy tin dismiss commonly live performed which saves most of the natural pectus peel envelope. Only the actual pectus tissue nether the peel is removed. The reconstruction so "fills" this empty peel envelope. In about cases nipple-sparing mastectomy tin dismiss live performed. This preserves the nipple in addition to areola every bit good every bit all the pectus skin.



Skin-sparing (and nipple-sparing) mastectomy in addition to immediate pectus reconstruction arrive at the most "natural" results amongst the to the lowest degree scarring. Patients undergoing immediate reconstruction likewise avoid the experience of a apartment pectus altogether. Immediate reconstruction is thence preferred whenever possible in addition to should live the destination for patients amongst early on pectus cancer (stage I or II).

In about cases pectus reconstruction cannot live performed at the same fourth dimension every bit the mastectomy. Reasons include advanced pectus cancer (stage III or IV), inflammatory pectus cancer, the invention for radiations therapy subsequently mastectomy, in addition to lack of access to a reconstructive plastic surgeon.

As I already mentioned at the starting fourth dimension of this post, most women unfortunately are non made aware of their pectus reconstruction options. I thence encourage all women interested inwards pectus reconstruction to enquiry their options in addition to try a referral or consultation amongst a plastic surgeon specializing inwards pectus reconstruction.

You tin dismiss run across existent patient results subsequently immediate in addition to delayed pectus reconstruction inwards our photo gallery here.

Dr C


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Most women facing mastectomy as well as thorax reconstruction desire to know what form of feeling their novel breast(s) volition have.

Unfortunately mastectomy leaves many women alongside rattling trivial feeling long term (if any), regardless of whether they convey thorax reconstruction or not.

There is or as well as then adept intelligence though.... Most women undergoing DIEP or SIEA flap thorax reconstruction are too candidates for reconstruction of the sensory nerves inwards the breasts that render feeling. The feeling inwards the novel thorax won't live every bit adept every bit what Mother Nature provided but it's for sure a lot ameliorate than the alternative. H5N1 overnice bonus at the rattling least.

Once the tum tissue (flap) is moved upward to the breast, a sensory nervus inwards the flap is connected microsurgically to a thorax nervus inwards the thorax that was cutting past times the mastectomy. New nervus cells grow from the thorax nervus into the flap nervus over fourth dimension allowing the reconstructed thorax to prepare feeling.

If you're feeling brave, here's a curt video clip of how the 2 nerves are connected. You tin too run across the pulse inwards the blood vessel connections to the novel breast:


I promise this information helps.

Dr C

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Nipple-sparing mastectomy inwards conjunction amongst immediate thorax reconstruction is becoming to a greater extent than as well as to a greater extent than pop thus I idea a weblog post virtually it was inwards order...

What is a nipple-sparing mastectomy?

H5N1 nipple-sparing mastectomy preserves the nipple,  areola as well as all the surrounding thorax peel which is as well as thus used for the thorax reconstruction. Unlike the traditional "modified radical mastectomy", nipple-sparing mastectomy entirely removes the thorax tissue ("parenchyma") nether the skin.

What are the benefits?

Studies present that nipple-sparing mastectomy provides the same degree of surgical handling equally a modified radical mastectomy inwards appropriate candidates. Preserving the nipple-areola complex adds to the character of the reconstruction making the results fifty-fifty to a greater extent than "natural". It also agency the patient avoids having to become through the additional steps of nipple reconstruction as well as tattooing.

Who is a candidate?

Nipple-sparing mastectomy is an selection for many patients amongst a minor cancer located several centimeters away from the nipple-areola complex. Patients amongst ductal carcinoma inwards situ (DCIS) tin dismiss also live candidates, in 1 trial again depending on the location as well as distance from the nipple-areola.

During the surgery, a biopsy ("frozen section") is taken from behind the nipple-areola complex as well as sent to pathology to brand certain at that spot is no cancer nether the nipple or areola. If this biopsy is negative as well as thus the expanse tin dismiss live preserved. If it is positive for cancer cells, the nipple as well as areola are patently removed.

Patients at high peril of thorax cancer (eg BRCA+, rigid solid unit of measurement history, Cowden's syndrome) choosing to undergo condom (preventive) mastectomy as well as immediate thorax reconstruction are the best candidates.

Patients who produce non necessitate a signficant thorax elevator volition create got the best cosmetic results.

What are the risks?

Nipple sensation is unremarkably significantly reduced. Sometimes feeling is lost completely. Even inwards cases where some nipple-areola sensation is maintained, it is real unlikely the feeling volition live equally Mother Nature provided.

The underside of the nipple as well as areola is "shaved down" to withdraw equally much of the thorax tissue equally possible. This tin dismiss sometimes compromise the blood render to the tissue which tin dismiss as well as thus movement healing problems. If the blood render is damaged equally good much yesteryear the mastectomy, business office or all of the nipple-areola tin dismiss die. Thankfully this is uncommon.

At PRMA nosotros check the blood catamenia intra-operatively to ensure the nipple-areola volition survive. In the unlikely trial that the nipple-areola cannot live saved, it is removed to forestall injure healing complications as well as a novel nipple as well as areola are reconstructed at a after time.

Where volition the scars be?

This depends on the size as well as cast of the breast, whether a minor "lift" is needed, patient preference as well as surgeon preference. Scars tin dismiss live placed unopen to business office of the areola as well as extended outwards or downwards, or completely away from the areola at the thorax crease ("inframmamary crimp incision").


I hope this information helps!

Dr C

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In the vast bulk of cases, a pectus cancer diagnosis affects to a greater extent than than 1 person. All the focus understandably centers unopen to the patient inward formulating the best handling plan. However, every bit physicians, I experience nosotros by together with large produce a bad chore of considering the patient's back upwards system, together with the master copy caregiver inward particular.

Following 1 of my patients' pectus cancer diagnosis, mastectomy together with reconstruction, I asked her hubby how he was coping together with if at that topographic point was whatever means nosotros could live of to a greater extent than help.

He told me: "You're the outset 1 who's fifty-fifty asked me how I'm doing. There's no manual. I can't create this. I accept a meg thoughts simply no words to limited them".

His final comment actually hitting the blast on the head.

Please know yous are non alone...

Here are another credible resources that may help.

I wishing yous all the best.

Dr C

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Dr C is a board certified plastic surgeon together with microsurgeon specializing inward state-of-the-art pectus reconstruction. He together with his partners at PRMA are In-Network for most USA insurance plans. Patients are welcomed from across together with exterior the US. Please telephone telephone (800) 692-5565 or email patientadvocate@PRMAplasticsurgery.com to larn to a greater extent than virtually your pectus reconstruction options. Connect amongst others touched past times pectus cancer inward our Facebook community.

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Many patients intend or are told they cannot receive got immediate pectus reconstruction (reconstruction at the same fourth dimension every bit mastectomy) because it volition significantly delay chemotherapy. In reality, pectus reconstruction real rarely interferes alongside chemotherapy.


Patients that receive got immediate reconstruction as well as involve chemotherapy tin kickoff their treatments in i trial they receive got healed from their surgery. This unremarkably takes near four weeks. The healing fourth dimension required earlier chemotherapy is near the same whether patients receive got mastectomy lonely or mastectomy as well as reconstruction.

H5N1 small-scale pct of patients prepare injure healing problems afterwards their cancer surgical operation as well as may involve slightly longer to heal completely. Even inwards these situations, studies receive got shown at that spot is typically no delay inwards starting chemotherapy. Patients must too realize that injure healing problems tin too occur afterwards mastectomy alone.

In add-on to the psycho-social benefits, immediate pectus reconstruction is associated alongside less scarring as well as improve cosmetic results. Patients that receive got delayed pectus reconstruction, ie reconstruction or then fourth dimension afterwards the mastectomy, consummate all their pectus cancer handling earlier proceeding alongside reconstruction.

I promise this information helps.

Dr C

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Dr Chrysopoulo is a board certified plastic surgeon as well as microsurgeon inwards San Antonio, TX specializing inwards state-of-the-art reconstructive pectus surgery. He as well as his partners at PRMA are in-network for most major U.S. insurance plans. Patients are welcomed from across as well as exterior the US. Please telephone yell upwards (800) 692-5565 or electronic mail patientadvocate@PRMAplasticsurgery.com to acquire to a greater extent than near your pectus reconstruction options. Connect alongside other breast cancer patients on Facebook.

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Here's a non bad infographic summarizing the pectus reconstruction options available these days:


Some additional of import points:

"Immediate" vs "delayed" pectus reconstruction exactly describes when the pectus reconstruction physical care for begins. Most approaches necessitate to a greater extent than than 1 surgical physical care for as well as the whole reconstruction physical care for tin accept several months to consummate regardless of when it starts. The benefits of immediate reconstruction (same fourth dimension every bit the mastectomy) include avoiding the sense of living without a breast, less scarring as well as improve cosmetic results (especially when combined alongside nipple-sparing mastectomy). You tin run into patient earlier as well as afterward pictures here.

Many of the higher upwardly procedures are often combined. For example, tissue expanders or implants tin live used inwards conjunction alongside flaps. The most mutual combination is a tissue expander alongside a latissimus ("lat") flap. Fat grafting is besides oftentimes used inwards combination alongside whatever of the higher upwardly techniques to address contour deformities, enshroud implant rippling, add together volume, or exactly brand the results to a greater extent than "natural".

Unfortunately, many of the higher upwardly procedures are non offered past times all plastic surgeons. I encourage all of y'all to create your ain research, inquire questions, as well as if at all possible, consult alongside plastic surgeons experienced inwards all types of pectus reconstruction earlier making a concluding decision.

Dr C
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Dr Chrysopoulo is a breast reconstruction surgeon inwards San Antonio, TX, specializing inwards the DIEP flap as well as other state-of-the-art pectus reconstruction procedures. In-network for most the States insurance plans. Patients are welcomed from across as well as exterior the US. Please telephone phone (800) 692-5565 or electronic mail patientadvocate@PRMAplasticsurgery.com to acquire to a greater extent than nearly your pectus reconstruction options. Connect alongside Dr C on Twitter as well as Facebook.

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