Kathy Smith has beaten the odds, a breast cancer survivor whose fight began more than 20 years ago. Her case isn’t so unusual; nearly a quarter of a million U.S. women will be diagnosed with breast cancer in 2013, according to the American Cancer Society’s recent estimates. What is unusual is Kathy has been through breast cancer and reconstruction twice.
By Carolynn Grimes
ThePlasticSurgeryChannel.com
Kathy’s Story
“In my mid-twenties I was diagnosed with breast cancer,” says Kathy. “I went through a mastectomy with reconstruction, and I felt numb through the whole process; it was shocking.” Kathy’s first breast reconstruction process was treated with a tissue expander that required two surgeries and a painful six month process. 
Fast forward twenty-one years later, Kathy was diagnosed with breast cancer for a second time. “Same thing, I had a mastectomy followed up with reconstruction. But not a tissue expander this time, this time I had a skin sparring mastectomy. When I woke up from surgery I had an implant in place which made a big difference,” says Kathy.
New Breast Reconstruction Techniques Improve Healing Process
“The techniques for mastectomy have improved,” says Dr. Richard Baxter, a board certified plastic surgeon from Seattle, Washington. “We do skin sparring technique now; we do immediate reconstruction, and in Kathy’s case, direct to implant, so there’s no tissue expansion phase.”
For Kathy’s second breast reconstruction, Dr. Baxter used a product called AlloDerm. AlloDerm is created from donated human skin to create an “internal bra” that supports the implants and gives the breasts a more natural looking appearance. AlloDerm is transformed into living tissue that resembles and functions just like your own tissue.
“The whole thing is done in one setting and patients are out of the hospital in 24 hours which is a completely new way of doing things from what we’ve done previously,” says Baxter. Kathy says her second breast reconstruction process wasn’t as painful. “I can compare the first time to the second time and the difference was like night and day. The first surgery I was in the hospital for five days and the second surgery I was in for two days.”
Baxter says in the last ten years or so, the options for patients like Kathy have changed dramatically. In addition to “the internal bra”, there are other direct-to-implant procedures. One of the alternatives is the tram flap procedure, where they take tissue from the abdomen, and move it up to make a breast.
Immediate Breast Reconstruction
Kathy is a good example of how much breast reconstruction has changed, says Baxter. “She previously had this old approach, where she had the mastectomy, tissue expansion and reconstruction, but the shape was never quite right because without the internal bra, you can’t expand the lower half of the breast as well as you’d like to. So you end up with sort of a half of a sphere, half of a cantaloupe shape instead of a nice teardrop profile.”
He says more and more women are making the decision to have a mastectomy with immediate reconstruction because of what surgeons can now accomplish with new procedures and technology. “Women are starting to hear about this and they are seeing before-and-after pictures on-line, and they’re thinking, this looks like a really appealing operation.” Baxter says we shouldn’t be surprised that many reconstruction patients have such high expectations. “We can do pretty wonderful things with breast reconstruction, but we need to keep in mind we’re treating cancer and there are limitations.”