Category: Breast Cancer Surgery

We have had the pleasure of working with Dr. Pinell for a little while now and I realized that I have yet to sing her praises on the blog. She is a wonderful addition to Davinci Plastic. I’m so grateful that she is a key part of the team for helping patients with their aesthetic and reconstructive needs. Dr. Pinell has breadth and depth of knowledge, skilled hands, and a huge heart.

Head

Dr. Pinell completed medical school at Emory University and remained there for General Surgery residency and a subsequent fellowship in Plastic Surgery. She learned the most advanced techniques under some of the greatest leaders and innovators in Plastic and Reconstructive Surgery worldwide.

Hands

In addition to a wide breadth of skill in body contouring, Dr. Pinell has specialized in breast reconstruction techniques that offer cutting edge choices for Breast Augmentation and Breast Reconstruction patients. She is able to help patients with a variety of oncoplastic techniques in conjunction with either a mastectomy or lumpectomy. She is grateful to offer women such options as using their own tissues to recreate the breast, as well as the prepectoral (above the pec muscle) technique for implants.

Heart

Dr. Pinell came to the medical field to make a difference in people’s lives after a time in D.C. working in health policy research. She has studied advanced techniques in order to best serve breast cancer clients with breast reconstruction. She considers it a privilege to come alongside women who are fighting this battle.

Although she grew up in the Washington D.C. area, Dr. Pinell’s heart to help people has stretched across the sea to her country of heritage, Bolivia. Here she has volunteered her time and surgical expertise to help needy children with reconstructive surgery for cleft lip and palate.

As a mom of 3 young boys, she also personally understands the physical sacrifices of motherhood. Dr. Pinell can really empathize as she offers solutions for helping mothers to feel confident again with their post baby body.

I’m confident you’ll love her as much as we do at Davinci Plastic, www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

With October being Breast Cancer Awareness month, I thought it would be appropriate to address common questions I get about breast cancer and implants. It is very wise to address all angles of questions about your Breast Augmentation so that you can have complete confidence and peace going into the surgery and from there on after.

Do breast implants cause cancer?

No. Breast implants are one of the most rigorously studied medical implants. Expansive medical studies of women with and without breast implants show no difference in cancer. There is not a higher of a prognosis of any kind or size or frequency in the group with breast implants. Therefore it is safe to conclude that the breast implant itself is not the cause.

Do breast implants prevent breast cancer detection?

No. The methods for breast cancer detection, such as self examination, ultrasound and mammography, are not hindered by breast implants. You should perform regular self exams to know your breasts before and after your augmentation. If the implant placement is below the muscle you should have no problem with palpating the breast tissue around the implant. It is also recommended for women over age 35 to have a mammogram before receiving implants in order to have a baseline comparison.

When receiving a mammogram, it is important to select a radiologist who is experienced with the methods necessary for an effective reading of breasts with implants. They should be competent in the Eklund technique and oblique view mammography.  Whether the implant is placed subglandular or submuscular, the Eklund technique significantly increases the amount of breast tissue that can be scanned.

Will mammograms damage breast implants?

This is very unlikely. When in the hands of an experienced radiologist, the pressure exerted by the mammogram should not be enough to burst the implant. Both Silicone and Saline implants are designed with the durability to withstand pressures and compression.

Does breast augmentation with fat grafting prevent cancer detection?

While fat grafting as a form of Breast Augmentation doesn’t prevent cancer detection, it makes detection more complicated. The die off rate of fat cells leaves behind irregularities within the breast tissue and calcifications that can look very much like breast cancer. Fat grafting is not causing cancer, however it is easy to mistake the fat calcification for cancer calcification. The truth usually needs to be clarified via biopsy, although it can cause much worry in the mean time.

How much of a risk is a Breast Augmentation regarding the likelihood of cancer?

If you have a Breast Augmentation with implants, you no longer can get good enough cancer detecting results with a regular 2 view mammography screening. However, the specialized methods, such as the Eklund technique, are available to still get a good view of the breast tissue hidden behind the implants. Studies demonstrate that there is no proven additional risk of getting breast cancer if you have breast implants, but you need to take advantage of the additional techniques for detection.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

When considering Breast Reconstruction after cancer, I will guide you through the possibilities for creating the most natural, beautiful breasts. There are a couple of different types of surgery that you may want to familiarize yourself with beforehand. These are the kinds of Breast Reconstruction surgeries available through my office. Some options utilize the body’s own tissue taken from areas with a little extra, such as the abdomen or thighs, and the others use silicone or saline implants.

DIEP Flap Breast Reconstruction

DIEP stands for Deep Inferior Epigastric Perforator. This technique uses excess skin and fat from the lower abdominal area. The incision is similar to the one used for a Tummy Tuck and can be easily hidden by clothing or bathing suit. Another benefit to this surgery is that it flattens the abdomen for an overall beautiful body contour. It spares the abdominal muscle and there is significantly less pain in the shorter recovery process. Since the muscles are in tact, the abdominal wall strength is not affected.

Tram Flap Breast Reconstruction

This is another technique that uses the abdominal tissue to rebuild the breasts, however the difference from the DIEP is that it does use abdominal muscle in addition to the skin and fat. The incision will still be discreet and hidden by the clothing or bathing suit, but recovery will take longer due to harvesting muscle. I am skilled in offering options within this surgery, which are to take the tissue connected to a blood supply, which is called pedicled, or not attached to the original blood supply and requires connection to a new one, which is called free flap. Both of these methods require immense skill and unique challenges. For example the pedicled technique is to avoid muscle rotation, which can create an abdominal bulge, and the free flap technique is even more intricate of a surgery as it requires successful reconnection of arteries using microsurgery.

Gracilis Flap Breast Reconstruction

This surgical technique uses excess skin and fat from the inner thigh to reconstruct a natural appearing breast. This can be done without taking any muscle, which it would then be called the Transverse Upper Thigh Flap surgery. Sometimes the inner thigh flap requires a small amount of muscle in order to assure an adequate blood supply to the flap. The muscle that’s used to do this is the gracilis muscle, which is what the surgery is named after. Unlike missing a part of the abdomen muscle, the gracilis muscle is often not missed unless you do a lot of exercises or sports mostly depending on quick changes of going side to side. A side benefit of taking tissue from the inner thigh is that it often can reduce inner thigh friction.

Latissmus Flap Breast Reconstruction

This surgery reconstructs the breasts using a flap of skin and muscle from the back of the same side as the operated breast. This living tissue is used to recreate the breast mound. It is mostly used for women who don’t have enough abdominal tissue or have had previous abdominal incisions. There are usually no complications and the blood supply is highly dependable. The use of the latissmus flap can be combined with implants.

Breast Reconstruction with Implants

Because of the familiarity with implants for Breast Augmentation, this is an option chosen by thousands of women each year who undergo a mastectomy. It is also commonly used for women who are thin and don’t have extra tissue to use. A major benefit is that this can be done sequentially under the same anesthesia as the mastectomy surgery, called immediate reconstruction. This process still usually requires 2 or more surgeries, as we will have to navigate unique issues with the skin stretching (possible loss of elasticity due to radiation treatments) and addressing scar tissue.

You can rest assured that I am using the most cutting edge and advanced techniques along with my immense experience to help guide you to the right surgical options for your Breast Reconstruction. Please schedule a consultation to discuss what might be the best option for you, www.davinciplastic.com.

Sincerely,

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

One of the many considerations of breast cancer that requires a mastectomy is Breast Reconstruction surgery. This can be a time of overwhelming choices and so my goal with each Breast Reconstruction patient is to provide compassionate care and the best natural looking results possible. This is a specialty I give the utmost attention to and have developed knowledge and skills that have provided beautiful results that have been very healing and satisfying to many clients.

Why Reconstruction?

While considering being in surgery again most certainly is not appealing after going through cancer treatments, I have found that it does help empower women to regain their feelings of femininity and sense of normalcy. Most times I’m helping to rebuild a breast mound after lumpectomy or mastectomy surgery, however I can also correct previous breast surgeries and nipple replacement.

Deciding on the Surgeon

Through my many years of experience and artistry, as well as using the most sophisticated and cutting edge techniques, I can help to create natural looking breasts to enhance body shape. Breast reconstruction surgery requires a thorough understanding of the intricacies of the human anatomy, as this is not the same process as the standard Breast Augmentation. I have extensive experience and years of specialized training in Breast Reconstruction surgeries to provide my patients with the most beautiful, natural looking results possible.

Making Decisions

Working alongside your oncologist, we will patiently and thoroughly discuss your options regarding Breast Reconstruction surgery. We will cover many topics, such as the possibility of performing Breast Reconstruction at the same time as the cancer removal under the same anesthetic, or if we should wait until after other treatments.

You also have options as to what you’d like to replace the breast tissue with, including your own living tissue from an area with some extra to spare, such as your inner thigh, or implants made of silicone or saline. All of these can be used to create beautiful, natural looking breasts. The best choice differs for each individual based on many factors so we will discuss this extensively. Some of these factors are (but not limited to):

• cancer type
• stage of breast cancer
• your personal preferences
• overall health

If you’re considering Breast Reconstruction after cancer, and you’re looking for compassionate and expert care for the best results possible, please visit our website to schedule a consultation at www.davinciplastic.com.

Sincerely,

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon