Frequently Asked Questions
What surgery is best for me?
Every patient’s breast cancer journey is unique. Deciding what type of reconstruction suits you and meets your individual goals is a very personal one. However, Dr. Burgess is available to help guide you through these important decisions regarding breast cancer reconstruction and the various surgical options. She will explain your alternatives in detail and provide breast cancer resources, as well as the opportunity to speak with her previous patients.
Where is surgery done?
Surgery is normally done within a hospital setting and location can vary depending on your insurance.
How long will my reconstruction process take?
The entire reconstruction process can take upwards of a year to complete. Each patient has their own reconstruction timetable, with independent factors, such as chemotherapy, radiation or personal and family agendas that may affect surgery scheduling. Breast reconstruction is usually a staged process, to allow for healing, settling of the new breasts or implants and mental adjustment to your new look.
What about chemotherapy?
Patients often undergo chemotherapy treatments simultaneously with their reconstruction. Your chemotherapy schedule is dictated by your oncologist. Dr. Burgess is frequently able to work your expansions around your chemotherapy appointments. Again, this is a patient specific issue that is dealt with on an individual basis.
What about radiation?
If it is determined that you may need radiation in your recovery, you will visit with a radiation oncologist. The radiation oncologist will determine whether or not you would benefit from radiation and prepare your treatment plan. Since radiation can have a lasting effect on the reconstruction process, Dr. Burgess will work closely with you to determine the best surgical option and timeframe for you, relative to your radiation.
What type of anesthesia is normally used?
The majority of the reconstructive breast surgeries are done within a hospital setting, under general anesthesia. Due to the length and complexity of some of the breast surgeries, Dr. Burgess feels it is best to have you go to sleep for your surgeries and under the care of an anesthesiologist.
What types of medications are used postoperatively?
During the reconstruction process there are a variety of medications Dr. Burgess prescribes to make it as comfortable an experience as possible for patients. Those medications may include: a narcotic medication for pain control, Ibuprofen for pain and inflammation, a muscle spasm medication, an antibiotic, a stool softener to prevent constipation for after surgery. We will do an in-depth review of any current medications and supplements you take and determine if you need to stop any of those medications, due to bleeding risks with surgery. It is crucial to provide an accurate and up-to-date list of your medications and supplements, (including herbal medications) and to keep it current throughout your reconstruction process.
Are there support groups available?
There are many support groups available to those with breast cancer, breast cancer survivors and their families. At your consult, we offer materials to get you and your family in contact with some of these groups. Also, please see the “Links” tab as well.
What are the major risks of surgery?
Cigarettes and other nicotine-containing products are extremely detrimental to your health. When considering breast cancer reconstruction, it is of utmost importance to avoid smoking, using anti-smoking aids that contain nicotine and avoiding secondhand smoke. This is vital to the ultimate success of the reconstruction procedure because nicotine acts as a vasoconstrictor, causing blood vessels to narrow, resulting in a drastic reduction in the oxygen and nutrients that can reach a healing area. Unfortunately, nicotine patches can mimic this effect as well.
Dr. Burgess has patients sign a “No Smoking Waiver” if they currently smoke. We ask that patients avoid smoking a minimum of several weeks before and after surgery, although our goal would be to have patients quit completely. This allows patients to take responsibility and control with regard to their heath and healing process.
For patients that live with smokers, it is also just as crucial for the patient to avoid secondhand smoke during the healing process. Even breathing secondhand smoke can be harmful to fresh surgical sites that may be struggling to heal from the presence of nicotine.
Diabetes is a multi-faceted disease that affects the glucose levels in the bloodstream. Usually, those with diabetes have a surplus of glucose or sugar in their blood that can cause multiple, varying symptoms. If you are diabetic and considering breast cancer reconstruction, certain precautions and care must be taken to ensure the best possible outcome for you.
First off, diabetics need to have their diabetes under good control, with the help of their primary care physician, or if needed, an endocrinologist. It is imperative to have stable blood glucose levels leading up to any surgical procedure. In addition, it is important that patients are not suffering from other diabetic complications during reconstruction, such as weight loss, fatigue, slow-healing sores, blurred vision or frequent infections.
Dr. Burgess would require acceptable lab values, including diabetic testing results and absence of diabetic health-related issues when considering reconstructive surgery. Because diabetes can delay wound healing, it would be essential to have well-controlled blood sugar values throughout the entire peri-operative period.
Bleeding, Infection and other potential risks
Blood thinners are certain substances or medications that can increase the blood’s clotting time. This can allow for excessive bleeding, which is of great concern when considering any surgery. People are put on blood thinners for a variety of reasons. Some take daily aspirin for their cardiac health, while others take major blood thinners to prevent strokes.
Dr. Burgess must be made aware of any blood thinner medications or supplements that patients take, prior to any surgical procedure. During your initial consult, please be prepared to provide a detailed and up-to-date list of all your medications and supplements. This allows the doctor to determine what medications may be an issue with regard to any reconstructive surgery.
Common blood thinners are: Aspirin, Coumadin, Lovenox, Heparin, Plavix and Ibuprophen. This is not an all-inclusive list. Many other medications and supplements can put you at risk for a bleed during surgery. If you are on blood thinners, Dr. Burgess will determine if you are a candidate for reconstruction. She must carefully weigh the possible side effects of your particular medications versus the risk of being off that medication for surgery. Also, certain supplements and vitamins can also increase your bleeding risk. Please be sure to include any over-the-counter supplements in you medication profile, as these can cause problems with clotting as well.
Infection is a potential complication to any type of surgical procedure. Prior to any surgery, Dr. Burgess will assess your general health. It is important leading up to surgery to let her know if you feel ill or think you may be getting sick. We may have to reschedule your surgery if you are sick or have any type of infection. Generally, patients receive antibiotics during surgery, as well as antibiotics following their procedure. Dr. Burgess sees patients frequently during the first few weeks following their procedure to assess overall healing and general health status.
Other major medical issues
Because breast cancer reconstruction is an elective procedure, patients should be in good overall health. This is important from a healing standpoint as the reconstructive process can take upwards of a year to complete. Patients who are healthy and reasonably fit going into the reconstruction process frequently recover faster and have fewer complications related to surgery.
Sometimes women also have other major medical conditions that can affect their recovery from an elective surgery. If you do suffer from another chronic disease or illness, it is important to discuss this with your plastic surgeon. Depending on the type of disease and how it influences your generalized health, you may still be a candidate for reconstructive surgery. Often times, Dr. Burgess may coordinate care with your primary care physician, or specialist to ensure you are cleared for surgery.
Questions for your Plastic Surgeon
- How long have you been in practice?
- Are you board certified?
- What specific surgeries do you perform?
- What is your role in my reconstruction?