October is Breast Cancer Awareness Month, and one of the most extreme measures some cancer survivors have to go through is to have a mastectomy done.
We spoke to Dr Kajal Lutchminarian to find out all there is to know about the procedure.
Lutchminarian is an APRSSA award-winning plastic, reconstructive and aesthetic surgeon.
As a female plastic surgeon, she says that she receives many enquiries about mastectomies and says that it’s very important for her to provide her patients with correct information.
We asked her a few questions about the procedure and what it entails.
What is a mastectomy?
A mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely.
This includes the removal of the whole breast, or spare the skin or the skin and nipple depending on what the indications are for the mastectomy.
There are two different types of mastectomies, a therapeutic mastectomy is used to treat active disease or cancer, whereas a prophylactic mastectomy is used as a preventative measure to treat people who are at high risk for developing breast cancer or breast pathology.
Why do women have mastectomies done?
Women undergo mastectomies either for breast cancer or for severe inflammatory breast disease.
They can also have it as a preventative measure even before they have any cancer if they are at high risk of developing cancer and carry a gene that puts them at this risk. This gained popularity after Angelina Jolie underwent a prophylactic mastectomy.
There are other indications for a mastectomy as well, such as gender reassignment surgery where a patient wants to undergo a change of their gender and this is done after many psychological and medical evaluations and processes.
What does the procedure involve?
Depending on the type of mastectomy, the patient would go to the theatre under anaesthetic and have the breast gland, some skin and/or muscle removed.
This is usually performed with a multidisciplinary team which may include a general surgeon and plastic surgeon.
The breast may be reconstructed either immediately at that time or in a delayed fashion and these options also each have their own pros and cons. The breast is either reconstructed with an implant or the patient's own tissue or both.
What can a woman expect after the procedure?
The post-op recovery is a journey. On average, a reconstructed breast after cancer can take anywhere from one week to a year, depending on the defect.
There are psychological, emotional and physical strains on the patient and this is best handled with a holistic multidisciplinary team approach including a psychologist, dietitian, wound care specialist, general surgeon, plastic surgeon and physiotherapist.
They may require multiple surgeries and treatments like chemotherapy and radiotherapy, which are necessary but also carry side effects.
What cosmetic surgery options are there for women who have had a mastectomy?
A woman can opt to undergo immediate reconstruction after mastectomy or delay it.
The pros of having an immediate reconstruction are that the patient will undergo it with her surgeon and takes into account factors like what stage of cancer they have, having one surgery instead of multiple, which one may have a better cosmetic outcome for that individual, which surgery may take much longer and one would have to take the patients overall health into account and whether they require post-operative chemo or radiotherapy.
They can also opt for the type of reconstruction whether using implants or to use their own tissue or a combination of both, which will depend on various factors as above, including tissue quality, age and stage of cancer.