It may be hard to tell, but this is a picture of Dr. Burgess alongside her husband. While taking a break from their respective practices, the two joined a medical mission to perform cleft lip and palate surgeries on children in the Philippines.
Archive for the ‘Reconstructive Surgery’ Category
Study Correlates High BMI With Increased Risk During Implant Breast Reconstruction
Whether to have implants or free flap breast reconstruction is among the many decisions women face after a mastectomy.
Your weight and body mass index (BMI) may have a major impact on which procedure will be safest and most successful. Obesity is known to increase the risk of complications and implant failure in breast reconstruction.
A recent study published in Plastic and Reconstructive Surgery lent further weight to the theory that free flap breast reconstructions are more successful for women who are considered obese. Level of obesity and timing of reconstruction may also greatly increase implant failure rates. Other risk factors include age, smoking and other illnesses.
In the study, researchers analyzed the outcomes of reconstruction after breast cancer surgery in patients with a body mass index (BMI) of 30 or higher. While initially the overall complication rate was somewhat lower for implants, major complications leading to reconstruction failure were far more common – nearly 16 percent with breast implants compared to 1.5 percent with free flaps.
Timing of surgery is another major risk factor. While complications for the two procedures were similar for immediate versus delayed reconstructions in women with class I obesity (BMIs between 30-35) or lower, one fourth of immediate implant reconstructions failed with class II (BMI 35-40) and class III (BMI 40 or higher). Furthermore, the complication rate was even higher for those with BMI of 37s or greater.
Because of the rising obesity rate, more women will be facing reconstructive surgery. Given the psychological and physical seriousness of a failed reconstruction, consult with your physician and other healthcare professional about the best options for you, with an eye to your overall weight and general health. Chances are, if you fall into a high-BMI or other risk category, using free flap reconstruction or – if you opt for implants – delaying surgery may be the most prudent path.
Data compiled from the National Cancer Database of the American College of Surgeons and the American Cancer Society of 396,434 mastectomy patients has shown that more women than ever are undergoing immediate or early breast reconstruction.
Twenty-three percent of women in 2007 elected to have immediate or early reconstructive surgery, nearly doubling from just twelve percent in 1998. While these results suggest that more women have access to breast reconstruction surgery, data also indicates that access barriers still persist for women who are post mastectomy.
Patients Face Racial, Socioeconomic and Geographic Barriers
While research did show that the rate of immediate or early reconstructive surgery has been growing, growth trends were not equal across all subgroups of women.
According to the data, the most likely recipients of immediate or early breast reconstruction from 1998 to 2007 were non-African American women under the age of 50 who either lived in a large metropolitan area, were cared for by an academic affiliated medical institution or earned a higher than average household income.
The disparity measured among differing racial, socioeconomic and geographic groups was statistically significant and the gap did not appear to be narrowing over time.
Breast reconstruction surgery has become available to more women than ever before, but despite this overall increase in utilization, the fact still remains that the medical industry is not doing enough to increase awareness, education and accessibility for immediate or early breast reconstruction for women across all socioeconomic, racial and geographic groups. Continued efforts by medical professionals are essential to progress.
According to a new study by the NHS Information Centre, it seems that women who delay reconstructive breast surgery following their mastectomies are happier with the results than those women who had immediate breast reconstruction.
Researchers found that 76 percent of the women who decided to wait were satisfied with their new breast’s appearance, while 59 percent were happy with the results after immediate breast reconstruction. There was a narrower but still noticeable gap when it came to feelings of sexual attractiveness, as nearly half of women who delayed felt attractive, as opposed to a third of those who had an immediate procedure.
These findings come from a national survey of 7,000 patients in British state and private hospitals. The study was the first to ask women about their feelings 18 months after having mastectomies (breast removals) for breast cancer, and defies previously held views on reconstructive surgery satisfaction rates.
According to an article in the Daily Mail, experts agree this is not a reflection on the quality of the work, but rather has to do with how women compare their new breasts. Women who receive implants or similar procedures immediately following the removal of their original breast tend to compare their new breast with the old. Women who wait are more likely to compare their new breast favorably with the scar left by the mastectomy.
In other words, whether or not a woman waits can bear upon her emotional preparedness and personal outlook. Women who wait have an improvement to look forward to, while women who have an immediate replacement will wish for what they have lost.
Of course, every woman is different, and statistics can only go so far in making prescriptions for action. Women who are undergoing mastectomies and who desire reconstruction should always educate themselves, talk to their doctors, and carefully consider their options. Their happiness is in their hands.
He was known as “the Maestro,” the Royal Air Force plastic surgeon who transformed the face of his profession as he treated pilots who were badly burned during World War II.
Sir Archibald McIndoe, who was recently remembered in the Journal of Burn Care & Research, also realized the value of social reintegration earlier than almost anyone at the time.
When burned pilots were transferred to his East Grinstead hospital in the weeks following the Battle of Britain, McIndoe was one of only four plastic surgeons in the country. The brilliant and charismatic surgeon developed new techniques when little was known about the treatment of severe burns, reconstructing hands and faces that had been disfigured. Time Magazine wrote that McIndoe would “take charred, featureless living remains and remake them into presentable human beings.”
But McIndoe didn’t stop there; he knew that physical recovery was only half the battle, and that his patients needed to be prepared for the world beyond the hospital. McIndoe arranged for his patients to be invited to events and to attend theater and film openings. The recovering war heroes no longer hid because of their injuries, and thanks to McIndoe’s efforts, East Grinstead became known as “the town that didn’t stare.”
Patients even formed a drinking club called the Guinea Pig Club, named after the experimental nature of McIndoe’s treatments.
“We are McIndoe’s army,
We are his Guinea Pigs.
With dermatomes and pedicles,
Glass eyes, false teeth and wigs.”
– From the Guinea Pig Anthem
By the end of the war there were over 600 members, and the club still meets today to offer help to burn patients. Sir Archibald McIndoe died in 1960, but his legacy lives on in the tradition of reconstructive plastic surgery, which continues to help injured soldiers, accident victims, and many others who suffer from disfigurement.