Restoring a sense of self with reconstructive surgery

Mastectomies are painful, traumatic experiences physically and emotionally for women who have survived cancer.

But with advancements and the growing popularity of reconstructive breast surgery, more women are coming out from under the shadow of losing their breasts and reclaiming their sense of self.

Miami-based plastic and reconstructive surgeon Dr. Harry Salinas has said he has seen firsthand the impact reconstructive surgery has on a breast cancer survivor.

“For them 10, 20 years after their breast cancer treatment and they look at themselves in the mirror and they don’t have the reminder, it is a very dramatic difference. I’m in Miami and to our population it is very important culturally and our patients are incredibly grateful and incredibly happy,” he said.

Salinas was recently on island for a special breast cancer symposium and he sat down with the Cayman Compass to discuss the recovery option for cancer survivors.

Reconstructive breast surgery

Reconstructive surgery, he said, can take two forms: either an implant or reconstructing the breasts using tissue from the lower abdomen.

While both are major surgeries, Salinas said, reconstructing the breasts can be a better option in terms of longevity since the implants need lifelong maintenance.

However, he said, the aftereffect of either of the surgeries can make a difference in the patient’s emotional recovery from cancer.

“With the modern breast care we can really restore our patients for them to look and feel like they never had a mastectomy. It is a very dramatic look,” he said.

Salinas said in the past, breast cancer patients who were treated in the 1980s or the 1990s would be left with significant scars and “the stigma is always there for the rest of their lives”.

“If you see what our patients look like in 2019 you might think that they did cosmetic surgery; you might think that they never had a mastectomy,” he said.

US law helped increased access

Salinas, who is works for the Miami Cancer Institute at Baptist Health South Florida, said he has seen more women in the US opting to have reconstructive surgery.

He said it is growing in popularity largely due to the US Women’s Health and Cancer Rights Act.

“For every woman with a breast cancer diagnosis, by federal law the insurance company has to cover the reconstructive surgery. They have more access to care than they used to and that has increased the volume of reconstruction because of better access, because of better awareness. In the 80s or 90s the insurance company could have said ‘I’m sorry that’s cosmetic you can have your mastectomy and that’s it.’ They just can’t do that at all today,” he said.

He said the access to surgery made it much better for the patient.

The law, he said, was a huge leap forward in the quality of life of the patients.

“In addition to battling their cancer, they don’t have to battle with the insurance company to get the reconstructive surgery,” Salinas said.

He said, as with any surgery there are risks and lengthy recovery times involved, and the compatibility of the procedure depends on the patient.

Salinas recommends having the discussion on reconstructive surgery in the early stages of the patient’s cancer diagnosis as it is crucial to determining which procedure is the most viable option.

“We can do a much better job at it [the surgery] if we are involved from day one. If we are involved from the day of the mastectomy it is a lot easier to do an immediate reconstruction, as we call it. When we do it at the same time of the mastectomy, we don’t have delay,” he said.

Reconstructive surgery is available in Cayman.

Apart from surgeries, women who have mastectomies also have the option of using weighted and specially fit bras to help them keep their natural balance and avoid back problems. The Breast Cancer Foundation office in Grand Harbour has a bra fitting room for women in need of such support.

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