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Breast Reconstruction After Mastectomy

Study finds more women receiving breast reconstruction after mastectomy

A new study finds that the majority of women who undergo mastectomy for breast cancer go on to get breast reconstruction, a practice that has increased dramatically over time.
Researchers found that 46 percent of patients received reconstruction in 1998 but that figure rose to 63 percent by 2007.
“Breast reconstruction has a big impact on quality of life for breast cancer survivors. As we are seeing more women survive breast cancer, we need to focus on long term survivorship issues and ensuring that women have access to this important part of treatment,” says study first author Reshma Jagsi, M.D., D.Phil., associate professor of radiation oncology at the University of Michigan Comprehensive Cancer Center.
The researchers, from academic medical centers and private practice, looked at insurance claims data from a large nationwide employment-based database of medical claims. They identified a total of 20,506 women who had been treated with mastectomy for breast cancer between 1998 and 2007. Results appear in the Journal of Clinical Oncology.
While overall rates of reconstruction increased, women who received radiation therapy were less likely to get reconstruction. This is especially concerning because radiation therapy is increasingly being used after mastectomy as a way to further reduce the risk of the cancer returning in women with more aggressive or advanced disease.
The researchers note that reconstruction is more challenging after radiation, which limits the reconstruction options available for these patients. And often the results are not as good.
The study also revealed dramatic variation in reconstruction based on geographic region, from a low of 18 percent in North Dakota, to a high of 80 percent in Washington, D.C. This was largely associated with the number of plastic surgeons working in each state.
Other findings reported show that the rate of bilateral mastectomy increased six-fold between 1998 and 2007, and that three-quarters of women receiving bilateral mastectomy also have breast reconstruction.
The researchers also note that more women are receiving implants rather than recreating breasts using tissue from other parts of their body, called autologous reconstruction. Autologous techniques tend to deliver better cosmetic results and higher satisfaction, but it’s a time-consuming, demanding operation that requires a longer hospital stay and recovery time. The researchers raise concern that current medical reimbursement discourages surgeons from offering autologous reconstruction.
“Overall, our finding of substantial increases in breast reconstruction over time is good news for women with breast cancer and reflects positively on cancer care in the United States. However, we need to keep working to ensure that all women have access to quality breast cancer care,” Smith says.

This information is brought to you courtesy of Dr. Bishara and The Paragon Plastic Surgery & Med Spa staff.
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En Espanol
ESTUDIO REVELA QUE MÁS MUJERES QUE RECIBEN LA RECONSTRUCCIÓN DE MAMA después de la mastectomía
Un nuevo estudio revela que la mayoría de las mujeres que se someten a una mastectomía para el cáncer de mama va a conseguir la reconstrucción mamaria, una práctica que ha aumentado drásticamente con el tiempo.
Los investigadores encontraron que el 46 por ciento de los pacientes recibieron la reconstrucción en 1998, pero esa cifra se elevó a 63 por ciento en 2007.
“La reconstrucción mamaria tiene un gran impacto en la calidad de vida de los sobrevivientes de cáncer de mama. Como estamos viendo más mujeres sobreviven al cáncer de mama, hay que centrarse en las cuestiones de supervivencia a largo plazo y asegurar que las mujeres tengan acceso a esta parte importante del tratamiento,” dice primer autor del estudio Reshma Jagsi, MD, D. Phil., profesor asociado de oncología de radiación en la Universidad de Michigan Comprehensive Cancer Center.
Los investigadores, de los centros médicos académicos y la práctica privada, analizaron los datos de reclamaciones de seguros de una gran base de datos a nivel nacional basada en el empleo de las reclamaciones médicas. Se identificaron un total de 20.506 mujeres que habían sido tratadas con mastectomía por cáncer de mama entre 1998 y 2007. Los resultados aparecen en la revista Journal of Clinical Oncology.
Mientras que las tasas globales de reconstrucción aumentaron, las mujeres que recibieron radioterapia tenían menos probabilidades de conseguir la reconstrucción. Esto es especialmente preocupante porque la radioterapia se utiliza cada vez después de la mastectomía como una manera de reducir aún más el riesgo de reaparición del cáncer en mujeres con enfermedad más agresiva o avanzado.
Los investigadores señalan que la reconstrucción es más difícil después de la radiación, lo que limita las opciones de reconstrucción disponibles para estos pacientes. Y muchas veces los resultados no son tan buenos.
El estudio también reveló dramática variación en la reconstrucción según la región geográfica, entre un mínimo de 18 por ciento en Dakota del Norte, y una máxima de 80 por ciento en Washington, DC Esto se asoció en gran medida con el número de cirujanos plásticos que trabajan en cada estado.
Otros hallazgos reportados muestran que la tasa de mastectomía bilateral multiplicado por seis entre 1998 y 2007, y que las tres cuartas partes de las mujeres que recibieron mastectomía bilateral también una reconstrucción del seno.
Los investigadores también señalan que más mujeres están recibiendo los implantes en lugar de recrear senos utilizando tejido de otras partes de su cuerpo, llamados reconstrucción autóloga. Técnicas autólogas tienden a obtener mejores resultados estéticos y una mayor satisfacción, pero es una operación exigente que consume tiempo y requiere hospitalización y el tiempo de recuperación más largo. Los investigadores plantean la preocupación de que el reembolso médico actual desincentiva a los cirujanos de ofrecer la reconstrucción autóloga.
“En general, nuestro hallazgo de un aumento sustancial de la reconstrucción del pecho a través del tiempo es una buena noticia para las mujeres con cáncer de mama y se refleja positivamente en la atención del cáncer en los Estados Unidos. Sin embargo, tenemos que seguir trabajando para garantizar que todas las mujeres tengan acceso a cáncer de mama calidad cuidado “, dice Smith.
Esta información es traído a usted por cortesía del Dr. Bishara y La Cirugía Plástica y Paragon Med personal del spa.
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Breast Implants, Breast Lifts

Breast implants are still overwhelming choice for women, but since 2000 breast lifts are up 70 percent

New statistics released by the American Society of Plastic Surgeons (ASPS) show that breast lift procedures are growing at twice the rate of breast implant surgeries. Since 2000, breast lifts have grown by 70 percent, outpacing implants two-to-one. Breast implants are still by far the most performed cosmetic surgery in women, but lifts are steadily gaining. In 2013, more than 90,000 breast lift procedures were performed by ASPS member surgeons.
“Many women are looking for a youthful breast by using the tissue they already have,” said ASPS President Robert X. Murphy, Jr., MD.
According to the new statistics, women between the ages of 30-54 made up nearly 70 percent of the breast lift procedures performed in 2013.
According to the latest statistics from ASPS, fewer than 53,000 breast lifts were performed in 2000. Last year there were 90,006, an increase of 70 percent since 2000.
Breast augmentation remains the most popular plastic surgery procedure for women. In 2013, there were 290,224 breast augmentation surgeries performed by ASPS member surgeons. That represents a growth of 37% since 2000, just under half the rate of breast lifts.

This information is brought to you courtesy of Dr. Bishara and The Paragon Plastic Surgery & Med Spa staff.
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Be Bikini Ready Before Summer


Preparation and effort applies to those who want to improve their bodies before summer of 2014. The Paragon Plastic Surgery & Med Spa is here right now to provide the kind of outstanding plastic surgery residents trust for producing the best possible results. Getting great results with liposuction, breast augmentation, or another procedure takes a little time.  If you’ve watched your diet, worked out intensely, and are already most – but not quite all – of the way to a truly amazing beach body, now is when you should contact us for cosmetic procedures.
While recovery times are growing less lengthy with the highly advanced procedures available, there is still no such thing as an instant liposuction, breast augmentation/reduction, or tummy tuck. This could be the perfect moment to get started and ready for summer. The end of the school season is fast approaching, and beach weather will be here before you know it.
This Paragon Plastic Surgery & Med Spa offers a personalized approach that takes patients through the entire process of obtaining a procedure and provides complete support before, during, and after the procedure. This may also include assistance with financing an operation.
For further information, please call us at (817) 473-2120. You can also visit our website any time on the net at www.MarkBisharaMD.com or through Facebook at Paragon Plastic Surgery and Med Spa. The entire team of friendly and knowledgeable staff look forward to hearing from you.
 

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Face, Necks, Butts are Growth Areas for U.S. Plastic Surgeons


Eyelid surgery and facelifts are up. So are butt augmentations and neck lifts, according to new figures from the American Society of Plastic Surgeons that show a steady increase in cosmetic and reconstructive surgery procedures in the United States.
This was the fourth consecutive year of growth, the society reported, noting more than 15 million cosmetic surgeries and minimally invasive procedures were performed in 2013, an increase of 3 percent from the year before.
Nose jobs, liposuction and laser hair removal missed the boom, however. These procedures declined from the previous year, the report said.
Meanwhile, reconstructive surgeries increased by 2 percent, the society reported.
Better technology and new products, including a facial filler that uses hyaluronic acid (Juvederm Voluma) to treat mid-face volume loss as well as two types of silicone gel breast implants recently approved by the U.S. Food and Drug Administration, are likely the reason behind the upward trend, the society noted.
“The demand for plastic surgery remains strong, with our statistics showing increases in both cosmetic surgical and minimally invasive procedures,” said society president Dr. Robert Murphy.
“Facial rejuvenation procedures were especially robust last year, with more Americans opting for facelifts, forehead lifts, eyelid surgery, fillers and peels,” Murphy said in a society news release. “With new devices and products hitting the market each year, there are more options and choices available to consumers wanting to refresh their look or [undergo] a little nip and tuck.”
Of the 13.4 million minimally invasive procedures performed in 2013, the most common included:

  • Botox injections: 6.3 million injections, up 3 percent
  • Soft tissue fillers: 2.2 million procedures, up 13 percent
  • Chemical peels: 1.2 million procedures, up 3 percent

With more people taking steps to smooth out their wrinkles and folds, the report noted that Botox injections jumped 700 percent since 2000. And hyaluronic acid facial fillers have increased 18 percent since 2012.
There were also 1.7 million cosmetic surgeries in 2013, up 1 percent from a year ago. Among the most common procedures:

  • Breast augmentation: 290,000 procedures, up 1 percent
  • Nose jobs: 221,000 procedures, down 9 percent
  • Eyelid surgery: 216,000 procedures, up 6 percent
  • Liposuction: 200,000 procedures, down 1 percent
  • Facelifts: 133,000 procedures, up 6 percent

Silicone implants were used in 72 percent of all breast augmentations, while saline implants were chosen for 28 percent of these surgeries. The experts noted new technology offers women more natural looking and feeling results.
Butt augmentation with fat grafting and neck lifts are two new procedures also on the rise in the United States, according to the report.
There were 10,000 butt augmentation procedures performed in 2013, up 16 percent from 2012. More than 55,000 neck lifts were also performed last year, up 6 percent from the year before.
Reconstructive plastic surgery to improve both the appearance and function of abnormalities also increased 2 percent in 2013. The top reconstructive procedures performed last year include: tumor removal, up 5 percent from 2012; laceration repair, with 254,000 procedures; and scar revision.
Breast reconstruction, with 96,000 procedures, was up 4 percent last year.
“It’s promising to see breast reconstruction rates rising,” noted Murphy. “Less than 20 percent of breast cancer patients undergo breast reconstruction because they are not always informed of their options, although studies show that reconstruction greatly improves quality of life.”
This News Brought to You Courtesy of Dr. Bishara and The Paragon Plastic Surgery & Med Spa
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Silicone Breast Implants

Breast augmentation surgery, also known as augmentation mammoplasty, involves enlarging or reshaping the breast with the use of an implant. If you are thinking about getting breast augmentation surgery, there are a few things you should know before embarking on the process. The first thing is to not be intimidated by the word “surgery”. This type of cosmetic enhancement is one of the most common types of procedures performed in the United States, with thousands of women having breast augmentation done every year.
About Silicone Implants
Silicone implants are considered to be more realistic in that the gel with which they are filled has a similar consistency to breast tissue. Saline implants are firmer and filled with salt water instead of gel. While there is the potential for a silicone gel implant to rupture as a result of an injury, this is a rare event. If it does rupture, the silicone should remain within the implant shell or move to the implant pocket. If a saline implant ruptures, its contents will be absorbed by the body.

  • Silicone is used safely in the body in many medical devices and products, including pacemakers, hear valves, artificial joints and baby pacifiers
  • Silicone gel breast implants are among the most studied medical devices in existence, with thousands of peer-reviewed and published reports on studies
  • Silicone implants have a softer feel that is closer to that of natural breast tissue than saline implants

Dr. Mark Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office for more information at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
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