3 Approaches to Breast Reconstruction

Ever since I worked with Atlanta Plastic Surgery co-founder Dr. Carl Hartrampf to develop the TRAM flap technique for breast reconstruction back in the 1980’s, cosmetic and reconstructive breast surgery has been an extremely important part of my practice.  I have always believed that helping women who have been affected by breast cancer through breast reconstruction surgery is one of the most significant things a plastic surgeon can do and I personally consider it an honor to help these women take back a sense of control over their lives.  Although breast cancer is believed to affect as many as one in eight women and the number of breast reconstruction procedures continues to increase every year, many still have questions about what this entails.  Essentially, there are three distinct ways to approach breast reconstruction surgery after a mastectomy.

3 Approaches to Breast ReconstructionBreast Reconstruction with Tissue Expander and Implant

Oftentimes, the easiest way to reconstruct the breast after a mastectomy is with an artificial breast implant, identical to the kind used during a cosmetic breast augmentation procedure.  Because there are so many types of breast implants choose from, many patients see this as an opportunity to get breasts that are exactly the size and shape they have always wanted.  However, it is possible that after a mastectomy the patient may lack sufficient skin to accommodate the desired breast implants.  In these cases, a specialized form of temporary breast implant called a tissue expander can be used to gradually stretch the skin around the breast so that the new implants can then be safely inserted.

Breast Reconstruction with Autologous Tissue Flaps

For women who desire a more natural approach to breast reconstruction, autologous tissue flaps use skin, fat, and muscle that are moved from another location in the patient’s own body to reconstruct the breast mound.  Different forms of the procedure can utilize tissue from different areas of the body, depending on the specific anatomy of the patient, but the most common type, called the TRAM flap procedure, focuses on the abdominal area.  Because tissue flap breast reconstruction procedures use living, growing tissue, the results can continue to change as the body ages, often creating a more natural looking final result.  However, it is important to note that not all women are suitable candidates for this procedure, so a detailed consultation will be needed in order to determine whether it is an appropriate approach for you.

Oncoplastic Surgery

Sometimes, when breast cancer is caught in the earliest stages, a full mastectomy may not be necessary for treatment and much of the breast tissue may be spared.  However, even a limited lumpectomy can potentially change the appearance of the breasts.  Oncoplastic surgery is a relatively new approach to breast reconstruction where the surgeon performing the mastectomy works closely with the plastic surgeon, carefully planning the placement of incisions and rearranging of the breast tissue to preserve or even enhance the overall appearance of the breast.  In some cases, breast implants or even fat transfer techniques can be used to further enhance the appearance of the breasts and give the patient the look she may have always wanted.

Every woman’s body is unique, so there is no such thing as a “one-size-fits-all” breast reconstruction procedure.  In my more than thirty years as a board-certified plastic surgeon, I have performed thousands of cosmetic and reconstructive breast procedures and can work with you to determine which approach will ultimately be best for you.  If you have questions about your options or want to schedule a consultation, please feel free to contact me, Dr. Philip Beegle.  And don’t forget to stay connected by following me on Facebook.

The Many Options in Breast Implants

With nearly 300,000 performed in the last year alone, breast augmentations are by far the most popular cosmetic plastic surgery procedures in America, and I have had the opportunity to perform thousands of them in the more than thirty years that I have been a board-certified plastic surgeon.  In my experience, one of the reasons for the enduring popularity of breast augmentation procedures is that they can be specifically customized to address the needs of individual patients, primarily by using breast implants of different sizes, types, and shapes.  Breast implants have evolved a great deal, and here are the important things you need to know about all of the advanced options that are available.

The Many Options in Breast ImplantsChoice of Material: Silicone or Saline

All breast implants are composed of an inert silicone elastomer shell that can be filled with either sterile saline, fluid silicone, or an advanced, highly cohesive silicone gel.  I have found that the majority of women prefer silicone implants, because they find them to be more natural in appearance and ‘feel’ and because they are less likely to fold or ripple along the lower edge or side of the breast.  Saline implants, however, can be inserted into the breast pocket while they are empty and then filled after they are inside, requiring smaller incisions and potentially leaving smaller scars.  Tissue expander breast implants, which are used during some forms of breast reconstruction surgery, are also filled with sterile saline so that additional volume can be slowly added to expand the breast pocket.  Finally, the newest form of breast implant, called gummy bear implants, use a malleable silicone gel that holds its shape even if the outer shell is damaged.  Ultimately, the determination of which type of implant will produce the best breast augmentation results for an individual patient is largely a matter of personal aesthetic taste.

Choice of Shape: Round or Tear-Drop

The shape of your breast implants will affect the appearance of your breasts after augmentation.  For many years, round (or spherical) implants were used because they were able to provide exceptional shape, projection, and a rounded fullness to the upper portion of the breast.  However, more recently, women have become increasingly interested in achieving more subtle and natural-looking breast augmentation results, and so there has been an increase in the number of shaped implants, which are designed to look like a tear-drop in order to more accurately mimic the natural contours of the female breast.  During your consultation, we will discuss how different sizes and shapes of breast implants will affect your results, so that you can choose the option that is right for you.

Choice of Surface: Smooth or Textured

The choice of whether the outer surface of a breast implant should be smooth or textured depends on a variety of factors.  Round implants are typically constructed with a smooth surface since these are generally softer than textured implants and it does not matter if they shift slightly in the breast pocket.  However, tear-drop shaped implants need to maintain their orientation and position, so their surface is highly textured.  This allows healing tissue to adhere to the implant, making them less likely to rotate inside the breast.  Studies have also suggested that texturing may also reduce the risk of capsular contracture and malposition, two complications that may occur after breast augmentation surgery.

With so many options in breast implants to choose from, it is easy to find the specific combination of features that will achieve your desired look.  In some cases, I can even use fat transfer techniques to effectively “soften” the transition zone for more seamless and natural-looking breast enhancement results.  If you have any questions about your breast augmentation options, or would like to schedule a full consultation to determine which approach is right for you, please feel free to contact me, Dr. Philip Beegle.  Stay connected by following me on Facebook, or by getting the latest news and updates in Blogging for Breast Care over the upcoming months.

What Can a Breast Lift Do for You?

One of the greatest things about plastic surgery is that it can mean something completely different to each individual patient.  Everyone has specific areas of their body that they might like to change, and there are dozens of different procedures that allow plastic surgeons to customize the outcome to each patient’s unique desires.  For example, when most people think of breast surgery, they think about traditional breast augmentation, a procedure designed to make the breasts larger with silicone or saline implants, but this is certainly not the only option available.  Instead, many of the women who come into my office are interested in procedures that can give the breasts a lifted, more youthful look without necessarily increasing their size.  Such a procedure is called a mastopexy, or breast lift, and it is rapidly becoming one of the most popular cosmetic plastic surgery techniques performed in the United States.

What Can a Breast Lift Do for YouAs we age, our skin gradually becomes less elastic and the underlying muscles and tissues less resilient.  This means that, over time, wrinkles start to form and the body’s contours slowly sag and droop.  This natural process affects every part of the body, but can be particularly noticeable in the breasts, where shifting volume can often make it appear as though there is a large, blank area between the collarbone and the nipple.  Moreover, significant fluctuations in weight, whether they are brought about by changes in diet and exercise or pregnancy and breast feeding of an infant, can further exacerbate this process.  Eventually, this can mean that many women find their breasts hanging lower and their nipples pointing downward.  These women very seldom want larger breasts, and adding breast implants would likely do little to remedy the problem.  A breast lift works by surgically removing the excess, sagging skin from the breasts while it lifts and tightens the supporting tissue.  This effectively moves the breasts to a higher position on the chest, giving them a tighter and firmer appearance.

Because skin must be removed during a breast lift, different types of incisions are required than the ones used in a breast augmentation procedure.  In some cases, advanced “short scar” techniques make it possible to perform breast lifts without making an incision under the breast.  However, during our initial consultation I always explain to my patients that an anchor-shaped incision is usually required in order to fully reshape the breast skin, but most prefer the unobtrusive scars to the obvious sagging they have been experiencing.  If the patient desires, I can also reduce the size of the areola at this time using a procedure known as an areolar reduction.  Although a small amount of volume is lost during a breast lift, the goal of the procedure is actually to remove as little tissue as possible while instead moving the existing breast tissue from the lower half to the upper half of the breast.  Many women, however, choose to combine a breast lift with a breast reduction procedure if that is required, particularly if the size of the breasts is (in part) what is causing them to sag.

The most important thing to remember about breast surgery, or about any other form of plastic surgery for that matter, is that every patient is unique.  I believe that really listening to my patients when we discuss their goals and expectations is the best way to find out which procedures will provide them with the most benefit and achieve optimal plastic surgery results.  If you are interested in learning more about how to best achieve your individual aesthetic goals, please contact me, Dr. Philip Beegle.  You can also stay connected by following me on Facebook, or by getting the latest news and updates in my Blogging for Breast Care feature articles.

Katie’s Journal: One Patient’s Journey through Breast Cancer (Part Six)

Many women who undergo treatment for breast cancer refer to their experience as a journey, because the road to recovery can often be a long one, with many different obstacles to overcome along the way.  Over the past several months, we have had the opportunity to hear the story of Katie, a patient of Dr. Philip Beegle whose journey began back in April of 2016.  In this month’s installment, Katie talks about going through her final chemotherapy treatment and her breast reconstruction with Dr. Beegle.

Dr Philip Beegle Spotlight PatientsNovember 10th: Today I received my fourth and LAST chemotherapy treatment!  Since it also happened to be my birthday, my friend who takes me to chemo brought balloons to put on my treatment chair. I have seen, first hand, that the staff at my oncologist’s office works very hard, and the doctors, nurses, lab techs, office staff and infusion team have all been terrific.  So I took in coffee cakes and cupcakes to thank them for their wonderful work.  You see, as you go through cancer treatment, a bond develops. You see other patients and staff on a regular basis and you become friendly with them.  Everyone works together to help us through treatment and we are forever united to achieve one goal, to LIVE.

This time the initial fatigue that I usually experience did not seem as severe.  However, four days later, I developed my usual side effects from chemotherapy:  body aches and pains, constipation, mouth and throat issues.  They are always pretty much the same for me and I usually just try to get through it the best I can, but this time, knowing that I was finally done with chemo and could finally move forward, I felt more positive and less depressed.  This afforded me a tremendous sense of solace.

With my chemotherapy now behind me, it was also time to begin planning for the next step in my journey, my upcoming bilateral mastectomies and subsequent breast reconstruction.  For me this will be a “staged” procedure, involving two surgeries performed over the course of several months.  During the first stage, my breasts will be removed and reconstructed with fat and tissue taken from my abdomen, using a free TRAM flap breast reconstruction technique.  In the second stage, which will take place three to six months later, silicone breast implants will be placed to add projection and volume.  At that time, my nipples will also be reconstructed and, if necessary, any breast shape issues can be addressed.

Early in December, I met with my plastic surgeon, Dr. Philip Beegle and his staff.  We thoroughly discussed all of the details of the surgery, including my optimal breast size, the actual technique that would be used, the risks involved, and what I could expect during my recovery.  Pre-op photos were taken and I received written post-operative instructions as well as the prescriptions for medications that I will need.  After that meeting I definitely felt much more prepared and confident.

Dr. Beegle’s office coordinated with my breast surgeon, Dr. Jennifer Amerson of Breast Care Specialists, who will be performing the mastectomies.  My surgery is set for December 20th, approximately five and a half weeks after my last chemo treatment.  Although I am not thrilled about the idea of spending Christmas day recovering after breast reconstruction surgery, I am anxious to get this behind me and be on my way to recovery in the New Year.  As I prepare for surgery, I feel that the hardest part, chemo, is now behind me.  I feel a little nervous about the recovery process, but also a renewed sense of control.  I am looking forward to finally moving on.

You can read all about Katie’s experiences on her journey to breast cancer recovery and learn about what happens in our ongoing Katie’s Journal blog series.  If you would like to learn more about your breast reconstruction options, please contact Dr. Philip Beegle to schedule a consultation.  You can also stay connected by following Dr. Beegle on Facebook, or by getting the latest news and updates in our other Blogging for Breast Care feature articles.

Coping with the Side Effects of Chemotherapy

In the more than thirty years that I have been a board-certified plastic surgeon, I have had the honor of helping thousands of women regain a sense of wholeness and normalcy after undergoing mastectomies for the treatment of breast cancer through surgical breast reconstruction.   Following the stories of these inspiring patients has taught me that a woman’s road to recovery from breast cancer can often be a long and difficult one, and that it neither begins nor ends with the breast reconstruction procedures I perform.  In my blog, I have had the opportunity to educate women about all aspects of breast care, including every stage of breast cancer from the initial diagnosis through treatment, reconstruction, and eventual recovery.  Oftentimes, the part of breast cancer treatment that fills patients with the most apprehension is chemotherapy, and understanding what to expect can go a long way towards helping relieve some of that fear.  Although it is important to stress that every individual patient experiences chemotherapy differently, both physically and emotionally, here is some advice on how to deal with a few of its most commonly experienced side effects.

Coping with the Side Effects of ChemotherapyDecreased Blood Cell Counts

Red blood cells carry oxygen throughout your body, white blood cells help fight infection, and platelets help stop bleeding.  Because these cells divide rapidly, just like cancer cells, they can often be adversely affected by certain chemotherapy drugs.  When this occurs anemia and a lower resistance to infection can result.  Expect to need extra rest and try to maintain a healthy diet to keep your strength up.  Carry hand sanitizer and try to avoid sources of bacteria (like crowds, raw food, or animal waste) to remain free from infection.

Nausea and Vomiting

Perhaps the best known and most uncomfortable side effects of chemotherapy are persistent nausea and vomiting.  Chemotherapy drugs can irritate the gastrointestinal (GI) tracts and stimulate certain chemical receptors in the brain, triggering these side effects.  I would recommend staying away from foods or drinks with strong odors and sticking to meals that are bland and more easily digestible.  Eating smaller meals more frequently throughout the day can help, as can sucking on sugar-free mints or candies.  Your oncologist will also prescribe anti-nausea medication during your course of treatment.

Hair Loss

The follicles that produce hair are the most rapidly dividing cells in the body, and so they can mistakenly become a target for chemotherapy drugs.  Chemotherapy hair loss can occur anywhere and usually starts about two to three weeks after chemotherapy has begun.  Certain preventative measures, like “cool caps” worn during chemotherapy sessions, can sometimes restrict blood blow and prevent the chemotherapy drugs from reaching the scalp, but these measures do not necessarily work for all patients.  Fortunately, the damage to the follicles is not usually permanent, so hair will generally start to grow back two to three months after the chemotherapy has stopped.  Many patients use hats, head scarves, or wigs while undergoing chemotherapy.

Unfortunately, the effects of chemotherapy can often be unpredictable, and these symptoms are only the tip of the iceberg.  It is extremely important that you communicate with your doctor about any chemotherapy side effects that you may be experiencing, no matter how insignificant they may seem, so that they can determine how best to deal with them.  If you are interested in breast reconstruction, or in any of the other reconstructive or cosmetic plastic surgery procedures that I perform, please feel free to contact me, Dr. Philip Beegle, to schedule a consultation.  Stay tuned to my Blogging for Breast Care articles to learn more about breast surgery, hear inspiring stories from breast cancer survivors, and keep updated on the latest developments in breast care.

Interested in Transferring Fat to Your Breasts? Here’s How!

With nearly 300,000 procedures performed in 2015 alone and a 98% patient satisfaction rate, breast augmentation continues to be the single most popular form of plastic surgery in the United States.  However, even though numerous studies over the course of several decades have consistently proven the safety of artificial silicone breast implants, some women who might otherwise be interested in breast augmentation hesitate because they are uncomfortable with the idea of incorporating any artificial material into their bodies.  For these women, fat transfer techniques may provide an effective alternative to traditional breast implants.

Interested in Transferring Fat to Your Breasts Here’s How!The fat transfer process begins with a relatively simple liposuction procedure.  A small amount of fat is removed from a location that the patient would like to see reduced, like the thighs or abdomen.  This fat is then thoroughly purified and processed into a liquid form that can be injected directly into other areas of the body, naturally increasing their volume and projection.  Fat transfer has been used for years in a variety of plastic surgery techniques, ranging from minor facial rejuvenation to the Brazilian Butt Lift.  Many plastic surgeons have even used transferred fat to improve the results of their breast augmentation and breast reconstruction procedures.  Injecting fat between the breast bone and the edges of the breast implant effectively “softens” the transition zone and achieves more seamless and natural-looking breast enhancement results.

Until recently, however, it has not been practical to use transferred fat alone, without a breast implant, as a way to increase breast size.  There is only a limited amount of space available in the breast cavity, and injecting large volumes of fat could potentially create excessive pressure that would impair blood flow and endanger the survival of the transferred fat cells.  This would mean that the fat would quickly break down and the results would be relatively short-lived.  However, by using various “pre-expansion” techniques, like a tissue expander, we can provide extra room in the breast and potentially triple the volume of fat that can be safely transferred.  This makes it possible, in some cases, to achieve a noticeable and long-lasting increase in breast size without the need for an artificial breast implant.  However, it is also important to emphasize that only relatively modest size-increases are possible with fat grafting alone, and women who are interested in significant changes may still require implants.

As with any cosmetic breast surgery procedure, it is important to remember that every patient is unique and so the potential results or even the appropriateness of any technique can vary.  The transferred fat cells come from the patient’s own body, and so pose virtually no risk of triggering allergic reaction or causing certain complications, but fat transfer is still not necessarily the right choice for everyone.  Natural metabolic processes can potentially reabsorb some of the transferred fat cells back into the body and the extent to which this will occur can vary from patient to patient, so the long-term results are sometimes unpredictable and the procedure may need to be performed more than once.  Ideal candidates should also have some amount of excess fat in their thighs, flanks, or abdomen that they would like to eliminate, and of course should be in generally good health and non-smokers, as long term smoking can create difficulties during recovery.

Fat transfer is just one of the many options available in cosmetic and reconstructive breast surgery.  If you would like to learn more about how to best achieve your individual aesthetic goals, please contact me, Dr. Philip Beegle.  You can also stay connected by following me on Facebook, or by getting the latest news and updates in my Blogging for Breast Care feature articles.

Minimizing Your Breast Cancer Risk

In this blog, I feel privileged to have an opportunity to help educate women (and men) about a wide variety of issues pertaining to breast care, ranging from how best to recover after breast surgery to how to perform simple breast self-exams.  However, the most serious of these concerns is obviously breast cancer.  According to the American Cancer Society, an estimated 255,180 new cases of invasive breast cancer are expected to be diagnosed in the U.S. in the coming year, and many of my patients ask me whether there is anything that they can do.  Although our genes do have a significant impact on our risk of cancer, there are also several important cancer risk factors that actually are within our control.  The World Cancer Research Fund estimates that about 20% of all cancers diagnosed in the U.S. are actually related to the amount of body fat a patient has, their individual level of physical activity or inactivity, their overall alcohol consumption, and their particular nutritional status.  Changes of these three key factors could potentially be important for the prevention of cancer.

Minimizing Your Breast Cancer RiskMaintain a Healthy Weight

While switching to a healthy diet is good, maintaining a healthy weight should really be the goal and a long-term lifestyle choice that begins with making healthy choices early.  Make an effort to eat plenty of fresh fruits and vegetables and to incorporate whole grains and healthy fats into your diet.  Avoid excess alcohol consumption and high calorie foods and limit your sugar and carbohydrate intake.  When planning your diet, try to emphasize natural, plant-based foods over processed foods.

Set Realistic Goals for Regular Physical Activity

Getting enough exercise is important, but it can often be difficult for busy people to find the time to get out and engage in physical activity, much less find the motivation to maintain a regular exercise routine.  That’s why it is so important to set realistic and attainable short term goals.  Your goal should be to engage in moderately intense activity, like taking a brisk walk, for at least 150 minutes a week, vigorous activity, like playing a pick-up basketball game, for about 75 minutes each week, or some combination of the two.  That works out to only about fifteen to twenty minutes each day spread throughout the week.

Avoid Environmental Carcinogens

There are a variety of different environmental factors that may increase your cancer risk.  Some, like alcoholic beverages or the smoke from tobacco products, are well known and should generally be avoided if at all possible.  Others, like excessive exposure to radiation (in the form of ultraviolet light from the sun or repeated medical x-rays) may not be avoidable, but can be easily minimized by taking relatively simple protective measures.  Make an effort to learn about the other environmental carcinogens linked to products at home (like radon) or in the workplace (like exposure to certain industrial chemicals) so that you can take appropriate precautions.

We can all make healthy choices, each and every day, and those choices may be reinforced by the social, physical, and economic environment in which we live.  Become an active force in your family and in your community by helping to create an environment that encourages people to make healthy choices when it comes to diet and physical activity.

Even if you are taking all necessary steps to reduce your breast cancer risk, early detection and prompt treatment can also make a tremendous difference.  If you have been diagnosed with breast cancer, and have questions about your breast reconstruction options, please feel free to contact me, Dr. Philip Beegle.  You can also stay connected by following me on Facebook, or by getting the latest news and updates in Blogging for Breast Care over the upcoming months.

The Potential Health Benefits of Breast Reduction Surgery

The Potential Health Benefits of Breast Reduction SurgeryWe all know that the cosmetic breast surgery can improve one’s physical appearance, and in some cases may even be able to improve one’s state of mind, but fewer people are aware that some of those very same procedures may actually be able to provide health benefits as well.  I am speaking specifically about reduction mammoplasty, or breast reduction, a procedure that (according to statistics compiled by the American Society of Plastic Surgeons) benefited more than 100,000 women in 2015 alone.  As a board certified plastic surgeon, I have been performing breast reduction surgery on patients of all ages and body types for more than thirty years, and in that time I have found that they can provide relief for several common health concerns, including:

  • Back and Neck Pain: Excessive weight in the chest can cause the shoulders to roll forward, placing strain on the vertebrae of the lower back and causing chronic pain and improper posture.
  • Numbness in Arms and Hands: When the weight of the breasts places too much tension on the nerves that run behind the collar bone, patients can feel a tingling or numbness in their fingers, arms, and hands.
  • Rashes and Skin Irritation: Heavier breasts tend to sag and droop excessively, which can result in rubbing and chafing which can, in turn, lead to painful skin irritation.
  • Lack of Exercise: Larger breasts can potentially impede common physical movements and make running and other forms of exercise much more troublesome. This physical inconvenience may discourage some women from engaging in outdoor activities or aerobic exercise.

All of these benefits are often in addition to the less tangible but still important ones, like reduced self-consciousness and an ability to more easily find clothing that fits properly.  Additionally, in cases where the added weight and volume of the breasts has caused them to sag or droop, I can also simultaneously perform a breast lift to give them a firmer and more youthful appearance.  The size of the areola can even be reduced, if necessary, using a technique called areola reduction.  During our consultation we can discuss, in detail, your personal aesthetic goals and your body’s requirements, and even examine before and after photographs so that we can determine an approach that will produce optimal results.

If you are interested in breast reduction, or in any other form of breast surgery or cosmetic plastic surgery procedure, please feel free to contact me, Dr. Philip Beegle.  Some reconstructive plastic surgery procedures can even be covered by insurance and we also provide a variety of options for financing, including Alphaeon® and CareCreditSM in order to assist you.  Remember to stay connected by following me on Facebook, or by getting the latest news and updates in Blogging for Breast Care over the upcoming months.

Katie’s Journal: One Patient’s Journey through Breast Cancer (Part Five)

Battling breast cancer is never easy, and the struggle can take a toll both physically and emotionally.  Still, some patient’s journeys are longer than others.  Over the past several months, we have followed the story of Katie, one of Dr. Philip Beegle’s breast reconstruction spotlight patients, as she has worked to overcome the various challenges along her road to recovery.  This week we pick up with Katie in her next installment, as she continues with her chemotherapy treatment and deals with some of the side effects.

dr-philip-beegle-spotlight-patientsSeptember 29th:  It has been a week and a half since my last entry and I received my second chemo infusion today.  I think it went better than the first. I was less anxious because now I know the drill, what to expect, and that I WILL get through this!  I had difficulty sleeping last night because of the steroids, so I was very sleepy during the infusion.  Tomorrow I am scheduled to return to the clinic to receive a shot of Neulasta, an injectible medication that stimulates the growth of new white blood cells.  These help protect against the risk of infection for patients undergoing chemotherapy.

Over the next few days, I noticed that I felt more fatigued, emotional, and depressed.  The GI symptoms I experienced previously were not as bad this time and only lasted about two days, but I now know what to take so the symptoms improved quickly.   I am not nauseated, which is a blessing!  Patients usually receive three days of anti-emetic medications to take around the clock and these have really helped.  (You can read more about ways to deal with the side effects of chemotherapy in the last installment of Katie’s Breast Cancer Journal.)

October 4th Post-Chemo Day Five:  For the first part of the week, I stayed in most of the time and just rested.  I thought I was feeling better and so ventured out, but ended up feeling light-headed and sick again.  I have found that it is important to stay hydrated as it helps to flush out the chemo and keeps your blood pressure stable.  This time around, I had not been as fastidious as I should have been, but once I began drinking more fluids, things improved.  I had a follow up with the oncologist for a low grade fever and aches, but they just recommended Ibuprofen and Claritin to help with the flu symptoms and an antibiotic in case I felt sicker over the weekend.   Also, I noticed a slight rash on my head, which improved with Benadryl for the itching and Epsom salt washcloth soaks.   Luckily, all of my symptoms improved and I began to feel better over the next few days.  My oncologist also monitors my white blood count (or WBC), which decreases as a result of chemotherapy.  Luckily my WBC is responding to the Neulasta and he seems pleased at my progress.  This is encouraging!

October 10th Post-Chemo Day Eleven:  I am running a low grade fever again.  I also have a little runny nose and my ear is hurting.  I am getting frustrated as these little things are very irritating.  In some ways, I am actually having a harder time with this second treatment.  I seem to be more emotional and my energy level is lower.  Although I wake up with energy, I grow tired quickly as the day goes on.  I am starting to feel better, but I am depressed because I know that by the time I am back to my old self, it will almost be time for the next treatment.

I am no longer wearing the cold caps, since a good portion of my hair has already thinned or fallen out.  I have learned that you need to wear them during the chemo infusion and for several hours afterwards on each of the first couple of days after the treatment to keep the chemo agents from attacking the hair follicles and causing hair loss.  For the first treatment, I did not wear them during the chemo infusion or as often as I should have and subsequently my hair thinned much faster than I anticipated.  While I have tried to make it funny and not so devastating, it has really been hard to lose my hair.  I have always had great hair and I think most women identify closely with theirs.  Any woman will tell you that when your hair looks good, you look good!  Now most people will know I have cancer and I think that is the hardest part, because what was private is now public.

After so much chemotherapy hair loss, I frantically began to look for a wig.  This was overwhelming because I didn’t really feel great to begin with and the very fact that I needed to buy a wig at all was demoralizing.  I did my research, which involved a good deal of time, money, and emotions, and in the end bought two wigs. The first one I found was on sale for $500.  It was made of synthetic hair, which means that it cannot be colored, and I did not initially like it because I am used to my “puffy hair”.  My colleagues say it looks natural but I find it to be a huge adjustment because no matter what it looks like, it is not MY hair!  I found my second wig at a specialized salon that has a special service for fitting wigs, cutting, and coloring them to your style.  They deal mostly with cancer patients and although they were quite expensive, I feel they provided a much more satisfactory product.  For $1,700 I received a wig that was professionally fitted, colored, cut, and styled to my preference.  The service even included a head stand for when I was not wearing it, a comb, spray, future adjustments and a free make up consultation.  Unfortunately only $700 of the total was covered by my insurance, but I feel as though it was worth it.  While researching wigs, I learned that many local hospitals have wig boutiques in their Women’s Center and that you can buy a wig online, but I felt like I needed professional guidance.  When I was at lunch with a friend last week, she did not even notice that the wig I was wearing was not my own hair!  So perhaps it paid off in the long run!

There you have it! Two treatments down, two to go! Cancer, you are outta here!

The Importance of Breast Self-Exams

The American Cancer Society estimates that in 2016, more than 200,000 women in the United States were diagnosed with breast cancer.  As a board-certified plastic surgeon with more than thirty years of experience performing all types of breast reconstruction surgery, I have had the privilege of helping hundreds of these women in their journey to breast cancer recovery.  However, it has certainly been my experience that the earlier breast cancer is detected, the easier it is to treat and the higher the survival rate.  Even though advancements in technology have continued to make mammograms safer and more effective, a woman’s first line of defense is still the monthly breast self-exam.

The Importance of Breast Self-ExamsAccording to Johns Hopkins Medical Center, at least forty percent of diagnosed breast cancers are first detected by women who feel a lump, so regular breast self-exams are very important.  While they should not be considered a substitute for a regularly scheduled mammogram, I believe that they can play a vital role in helping you become familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes.  Performing a breast self-exam usually takes just a few minutes every month, and can be broken down into three easy stages:

Step One: In the Shower

With the pads of your fingers, carefully feel the entire breast and armpit area, moving in a circular pattern from the outside to the center.  Specifically look for any breast lumps, thickening, or hardened knots that may be present and bring those changes to the attention of your healthcare provider.

Step Two: In Front of a Mirror

In front of a large mirror in a well-lit room, visually inspect your breasts with your arms at your sides.  Then, raise your arms high overhead.  Look for any changes in the contours of your breasts and for any swelling, dimpling of the skin, or changes in the nipples.  Next, rest your palms on your hips and press firmly to flex your chest muscles.  Your left and right breasts will most likely not exactly match (few women’s breasts do) but you should take special note of any dimpling, puckering, sores, or skin discoloration, particularly if those changes are only on one side.

Step Three: Lying Down

While you are lying down, the breast tissue should spread out evenly along the chest wall.  Place a pillow under your right shoulder and your right arm behind your head.  Then, using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit.  Use first light, then medium, and finally firm pressure.  Squeeze the nipple, checking for fluid discharge and lumps. Finally, repeat these steps for your left breast.

Early detection and prompt treatment can often make all the difference when dealing with breast cancer, so leave no stone unturned.  If you have been diagnosed with breast cancer, and have questions about your breast reconstruction options, please feel free to contact Dr. Philip Beegle.  Some reconstructive plastic surgery procedures can be covered by insurance and we provide a variety of options for financing, including Alphaeon® and CareCreditSM in order to assist you.  You can also stay connected by following me on Facebook, or by getting the latest news and updates in Blogging for Breast Care over the upcoming months.

Disclaimer: All information provided within this website and blog is for patient education and should not be deemed as medical advice. Dr. Philip H. Beegle should not be held liable for the completeness or validity of this information or for any damages from its display. Treatment information and medical recommendations must be made on a case-by-case basis; seek personalized care from a medical doctor for any medical questions or health issues you may have.
Some photos in this website feature models for illustrative purposes.
Photos of actual patients can be found in Dr. Beegle’s before and after photo gallery.