A newsletter from David J. Levens, MD, FACS
Board-certified plastic surgeon
Please contact me for a free consultation with Dr. Levens.
Breast Reconstruction: Inspiring advice from three terrific women!
Cheryl, 56, of Dania, was diagnosed with breast cancer a year ago. A lump was detected during a routine medical exam. An ultra sound and needle biopsies confirmed cancer in one breast; a subsequent MRI showed a suspicious shadow on the other. She had a timely bilateral mastectomy, chose to have simultaneous reconstruction surgery and is progressing nicely. 
“I can’t say enough good things about the entire medical team that brought me through this terrible ordeal. Everyone, from my primary and oncology doctors to Dr. Levens and my general surgeon as well the technicians and medical staffs all worked together each step of the way to help me deal with the cancer and make informed decisions. I was presented with the option of doing the reconstruction at the same time as the mastectomies or later. I decided to get as much done at one time as possible. For me it was the right decision.
While dealing with breast cancer can, of course, be devastating both emotionally and physically, Cheryl’s diagnostic and surgical experiences have at least been relatively uncomplicated. Unfortunately, that’s not always the case.
Here are the stories, and some advice, from two patients who unfortunately endured much more complicated courses.
Brenda, 51, of Plantation, found two breast lumps through self-examination which she reported during a routine physical exam shortly thereafter. A mammogram was prescribed but the breast clinic she preferred had a 3-month wait.
“I have a personal and family history of fibrocystic disease and the nurse-practitioner and I both thought they were probably nothing,” she recalls, “so I wasn’t terribly concerned. When I finally had the mammogram, I was floored. It showed likely breast cancer, a very aggressive form.”
Abnormal cells were found in the other breast as well and a bilateral mastectomy was performed; Brenda had been initially advised that the lymph nodes appeared negative. Six days post-surgery however, she learned that the cancer had actually spread to the lymph nodes, requiring 16 months of intravenous chemotherapy and subsequent oral drug therapy.
Brenda’s initial reconstruction surgery was performed one month after her mastectomies and was “the start of another nightmare”, she says. “The reconstruction was disfiguring. One breast was positioned very noticeably lower than the other. I felt unsure about expressing my concerns with the surgeon who didn’t seem open to my uncertainties. Eventually I sought a second opinion and found Dr. Levens who ultimately started over with a secondary reconstruction with new implants. Today, my breasts look better than ever before, with incredible nipple reconstruction. My oncologist said it’s the best reconstruction she’s ever seen…I can even wear halter tops.”
Brenda’s advice to anyone diagnosed with breast cancer: “Act quickly when something is suspicious. My first mistake was waiting so long for a mammogram. Regarding both the mastectomy and potential reconstruction, ask questions and explore all of your options. Consider consulting with more than one breast general surgeon as well as more than one plastic surgeon to find personnel and offices with whom you are most comfortable….you will be spending a lot of time with them during the recovery and reconstruction process.”
Elaine, 57, of Coral Springs, also has an eventful and inspiring story. In New Jersey in 1994, during self-examination, she discovered a small lump on her left breast, but a mammogram was negative. A month later, her nipple bled. Her doctor dismissed it and initially refused to order an ultrasound, which ultimately showed very aggressive cancer. Her left breast was removed but at that time, health insurance didn’t cover reconstruction surgery or removal of a non-cancerous breast to create balance. Federal law mandated such coverage in 1997.
In 2000 and 2001, tired of “carrying around a heavy external prosthetic breast”, Elaine underwent several procedures: A subcutaneous mastectomy of her right breast to remove scars from former biopsies as well as nearly all of the breast tissue to help match the left mastectomy side. Then tissue expanders were placed in both breasts with saline injections to stretch the tissues and finally saline implants were inserted. Unfortunately complications required implant replacement two years later.
“The breasts were dramatically asymmetrical; one was very high, one low. The surgeon said perfect symmetry wasn’t possible but I wanted better. We also hadn’t progressed to creating a nipple on the left breast. I couldn’t bear to look at myself. I was horribly self-conscious. The saline implants became painful, and hard. Five years later, I read about Dr. Levens and went for a consultation. He performed an internal lift to raise the right breast, reshaped and lowered the left breast and inserted softer, more natural silicone implants. After all these years, I finally feel normal again. My whole outlook on my body has changed. At a minor further surgery we will make a nipple on the left side.”
Elaine’s advice: “Do self-exams. If you see something, if you feel something, do something--fast. Be pro-active about treatment. I really had to insist to get my original doctor to get that ultrasound ordered and it saved my life. It’s easy to accept what a doctor tells you, but it’s best to be an “educated consumer”, do your homework, and consider a second opinion. Finally, half the battle is having a good support group, in my case my husband, my 6-year-old son, family, friends and my students, along with a fighting spirit. When I was diagnosed with cancer, people said, ‘Why you?’ and I thought ‘Why not me?’ It can happen to anyone, you just have to face it, fight it and believe you can get through it.”