YOUR RECONSTRUCTION OPTIONS

Post mastectomy most women opt for breast reconstruction. There are a variety of reconstructive options but you may not be a candidate for all types. 

Remember: early detection saves lives!

Find out more about the treatments available to you at Milpark via their Breast Cancer website

When to have your breast reconstruction performed is a decision made in conjunction with the other doctors treating your breast cancer, as the need for chemotherapy or radiation will influence when reconstructive surgery can safely take place.

Breast reconstruction is either performed during the same time as a lumpectomy or mastectomy, or at a later date.

If Breast Reconstruction occurs at the same time it is referred to as immediate, and if it occurs at a later date it is referred to as delayed.

Immediate breast reconstruction offers psychological benefits by avoiding a time lapse in addressing any cosmetic change, and also minimizes the number of surgeries for the patient.

Delayed reconstruction is sometimes performed because the patient chooses to wait, or in some cases the patient was not aware at the time that reconstructive options existed.  Other patients are unhappy with the results of their reconstruction and now seek to undergo an alternative surgical method, such as replacing implants with their body’s own natural tissue.

There are a number of breast reconstruction procedures that can help rebuild the breasts. Procedures are tailored to the individual patient, and the type of procedure you have will depend on cancer considerations, your ultimate goals, and your unique body type.

But do not get overwhelmed. We will discuss this in more details during your consultation.

When it comes to breast cancer and breast reconstruction, it’s vital to be surrounded and helped by people who know exactly how to guide you and who can make the process run smoother for you.

The Breast Care unit at Milpark will be there for you every step of the way and will bring you invaluable support in every aspect.

 

Breast Reconstruction Techniques

Tissue Expansion is one of the breast reconstruction techniques that I offer.

This type of breast reconstruction involves the insertion of a silicone balloon under the skin to expand the tissue in the area. Periodic injections of saline solution cause the skin to stretch and form a pocket for a breast implant. The expander is removed after the growth process is complete and an implant is placed. The nipple and areola can be reconstructed later if the patient desires.

 

Breast Reconstruction with Implants

Some patients have enough skin in the breast area to place an implant for breast reconstruction without the need of a tissue expander. The implant can be placed under the skin and the nipple and areola reconstructed at a later date.
Did you know that women who need post mastectomy chemotherapy are still candidates for implants?

You will need to discuss all your reconstruction options with me. Your breast reconstruction approach and recovery will depend largely on:

• Your cancer
• The need for post-mastectomy radiation
• Long term risk
• Skin and tissue quality
• Desired aesthetic result

Whether you are considering breast reconstruction with implants during or after mastectomy surgery, you will want to discuss with me whether the use of a tissue expander will be necessary.

In addition, you can discuss your options for further reconstruction including re-creation of the nipple and areola.

Have you had breast reconstruction? I would love if you blogged your story – please send us your link. It would be a great help to others.

Flap Surgery

Flap surgery is a method of breast reconstruction that takes living tissue carrying its own blood supply from a donor area of the body to the breast area.

There are a variety of techniques with flap surgery including:

• TRAM Flap Reconstruction (skin, muscle, and fat taken from the lower abdomen and transferred to the breast area)
• DIEP Flap Reconstruction (skin, fat, and blood vessels are removed from the abdomen to reconstruct the breast)
• Latissimus Flap Reconstruction (skin, muscle, and fat taken from the outer back and rotated forward to form the breast mound, followed by implant placement). Nipple and areolar reconstruction can also be performed at a later time.

I hope you enjoyed this newsletter, remember that more information about  Breast Cancer and Breast Reconstruction surgery can be found by clicking on this link.  Lastly, if you would like to contact the Milpark Breast Care unit, dial+27 11 480 5779 or 0860 233 233 or send an email to breasthealth@netcare.co.za

DR SERRURIER MARCH NEWSLETTER: PROBLEMS AND SOLUTIONS

This month in my newsletter, I will be talking about problems and solutions. I often see patients who are bothered by a certain aspect of their body and either do not know what to resort to or choose the wrong procedure. I am here to help you decide on the best option and make the best out of your surgery.

If there is anything else you would like to know or something in particular that you would like me to explain, phone my rooms on 011 875 1630 or simply leave a comment on my Facebook page and I will get back to you as soon as I can.

Lastly, make sure to visit my website for more info on all the procedures I offer at my Fourways practice!

BREASTS PROBLEMS

Problems:

• You have saggy breasts
• You desire more cleavage
• There is a significant difference between one breast and the other
• You are self-conscious about breasts
• You feel that larger more perky breasts would make you feel more attractive and improve your self-confidence
• You have a hard time finding clothes that fit because of discrepancy between your breasts and your buttocks

Solution: Breast Lift!
Based on your answers to the last post, you may or may not also require a breast augmentation at the same time.

After breast lift surgery, you will notice that your breasts are firmer and higher. This will help to improve your confidence and self-esteem. Many patients are happy with the results and report that they feel younger looking and more ‘feminine’.

My Breast Lift page is full of informative resources

Why would I need to combine Breast Lift surgery with Breast augmentation?

Breast lift does not increase the size of your breasts although they may appear larger due to the fact that they are higher and firmer looking. The exception to this is if you have combined this procedure with breast augmentation surgery to enhance volume.

Problems:

• Your breasts are causing you severe psychological distress, are affecting your physical health or your ability to do exercise.
• You are experiencing backache, neck and shoulder ache.
• Your clothes don’t fit properly
• You do not like the way your breasts affect your overall appearance: large breasts can make you look unbalanced and have a big impact upon your appearance in general. Your breasts are out of proportion with the rest of your body. You feel that you are ‘top heavy’ and this can affect your self-confidence.
• You do not like being subject to inappropriate comments or attentions from the opposite sex.

Solution: Breast Reduction!

The main benefits are smaller, lighter and firmer breasts. They will be in proportion to the rest of your body. This also means no more physical discomfort such as backache or neck ache. The areola (the brown circular area round the nipple) can also be made smaller and better proportioned as well.

For Breast Reduction at my practice, click here

Breast reduction results in one of the most dramatic changes to physical appearance.

• Your clothes will fit better;
• You will no longer have physical discomfort
• Or have to endure unwanted comments about the size of your breasts. This is usually a particular issue for teenage girls.

Problems:

• You consider your breasts to be too small and would like to increase their size.
• You feel less than feminine as a result of having small breasts.
• Your breasts lost firmness, shape and volume after pregnancy
• Your one breast is smaller/bigger than the other
• You feel bigger, firmer breasts will give you a more youthful appearance

Solution: Breast Augmentation!

This highly requested surgery will have you feeling happier with your appearance, and will improve self-confidence and well-being. Breast Augmentation is the most requested surgery in my practice and in most cases women are looking for increased size with upper pole fullness.

Visit my breast augmentation page for more info!

The decision to undergo breast augmentation is a highly personal one and all that matters are how you feel about the results. If the results match your expectations then it has been a success.

It can give you a younger looking appearance but it is not a ‘fountain of youth’! As with any form of cosmetic surgery you need to have realistic expectations about what it can do.

STUBBORN FAT PROBLEMS

Problems:

• You are bothered by excess fat deposits – located anywhere on your body – that don’t respond to diet or exercise.
• You feel your body is disproportionate (but not necessarily overweight)

Solution: Liposuction and Liposculpture!

The results after liposuction surgery are instantly noticeable. You will have a firmer and more contoured appearance, which will improve your sense of well-being. The effects of liposuction are permanent, which means if you do increase your body fat, then it will NOT return to those areas you had treated.

Liposuction in more detail? Head over to my website!

Liposuction is especially beneficial to those patients who have undergone weight loss surgery. It can remove those last remaining pockets of fat. This will dramatically improve your appearance.

Liposuction can also be combined with other procedures such as abdominoplasty.

However I need to insist on the fact that Liposuction is not a solution to the problem of obesity or weight loss in general.  Also, it is not an effective treatment for cellulite.

Problems:

• You have recently had a baby and wish to tighten loose skin that has stretched as a result of your pregnancy.
• You have increased amounts of skin laxity or looseness from the belly button down to the pubic region
• You have excess skin and fat from the middle and lower abdomen and are looking to tighten the muscles of the abdominal wall to flatten your abdomen

Solution: Tummy Tuck!

During this surgery, I remove excess skin and fat from the waist, which cannot be shifted by diet and exercise alone.

There are three types of abdominoplasty:

• Complete abdominoplasty
• Partial or ‘mini’ abdominoplasty
• Extended abdominoplasty

But don’t worry; together we will discuss which one is best for your needs and characteristics.

Tummy tuck results are impressive: You will have a firmer, toned and flatter abdomen. If you had some lower abdominal bulge as a result of pregnancy then this will also be corrected. This also includes stretch marks! Your waist will appear slimmer and this tighter, youthful abdomen will boost your confidence and self-esteem.

Would you like to find out more about Tummy Tuck at my practice?

Problems:

• You do not like the way their nose looks and have been troubled by one or more of its features?
• You are concerned about the following?
• Damage to your nose caused by an accident or injury
• Congenital defect
• A nose that is too small or too large
• Excessively flared nostrils
• An enlarged, drooping or thickened nasal tip
• Crooked or off-centre nose

Solution: Rhinoplasty!

Rhinoplasty is performed for a variety of reasons which can include increasing or reducing the size of the nose; changing the nasal tip or the bridge, removing any unsightly humps or bumps and making the nose straighter or narrower.

The nasal tip itself can be rotated upwards or downwards, projected forwards or backwards or enlarged or decreased in size. The cartilage, bones and sometimes the soft tissues of the nose are reshaped.

After your rhinoplasty, your nose will be more natural looking and will complement your appearance. Whether larger, smaller or reshaped, you will look and feel better.

The vast majority of my patients are happy with the results of rhinoplasty.

If you would like to read more about this procedure, make sure to visit my website.

I hope you enjoyed this newsletter about various problems some of my patients encounter and the solutions I offer at my Fourways practice. Of course, I spoke about a few surgeries only so make sure to phone my rooms on 011 875 1630 if you would like to book an appointment or simply make an inquiry, we are here to help you!

You can also find me on Facebook and on Twitter.

Dr Charles Serrurier’s February Body Lifts

WELCOME!

This month, my newsletter is all about the lifts! As the year begins, it’s not always only our spirits that need to be lifted! And this is what I can help you with! At my practice, I offer many lifting options, whether it’s facial or body surgeries.

You will read about Breast Lift, Brow Lift, Face Lift, Arm Lift and Thigh and Buttocks Lift.

Of course, all the info will be concise so make sure to visit my website for more in depth explanations

Lastly, if there is anything else you would like to know or something in particular that you would like me to explain, phone my rooms on 011 875 1630or simply leave a comment on my Facebook page and I will get back to you as soon as I can.

 

BREAST LIFT

With age, pregnancy and breast feeding and fluctuation in weight, the ligaments and skin envelope which maintain the youthful shape of the breasts, stretch and elongate causing an unpleasant drooping of the breast on the chest wall.

This phenomenon is called ptosis and this is what the Breast Lift will correct.

How does breast lift surgery correct ptosis?
In order to reverse this drooping, I tighten the breast skin and reshape the breast tissue, which in turn will provide a more youthful shape with an improved nipple position. Also, did you know that I could reduce the diameter of your areola if you wish?

Breast Lift and Augmentation is a very common combination procedure!
If fullness and volume are important to you, an implant can be inserted during the breast lift to enhance size or firmness. This is a combination procedure called a Mastopexy Augmentation or Breast lift with additional implants.

Post-operative treatments too, can help reduce the visible scars quickly and effectively. I will discuss your initial reasons for wanting a breast lift and all the options available to you, and thereafter, will take care to ensure that you are satisfied with your new breast shape and scar treatment.

 

BROW LIFT SURGERY

Over time, frequent facial movements related to facial expressions can lead to a variety of lines and wrinkles in the skin. This is particularly true in the brow area where frown lines and forehead furrows may develop above the nose and across the middle of the forehead.

The brow lift, also known as a forehead lift, is a surgical procedure, which can eliminate lines and furrows in the brow and forehead area. At the same time, the eyebrows may be restored to a more elevated and youthful position and excess skin of the upper eyelids can be eliminated.

The result after a brow lift is a smoother forehead, lifted eyebrows, and an overall more youthful and refreshed appearance to the brow area.

Brow Lift surgery can improve a tired, angry or sad appearance that is often associated with an aged forehead. Specifically, the brow lift can correct the following:

• Frown lines
• Forehead furrows
• Forehead creases
• Drooping eyebrows
• Hooding over the eyes

The best candidates for a brow lift are looking to improve aging in the brow and forehead area, are in generally good health, and have realistic expectations.

Other complimentary treatments including Botox®, Fillers and Restylane® Vital. These non-surgical options are available as non-permanent solutions to the position of your brow & forehead lines.

 

FACELIFT

At my practice, Facelifts are nearly as popular as Breast Augmentations, and I often combine Facelift surgery with other procedures.

Can’t I have Botox and fillers instead of a Facelift?
Although signs of aging eventually appear in all areas of the face, for many people the mid to lower face and neck tend to fare the worst. As skin and tissue lose elasticity, gravity begins to pull them downward.

This is the single most common reason for Facelift Surgery. These areas unfortunately cannot be treated appropriately with Botox and Fillers.

Having a surgical facelift will tighten and reposition sagging skin, wrinkled skin, and loose muscles to leave you looking younger and refreshed. The perfect procedure to boost your confidence in the long term and to start the year feeling fantastic!

The best candidate for a facelift is a physically healthy man or woman who is realistic about their expectations, and interested in improving sagging facial skin, jowls, and loose neck skin.

 

BUTTOCKS  AND THIGH LIFTS

Now onto the lower body lifts! The lower body lift is performed for patients that desire improvement of the thighs and buttocks, and it is more common in patients after excessive weight loss.

Unwanted excess tissue of the inner and outer thighs can be treated by direct excision of loose skin and subcutaneous fat to improve the contour.

Lateral thigh lift and buttock lift are types of body contouring that remove excess skin and fatty tissue from the outer thigh and buttock regions. Artistic and anatomical removal of this tissue can result in an improved appearance and silhouette.

I always like to emphasize that these procedures are not a cure for obesity, and is most appropriate for persons with localized excess skin and fat bulges that are inherited, or remain despite weight reduction and exercise. And unfortunately thigh and buttock lifts are not a cure for cellulite or stretch marks.

 

ARM LIFT

Arm Lift will be my last topic of the month. Arm Lift is a technique to remove excess hanging skin from the upper arms usually after substantial weight loss.

I perform arm lift surgery at my practice to remove the excess skin from the upper arms and reduce the circumference of the upper arms.

There are multiple ways to sculpt the arm, including Liposuction, Minimal Access Brachioplasty (axillary scar and liposuction) and Traditional Brachioplasty.

The best candidates for Arm Lift are people with sagging skin of the upper arms. You should be physically healthy, psychologically stable, and realistic in your expectations. Arm Lift will improve your arm contours and remove “Bingo Arms”.

Please remember to subscribe,

kind regards,

DR CHARLES SERRURIER MARCH 2013 NEWSLETTER -BREAST LIFT-

BREAST LIFT  

This month in my newsletter I will be talking about Breast Lift. It is a common procedure at my practice so I thought I would give you a better understanding of this procedure: What it does, the techniques I use and what the recovery is like. Of course, if you are interested and would like to book an appointment with me to find out more about breast lift or any other procedure, feel free to phone on 011 875 1630

Also, remember to visit and to “Like” my Facebook page regularly for even more facts about the procedures I perform!

And for more info on all the procedures I perform visit my website: www.drserrurier.co.za

What can breast lift do for you?

After pregnancy, weight loss, breastfeeding or the mere process of ageing, the breasts tend to lose volume and droop, the skin surrounding the breasts stretches and the breasts lose their shape. This is completely normal. Sagging (ptosis) causes breasts to get a flattened and elongated shape as well as the nipple/areola to point downward.

Through breast lift surgery – I can tighten the skin, improve the shape and firmness of your breasts and restore their proper position on the chest. If need be, I can also reduce the size of the areola and give your nipples a more youthful and pleasing position. Breast lift alone will not add any volume but if we feel it would be beneficial, I can insert an implant at the same time. The procedure will then be called: augmentation mastopexy.

Together during the first consultation we will discuss your wishes, I will examine your breasts while taking into account many factors such as the degree of sagging, your skin elasticity, your nipples’ position but also your breasts’ volume and symmetry.

Some of my patients wish to have an implant inserted as well as the breasts lifted in order to add some lost volume. It is up to you and we will discuss this option together.

My Breast Lift techniques

Regarding the technique I will use, it all depends on your breasts’ characteristics but also your desired outcome. The incisions vary according to various factors such as the amount of lifting but also the nipple repositioning, the elasticity of your skin and other factors that we will discuss together.

→Some of my breast lift patients have small breasts that do not show much sagging. This is when I choose to go for short-scar surgery, like the ‘doughnut’ or peri-areolar mastopexy where the incisions are circular, around the areola.

→When there is severe breast ptosis and a very large degree of lifting is required, I opt for a very common technique involving three incisions in the shape of an anchor.

This is the classical breast lift incision that goes around the areola with a vertical and a limited horizontal incision in the crease beneath the breast.

Your recovery

It roughly takes me 2 to 3 hours to complete breast lift surgery. After your surgery, you will wear a surgical bra over a small gauze bandage. A few days post op I will remove the gauze but you will still need the support from a post-surgical bra for a few weeks.

This non-wired support will assist with healing and the final result.

I usually advise my patients to take one to two weeks off work off after the surgery in order to allow for an optimal recovery. You will be sore and I recommend no heavy lifting or exercise for 6 weeks post op – this is just to ensure a satisfactory result.

The breasts reach their final shape and feel approximately three months after breast lift. But you need to know that aging and gravity that cause sagging can unfortunately not be avoided. It is a natural process that it part of ageing. For most of my patients, a breast lift is however a one-time procedure; but if another lift is necessary, the same incisions can usually be used.

Dr Charles Serrurier

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                              

Suite A9,
Life Fourways Hospital

Cedar Road & Cedar Avenue West

Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631

FACEBOOK – Dr Charles Serrurier

BLOG – drcharlesserrurier.wordpress.com

WEBSITE – http://www.drserrurier.co.za

 

APRIL 2012 NEWSLETTER – Autologous Breast Reconstruction

Breast Reconstruction

For the month of April I want to revisit Breast Reconstruction but with a focus on Autologous Tissue Reconstruction.
Avoiding using an implant in breast reconstruction eliminates many possible extra complications associated with foreign bodies. Autologous reconstruction suits specific patients and is used specifically in certain circumstances e.g: radiation

“To undergo Breast Reconstruction is entirely your choice”

This newsletter will hopefully give you some insight into your options, what you can expect and also how to hasten your recovery.

 I hope you enjoy.

Dr Charles Serrurier

What is the process when undergoing breast reconstruction surgery?

If you choose to undergo Breast Reconstruction, we will discuss your individual case in detail to decide what is the best option for you.

In some cases autologous breast reconstruction is recommended. This allows further treatment post reconstruction and reduces risks associated with implants. The surgery is unfortunately long and can last anyting between 3 and 5 hours under general anaestethic.

The recovery time is also long due to the donor site sensitivity and breast sensitivity. Once recovered at approximately 6 months we will bring you back into theatre to reconstruct the nipple area too.

What donor sites can be used for autologous breast reconstruction?

There are traditionally three donor site options:

Each has it pro’s and con’s but each will have specific reference to your case and reconstruction.

1. DIEP Flap – abdominal tissue is used in the reconstruction. This process is however complicated due to the necessity to perform a free tissue transplant (free flap). This means microsurgery is involved and there is risk that the flap will not survive.
2. TRAM Flap – this is similar to the DIEP Flap but this time a small portion of the abdominal muscle is also used. There are free flap options but surgeons using this technique will nearly always attempt to use a pedicle (maintain permanent blood flow to the tissue) This method allows a very natural looking and feeling breast but again there is a significant risk of flap morbidity.
3. LATISSIMUS Flap – probably the most popular autologous reconstruction option. This method uses your Latisimus muscle in your back for reconstruction. This is quick surgery with good cosmetic outcome. The additional benefit is that there is permanent blood flow and flap survival rates are extremely high. The Latissimus is considered world choice of breast reconstruction.

Definition of Autologous Breast Reconstruction:

Autologous reconstruction refers to plastic surgery that uses your own tissue to replace tissue that was lost to an injury or surgery. You are both the donor and the recipient of relocated tissue during autologous reconstruction. In breast reconstruction this means using your own tissue to reconstruct your breasts following mastectomy.

Post reconstruction recovery

Hospital stay

You will be required to remain in hospital for a number of days post surgery. You will have drains inserted and the fluid drainage will need to be monitored closely. Pain can also be dealt with immediately during your hospital stay.

At home

You will be required to take it easy for 3 or 4 weeks – this means no work, and no heavy lifting. Someone should also help you with your driving during this time.

Remember that no bathing is allowed until the drains are removed. Showering is ok, but bathing can lead to infection complications.

It is also very important to keep your follow up appointments – these are to change dressings, remove drains and generally follow up on your recovery.

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                             

Suite A9,
Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631