Breast Reconstruction Specialist & Plastic Surgeon Dr. Constance M. Chen Provides Tips for a Comfortable Recovery

Dr.-Constance-M-Chen

While planning for breast reconstruction surgery, many women wonder about what they should wear during the recovery period. In the first weeks home, you may want to avoid tight-fitting, restrictive clothing and anything that requires you to lift your arms over your head. Clothes should be loose and comfortable and they should slip on easily and close in the front with zippers or buttons.

After surgery, both physical and emotional factors determine how well and quickly a woman will heal. Small things, like being able to get in and out of clothes easily, can ease recovery. Also, women should know in advance that they may leave the hospital with surgical drains in place and they will need to know how to manage the drains and accommodate them in their clothing as they resume daily activities. Knowledge and some planning can pave the way to a smooth recovery.

Dr. Constance M. Chen

“One or more surgical drains are usually required following mastectomy and reconstructive surgery”, says Dr. Chen. “The body doesn’t like empty spaces and will fill any area that has a potential space with fluid, which prevents the tissues from healing if not drained”. The drain is a flexible tube that connects from the surgical wound to a plastic bulb that collects the fluid, which is then periodically measured and emptied. Most people will keep the bulbs hanging on attachments on their surgical bra. Usually, patients go home with drains in place, and they are removed later in the doctor’s office. Your nurse or doctor will instruct you on how to manage the drains at home but it will take a little practice to learn the best way to keep the tubes and bulbs secure and discreet. If you want to Heal With Style, specialty companies such as Eileen + Eva make elegant postsurgical garments such as cardigans, wraps, and shawls with pockets for drains.

One item that many women find useful is a post-surgical camisole, which is a specially designed sleeveless tank top that provides needed support and may come in stylish colors and with lace trim. These garments are made of soft, stretchy, lightweight fabric and sometimes come with pockets that securely hold surgical drains in place and that can be detached after drains are removed. Some camisoles can be pulled up over the hips to avoid movement of the arms and shoulders. The needs of women who have had different types of breast cancer surgery differ. Lumpectomy, unilateral or bilateral mastectomy, breast reconstruction with implants or their own tissue, all leave women with unique requirements for recovery, particularly in choosing a bra. Nevertheless, they face the common challenge of finding comfortable and appropriate clothing.

Depending on what kind of surgery you had, your surgeon will talk to you about whether and when to wear a bra and what to look for, but there are overall guidelines for post-surgical bras.

Dr. Constance M. Chen

Some patients may be advised to wear a specialized bra that has attachments for drains for several weeks after surgery. When ready for a regular bra post-surgery, you can ensure your comfort by following these suggestions: Look for a bra made of soft, breathable fabric that is seamless or has flat seams to avoid irritation. Avoid underwire bras – especially while healing. Wide bands under the breasts ensure that the bra will stay in place and not dig into sensitive skin. A front-closing bra is a good idea, as you may have trouble reaching hooks in the back or pulling a bra over your head. The bra should not be so tight that it leaves marks when taken off.

Many cities and towns have boutiques that specialize in clothing and other items likes wigs and prostheses for breast cancer patients. Staff in these stores are often survivors themselves or are specially trained in fitting and working with women undergoing breast cancer treatment. What to wear may seem like an unimportant concern for a woman before surgery, but it can be helpful to plan for comfort after surgery and to think about what is important in terms of appearance and sense of self.

When it’s time to think about getting dressed, the clothes in your closet may not all work. Not only is your body different than it was before surgery but it will continue to change for some time. Whether you choose clothes designed for post-surgical wear or are able to find items in your own wardrobe or in regular shops that work for you, remember that the way you present yourself to the world is an important part of who your are and part of the process of putting cancer behind you.

 

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives. Come into the beautiful world of Dr. Constance M. Chen.

 

 

 

 

Managing the Emotional Aspects of Breast Reconstruction

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More than 268,000 new cases of breast cancer were diagnosed in 2018 in the US, according to estimates by the American Cancer Society. Many of these breast cancer patients need to decide whether or not to undergo mastectomy and breast reconstruction. A breast cancer diagnosis is difficult, and coping with decisions about surgical treatment and its aftermath adds an extra layer of complexity to the diagnosis. Fortunately, many tactics and resources can help manage the emotional aspects of mastectomy and breast reconstruction.

It’s physically and emotionally taxing to adapt to the changes in your body and your life after breast cancer. It’s abundantly clear why breast cancer patients would need effective tools to manage the emotional aspects of this tumultuous journey.

Dr. Constance M. Chen

Reconstruction can offer sense of control. Often, one of the ironies of dealing with a breast cancer diagnosis is the need to decide whether to undergo mastectomy, and if so, whether, when and how to have breast reconstruction. There are two main types of breast reconstruction – either using implants or a patient’s own tissue to create new breasts – but sometimes, part of the emotional burden of breast cancer is the choice itself.

According to 2014 research in the Journal of the American College of Surgeons, fewer than 40% of women who undergo mastectomy choose to undergo immediate breast reconstruction. For many women, they are not offered breast reconstruction because it is not available where they live. For others, the advanced state of their disease may force them to conserve their energy on physical survival alone. While breast reconstruction after mastectomy can lengthen a woman’s initial hospital stay and recovery period, however, doing so can provide important emotional advantages.

“For many women, it’s very helpful to wake up from a mastectomy and look down to see that she still has breasts,” says Dr. Chen, who is also Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. “And even if a woman chooses to or is advised to wait for reconstruction surgery at a later date, being able to look forward to regaining a more natural and familiar body shape offers a sense of control, which can help calm her during an emotional time,” Dr. Chen adds. “Women who opt to forego reconstruction can also achieve a sense of normalcy by using a mastectomy bra with slots for breast forms. Either way, looking and feeling more like their pre-mastectomy selves can help a great deal emotionally”.

 

Tips to find support

It’s OK – in fact, it’s expected – that you may need emotional and social support during the period surrounding breast cancer treatment, especially for women who’ve undergone mastectomy and breast reconstruction. It’s normal to mourn the loss of your breast(s) due to mastectomy and to be worried about the breast reconstruction process. Here are some ways to seek support and insight:

  • Communicate: Open communication with your partner and your surgeon helps manage expectations and concerns.
  • Find a therapist: One-on-one therapy is often incredibly helpful for dealing with the tough emotions following a mastectomy, Dr. Chen says. “Therapists – especially those who often deal with cancer patients – can help women cope with feelings of a changing body, femininity, and any accompanying anxiety or depression.”
  • Check out support groups: “Breast cancer support groups at your local hospital, or even online, can connect you with others in your shoes,” she says. “For example, Young Survival Coalition (http://www.youngsurvival.org/) is targeted toward women under the age of 40 years who are diagnosed with breast cancer, and Facing Our Risk of Cancer Empowered (http://www.facingourrisk.org) is targeted toward people affected by hereditary breast and ovarian cancer. We even have our own group of patients, the Bosom Buddies (http://constancechenmd.com/bosom-buddies) who are committed to helping other patients in their breast reconstruction journey.”
  • Tap the American Cancer Society: If you’re feeling at loose ends about who can help you manage your emotions, call the ACS at 1-800-227-2345 to be connected with a group or resource that can work for you. https://www.breastcancer.org/

Breast cancer can feel very lonely, but you don’t have to deal with overwhelming feelings about mastectomy and reconstruction on your own, It’s important to know that you have support and that your family, friends, and health care providers are there to help.

Dr. Constance M. Chen

 

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives. Come into the beautiful world of Dr. Constance M. Chen.

 

 

 

 

Plastic Surgeon and Breast Reconstruction Specialist Dr. Constance Chen Provides Tips for Patients Traveling to Another City for Breast Reconstruction

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Women undergoing mastectomy must make decisions about breast reconstruction: whether, when, and how to have breast reconstruction and, crucially, who should perform the surgery. Often, women are referred to a plastic surgeon by their breast surgeon and assume that all of their options will be presented.

In reality both mastectomy and breast reconstruction have come a long way, and not all plastic surgeons are able to offer all reconstructive options. Cutting-edge innovations can be life-changing, but patients often have to do some extra research to educate themselves to find the right solution for their problems.

Breast reconstruction has made significant advances in recent years. When working with a mastectomy surgeon who is able to preserve the breast skin and nipples, a reconstructed breast can look and feel just like a normal breast and sometimes other doctors don’t realize that it is not the woman’s original breast. Surgical options to create a soft, warm, natural breast from the woman’s own tissue have improved to the point that new microsurgical techniques allow plastic surgeons to reconnect nerves and restore feeling to the breast. Sometimes, however, it takes some work to find highly specialized surgeons who have the skill set and commitment to achieve the best results. In some cases, women may need to travel away from home for a team who can provide them with adequate breast reconstruction options.

Dr. Constance Chen

Surgeons vary widely in their experience and in the operations they feel comfortable undertaking. Patients should understand a surgeon’s certifications and ask how often they have performed various procedures. Importantly, each woman should make sure that the recommended surgery is the best one for her and not simply the one preferred by the plastic surgeon that she happens to meet.

For example, newer procedures for autologous reconstruction (with the woman’s own tissue), such as the DIEP or PAP flap, require specialized microsurgical skills to reattach tiny blood vessels under an operating microscope. Plastic surgeons with advanced microsurgical training are not available everywhere. Furthermore, just because a surgeon can perform the technical operation does not mean that the final overall outcome is the same as someone with more finesse. Surgeons often have drastically different philosophies about the importance of the final medical and aesthetic outcome.

Beyond professional qualifications, patients must find a surgical team with which they feel most comfortable. Are questions welcomed and answered fully? Do you feel you can speak freely and have open and honest communications about your concerns? What kind of support will you get on administrative and financial matters? If the best team for you is far from home, what kind of assistance and support can you count on for travel arrangements and for managing follow-up care?

Dr. Constance Chen

Dr. Chen stresses that open communication with the surgical team is the most important factor in arranging for surgery far from home. She adds these tips for patients:
● Whether your plan is to have the mastectomy and immediate reconstruction in a single surgery or you are having reconstruction some time after the mastectomy, many of the issues regarding travel are similar.
● You will need accommodations in a hotel or short-term apartment rental that caters to and has special rates for surgical patients. Your surgeon’s office or hospital should be able to provide recommendations and help you estimate how long you will need to stay for follow-up care after your discharge form the hospital.
● Some cities have special facilities for patients such as the American Cancer Society’s Hope Lodge, which offers guest suites for patients and caregivers as well as communal kitchens and activity rooms. Hope Lodge has 30 locations in the United States, including New York City.
● Several charitable organizations including Corporate Air Network and Angel Flight provide free air travel for cancer patients. More information on charitable medically-related travel is available at patienttravel.org, a national referral service.
● You may need to coordinate local care in advance with a primary care physician or local surgeon for a pre-surgical exam and lab work as well as for post-operative follow-up care once you return home.

For a woman recovering from breast surgery, breast reconstruction is often a crucial aspect of the healing process, both physically and psychologically. For some women, traveling to achieve the best breast reconstruction option provides an enormous boost to her sense of self. Knowing that she has found the surgeon who is committed to her well-being puts her on the right road to recovery so that she can live a long and healthy life beyond cancer.

Dr. Constance Chen

 

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives. Come into the beautiful world of Dr. Constance M. Chen.

 

 

 

 

Breast Reconstruction: Understanding the Women’s Health and Cancer Rights Act

Dr.-Constance-M-Chen

A diagnosis of breast cancer profoundly impacts a woman’s life. In addition to coping with overwhelming emotions, she must make important choices about treatment and all of its implications. One of those is the financial ramifications of her illness, particularly if she will need surgical treatment of her breast. She will need to learn all she can about her insurance coverage. Will the breast surgeon, the anesthesiologist, the hospital, the lab be covered?

What about procedures on the healthy breast to ensure symmetry? And what if she elects to have breast reconstruction at a later date? Fortunately, all insurance companies in the United States are required to cover breast reconstruction if mastectomy – which includes partial mastectomy (i.e., lumpectomy) – is also covered, so any woman undergoing surgical treatment of her breasts should be aware of her rights.

In 1998, Congress passed the Women’s Health and Cancer Rights Act (WHCRA), a federal law that requires group health plans and individual health policies that cover mastectomy to also cover breast reconstruction in connection with mastectomy.

Before the passage of the WHCRA, insurers could refuse coverage for reconstruction on the grounds that these were cosmetic procedures and not medically necessary. Women had to pay for reconstruction themselves or forgo it. Patients, survivors, healthcare workers, and their supporters worked hard to ensure that a woman would be legally guaranteed the option of reconstructive surgery following mastectomy.

Dr. Constance M. Chen

The WHCRA has specific provisions for breast reconstruction in connection with mastectomy. Insurance benefits are required to include the following:
●    All stages of reconstruction of the breast on which the mastectomy or lumpectomy was performed;
●    Surgery and reconstruction of the other breast to achieve symmetry and balance;
●    Prostheses, if needed, and treatment of any complications of surgery, including lymphedema;
●    One home healthcare visit within 48 hours of hospital discharge;
●    Outpatient or inpatient care in a healthcare facility based on generally accepted criteria.

Under the WHCRA, women are legally entitled to the breast reconstruction method of their choice – even if the woman’s chosen plastic surgeon is outside the insurer’s network. And while it is important to remember that patients will be responsible for deductible and co-insurance payments as with any other care covered by their plans, it is also true that when insurance companies have denied claims or presented obstacles to coverage, challenging those decisions, up to the state’s attorney general if necessary, can be successful with skilled patient advocates who fight for you.

“The WHCRA is of enormous value to women,” says Dr. Chen. “It provides a crucial baseline benefit in helping women recover from breast cancer. The sponsors of the WHCRA in Congress understood that breast reconstruction was often pivotal for a woman’s physical and emotional well-being. In my practice, we work hard to ensure that women can focus their energies on getting well without the additional burden of financial pressure, so we do everything we can to relieve our patients of the anxiety and stress of managing the relationship with their insurers”.

 

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives.