This week, nip/tuck got it right! My work is done…

Seriously, they got it right. No, I’m not talking about plastic surgeons like Dr. Troy having sex with their co-workers at the office; no, I’m not talking about plastic surgeons like Dr. Troy advising teenagers on the rules of three-way sex; and, no, I’m not talking about plastic surgeons like Dr. Troy finally coming to the realization that they have to get their life back on track and stop sleeping with their patients. No, I’m talking about patient, Megan O’Hara. She said, “You don’t cure an internal problem with an external fix.” She’s right, in this, an episode I’m going to call…

For All the Right Reasons.

Megan O’Hara was diagnosed with breast cancer. She beat it. To thank her husband for sticking with her through the radiation and chemotherapy treatments (and the infertility resulting from the chemo), as well as the double mastectomy, she decided to seek a consultation at McNamara/Troy regarding breast reconstruction and C-sized breast implants. “Thank you, honey, for giving me the strength to beat cancer.” Husband: “No, thank you!” Seriously… this is a serious subject.

According to the American Cancer Society (ACS), over 178,000 will be diagnosed with breast cancer in 2007, making it the most prevalent cancer in women. Of these women, it is estimated that almost 41,000 will not survive. So, with the exception of her husband, Mrs. O’Hara is one of the lucky ones. Of course, she’s just a character. In real life, real women have to contend with real breast cancer and what to do if they’re one of the lucky ones. According to statistics from the American Society of Plastic Surgeons (ASPS), 5.3 million reconstructions were performed by plastic surgeons in 2006. Of these, over 56,000 were breast reconstruction procedures.

Breast reconstruction can be performed to recreate natural looking breasts in patients that have had a mastectomy. Obviously, the surgery’s complex. For the surgeon, it’s technically complex and for the patient, it’s psychologically so. For instance, many women find it difficult to contend with a cancer diagnosis and subsequent treatment, while at the same time, attempting to decide whether or not to elect breast reconstruction surgery (note: although it can be performed later, having the surgery together with a mastectomy historically produces optimal results). Should a woman elect breast reconstruction, her plastic surgeon has four treatment options, depending upon factors such as the patient’s age, overall health, anatomy and, of course, her goals:

• breast implants
• TRAM flap: breast is reconstructed using fat, skin and muscle harvested from the patient’s abdomen
• DIEP flap: like TRAM, but only utilizes skin and fat
• LD flap: breast is reconstructed using skin and muscle harvested from the patient’s back

Regardless of the treatment option, breast reconstruction is absolutely not associated with a recurrence of breast cancer. And, should the disease recur, the reconstructed breast does not interfere in anyway with either radiation or chemo treatments. So, what did McNamara/Troy’s patient decide?

In the end, Mrs. O’Hara made an important decision (and a wise one at that) – she left her husband and opted against the C-sized breast implants. The fact is that although breast reconstruction can give a patient back what most consider a woman’s most feminine features, breasts don’t make a woman a woman (and neither does a husband, especially one who needs to be rewarded for sticking with his wife during an extremely difficult time). Which somehow brings us full circle, back to Dr. Troy.

Dr. Troy suggested in this episode that the practice advertise, using the slogan, “You know you can look better.” Obviously, each and every one of us can look better, and plastic surgery can and indeed helps millions of men and women every year to do just that. In fact, you can hear from some real patients about how plastic surgery helped them in these plastic surgery videos. But, when it comes to when or why you elect plastic surgery, only one reason really matters – yours.

See you next time.

Charlie Sheridan

Medical Editor and Consultant