Breast Cancer Awareness Month: Dr. Christine Petti on Breast Cancer and Mastectomy Reconstruction
WARNING: THIS POST CONTAINS GRAPHIC IMAGES
In honor of National Breast Cancer Awareness Month, Dr. Christine Petti details everything a woman should know about her breasts and what actually happens if you have surgery
Christine Petti, M.D., is a board-certified plastic surgeon with a private practice in the South Bay and Los Angeles area since 1988. She specializes in aesthetic plastic surgery, aesthetic laser surgery and non-invasive surgical cosmetic rejuvenation procedures and as the rare woman in a male-dominated filed, she offers a distinctive female perspective to cosmetic surgical procedures. She pioneered the concept 25 years ago of combining a plastic surgery practice with an on-site, full-service medical day spa, Spa Bella, which she serves as Medical Director.
Here she walks us through everything a woman should know and details the process of mastectomy reconstruction.
The photos provided in this post are from a patient of Dr. Christine Petti’s who recently underwent the surgery.
Before the reconstruction surgery
CelebZter: Does breast size matter when it comes to breast cancer?
Dr. Christine Petti: Breast cancer can occur in small and large breasts and does not seem to have any relation to size of the breast. There are many factors that can affect breast cancer, but breast size is not one of those factors.
CelebZter: What does a “lump” feel like?
Dr. Christine Petti: Breast lumps can vary in how they feel, and be very mysterious at times. In many instances, a breast lump that is cancer is most likely hard or firm to touch, irregular and poorly defined borders, is non-tender and usually does not change in any manner with the menstrual cycle.
CelebZter: How often have you discovered breast cancer in a woman who was coming in for breast surgery and didn’t know she had cancer?
Dr. Christine Petti: I have had many cases in my career in which I have incidentally discovered a lump in a patient’s breast who came in to see me in consultation solely to discuss breast augmentation. I have also been responsible for the diagnosis of a woman who came to see me for a facelift, when I insisted that she get a mammogram, after I reviewed her health history and saw she checked off that she had never had a mammogram. I said I would not do her facelift until she got a mammogram. Her mammogram had an early breast cancer and she called me crying, and thanking me for helping save her life!
After the initial surgery
CelebZter: What are some of the challenges working with a woman who has had a mastectomy?
Dr. Christine Petti: There are many challenges working with a woman who has had a mastectomy. A woman who has undergone a mastectomy has had an amputation—she has been not only stripped of a body part, but most importantly, she has been stripped of the very anatomy that identifies her personally and to those around her, as a woman. This has devastating consequences on the body and the mind. She has to stuff her bra each time she dresses to look “normal” and “feminine”. She is lopsided, having one of two “twin” body parts that are supposed to match. She is empty on one side and full on the other. She has a flat chest and a large scar to remind her every moment of her day, that she is less than “whole” and “half” a woman. The psychological consequences can be overwhelming— affecting her body image, confidence, and may interfere with her intimate social relationships and behavior. I have known many women over my own career, who have lost their husbands and/or significant others after a diagnosis and battle with breast cancer and mastectomy.
It is these very real health issues that woman who have had a mastectomy face, that inspired me to become a plastic surgeon many years ago when I worked on a special surgical rotation with an oncological surgeon who did many mastectomies, but was working on surgical techniques at that time in the 1980?s for means of “breast conservation/preservation”. I also wanted to be a reconstruction breast surgeon, so that I could ensure that any woman who chose to have a mastectomy would also have the option of “waking up with a breast”, rather than an empty and painful “hole” in their chest. I wanted to be on the restoration side of breast cancer surgery, rather than the amputation side.
The surgery is almost complete
CelebZter: When a woman has a mastectomy, does she lose sensation in her breast/nipple?
Dr. Christine Petti: If the mastectomy is complete, that is removes the entire breast with the nipple and areola, then there is permanent loss of sensation with removal of the entire breast. If the mastectomy is partial, the nipple and areolar tissue are maintained, it may be possible to preserve some sensation to the breast. The amount of sensation and the preservation of erotic sensation may vary, depending on the actual location of the breast cancer and the amount of tissue that may need to be removed to attempt an adequate surgical margin to help to cure the woman of the cancer at the primary site in the breast itself. All attempts can be made with modern surgical techniques to remove the cancer with adequate surgical margins, while trying to preserve blood supply and nerve supply to the nipple and areola.
CelebZter: Is there a bigger chance of the cancer returning if the breast is reconstructed?
Dr. Christine Petti: No, to date, there is no scientific evidence that a reconstructed breast makes breasts cancer recur or interferes with early detection of a breast cancer recurrence at the original site.
The operation is complete
CelebZter: Do you use fat transfer or implants? Which is better in this instance?
Dr. Christine Petti: As an experienced and contemporary breast surgeon, I use breast implants to reconstruct breasts after breast cancer. Fat transfer is not generally accepted and there are controversies with the techniques of fat transfer to the breast, since many cancers are detected early by fine micro-calcifications of the breast. Fat transfer can cause calcifications of the breast tissue, so it is not recommended as a first line of breast reconstruction and is not widely accepted in this country at this time.
To find out more about Dr. Christine Petti, please visit her website here.
