SPAIR and Reconstructive Surgery Breakthroughs In Breast Surgery: Two Women Share Their Stories
When Diane Wojtasinski walked out of a plastic surgeon’s office following a consultation for breast reconstruction, she was in tears.
“He made me feel like I shouldn’t want reconstructive surgery, like it was a stupid thing for a woman to want,” said Wojtasinski, who had just completed her fourth cycle of chemotherapy after having a mastectomy.
So Wojtasinski decided to hold off. She’d also gone to work for the oncologist who treated her, and she saw a lot of “horrible reconstructive surgeries” on other patients, which made her not want breast reconstruction even more.
But when her daughter invited her to visit in the Virgin Islands, the now 59-year-old cancer survivor from Saginaw, Mich. Couldn’t find a bathing suit that fit properly.
Then her cousin recommended she meet a friend, a plastic surgeon in Grand Rapids. She agreed and made the trip and met with Dr. Dennis Hammond, plastic surgeon and owner of the Center for Breast and Body Contouring.
“I was so impressed,” said Wojtasinski. “He showed my husband and me before and after pictures, explained everything he was going to do, and made us feel very comfortable.” It had been 10 years since her mastectomy, and she decided she was now ready for reconstructive surgery.
Advances in Breast Reconstruction
6,000 B.C. Fast forward to the 19th century, to the radical mastectomy, a disfiguring operation in which the breast cancer patient lost their tissue, lymph nodes and muscle.
Then, in the 20th century, breast cancer surgeons modified the radical mastectomy and also performed lumpectomy (removal of the lump), along with radiation.
Still, in the case of a complete mastectomy, disfigurement and scarring were guaranteed.
But times have changed.
“The whole treatment team – general surgeon, oncologist, radiation therapist and plastic surgeon – is coordinating treatment better than ever. As a result, the patient gets better results… in many incidents, we can make the patient look better than before (mastectomy),” said Dr. Hammond.
Another area of breast surgery – breast reduction – was traditionally performed with a long incision which ran along the underside of the breast from the lateral chest wall over to the mid-portion of the sternum. An additional incision ran up the center of the breast and around the nipple and areola. While this operation successfully reduced the size of the breast, it often was associated with unsightly scarring, particularly in the inner and outer portions of the scar under the breast. The shape, which was created at the time of surgery, was often lost as the breast settled, creating what is referred to as a “bottomed out” appearance.
In 1996, Dr. Hammond developed the SPAIR technique (short scar periareolar-inferior pedicle reduction mammaplasty), a form of breast reduction surgery that produces about 50 percent less scarring and allows the breast to be reshaped in a manner which maintains the natural soft curves. The results are long-lasting, with less scarring, and a faster recovery with fewer complications, according Hammond.
The SPAIR technique can also be applied to reconstruction after mastectomy and to repair scarring from previous surgery. In Wojtasinski’s case, SPAIR was used to rebuild the missing breast, matching it with the other breast, which went through reduction. Her procedure was also what’s called a Tram Flap, which uses tissue from the patient’s own abdomen, including skin, muscle and connective tissues (and, therefore, provides the patient with an abdominoplasty or “tummy tuck”).
SPAIR and Breast Reduction
Ellen Sherman, 49, of Grand Rapids, Mich. Is 5’2”.
Before her breast reduction, she weighed 145 pounds and suffered from back problems caused by her breast size, a 38DDD.
“They were too big and too heavy,” said Sherman, a principal oboe player with the Grand Rapids Symphony.
Breast reduction was something she’d considered for years, but it wasn’t until she saw a photo of herself that she realized how “out of proportion” her breast size was to her body and decided it was time to do something about it.
Sherman ran into one glitch: Her insurance company wouldn’t approve it.
“They (insurance) made it anything but easy,” said Sherman. In fact, she had to cancel her surgery just two days before it was scheduled because insurance had not approved it. Then, a patient advocate provided by her employer helped her work with her insurance company to get the go-ahead for the surgery by her insurance company. The surgery took place just days after the first cancellation.
So in December 2008, Sherman had her breast reduction surgery, performed by Dr. Hammond.
“I went from a 38DDD to a 34DDD,” said Sherman.
Sherman says she’s always been active, but now feels like activities such as swimming and exercising at the gym come easier.
Sherman said she did question her decision regarding a breast reduction. “Did I really want to alter what I had been given?” But after a “few moments” she knew she was ready.
Perhaps what’s even more surprising is that she experienced no pain and has minimal scarring. Typical recovery time is two to six weeks, depending on the patient and the extent of the surgery.
In contrast, Wojtasinski said her recovery was “pretty tough.” About one week after surgery, she noticed a gradual feeling of getting back to normal. She took about six weeks off from work to heal and had decided not to do the final step – a tattooed nipple – until later.
The Finishing Touch
Nicole Neumann, a tattoo artist, medical assistant and electrologist, works with Dr. Hammond’s patients to give them the final touch to their breast reconstruction: a tattooed areola and nipple.
“It’s part of the recovery process,” said Neumann, who covers the scar with a natural-looking nipple tattoo. So convincing is her work, patients interviewed for this story say others (i.e., spouses) are hard-pressed to tell the tattooed nipple from the real one.
The tattooing process includes implanting color into the derma layer of the breast where tissue has already been formed to look like a nipple. Little or no pain is involved, said Neumann, but local anesthesia is available to patients who request it.
New Wardrobes
Sherman now gets fitted for good-fitting bra, preferring European sizing to American. Wojtasinski now looks forward to shopping, trading her loose-fitting clothing for more form-fitting designs.
“My daughter is getting married and I chose a dress that I would never have chosen before,” added Wojtasinski.
“A V-neck with a little cleavage.”
Dr. Hammond is the world-renowned inventor of SPAIR technique for minimizing scarring of the breast incision. For more information about SPAIR, visit http://www.dennishammond.com/SPAIR-information.php