Does Immediate Breast Reconstruction Delay Chemotherapy?

Many patients think or are told they cannot have immediate breast reconstruction (reconstruction at the same time as mastectomy) because it will significantly delay chemotherapy. In reality, breast reconstruction very rarely interferes with chemotherapy.

Patients that have immediate reconstruction and need chemotherapy can start their treatments once they have healed from their surgery. This usually takes about 4 weeks. The healing time required before chemotherapy is about the same whether patients have mastectomy alone or mastectomy and reconstruction.

A small percentage of patients develop wound healing problems after their cancer surgery and may need slightly longer to heal completely. Even in these situations, studies have shown there is typically no delay in starting chemotherapy. Patients must also realize that wound healing problems can also happen after mastectomy alone.

In addition to the psycho-social benefits, immediate breast reconstruction is associated with less scarring and better cosmetic results. Patients that have delayed breast reconstruction, ie reconstruction some time after the mastectomy, complete all their breast cancer treatment before proceeding with reconstruction.

I hope this info helps.

Dr C

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Dr Chrysopoulo is a board certified plastic surgeon and microsurgeon in San Antonio, TX specializing in state-of-the-art reconstructive breast surgery. He and his partners at PRMA are in-network for most major US insurance plans. Patients are welcomed from across and outside the US. Please call (800) 692-5565 or email patientadvocate@PRMAplasticsurgery.com to learn more about your breast reconstruction options. Connect with other breast cancer patients on Facebook.

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Improve How Your Scars Heal

Wounds need a lot of energy to heal well. Since energy can only come from food, it is vital to eat healthily especially before and after surgery, or after an injury. Crucial nutrients for wound healing include protein, zinc and the vitamins A and C.

So what are the best things to eat? Meats, nuts, beans and dairy products are great sources of protein. Yogurt, green peas, beef, oysters, black beans and crab are great sources of zinc. Carrots, tomatoes, sweet potatoes, spinach and apricots are great sources of vitamin A. Citrus fruits and green leafy vegetables are great sources of Vitamin C.

Unfortunately, the body does not divert enough vitamin C to the skin. Using a topical scar treatment containing a stable form of vitamin C will increase the amount of vitamin C reaching the skin.

Good hydration is also crucial so it is important to drink enough water. Dehydration causes the skin and soft tissues to lose moisture and become dry. Dry wounds do not heal well. A good goal is to drink eight (8 oz) glasses of water a day. Avoid caffeinated products because caffeine can cause dehydration. Scar treatments containing dimethicone silicone also help boost hydration by trapping moisture. This improves scar healing.

Smoking can also really affect healing. The nicotine in cigarette smoke causes blood vessels to shrink, so tissues do not receive enough of the nutrients and oxygen required for healing. At best, this can cause the wound healing process to take much longer. At worst, smoking can cause wounds to breakdown and open up. These “problem” wounds typically eventually heal but leave the worst scars. Unfortunately, many smoking-cessation products will also increase the risk of healing problems because of the nicotine they contain!

Cigarette smoke also contains carbon monoxide. This combines with blood cells preventing them from carrying oxygen. This lowers the level of oxygen in the blood. Since oxygen is vital for healing, it is crucial to stop smoking to decrease the risk of healing complications.

Another great thing to do is exercise. Regular aerobic exercise improves healing and boosts the immune system. Start with walking and progressively build up to more of a sweat (but don’t forget to get the “all-clear” from your doctor if you are recovering from surgery).

Dr C


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PRMA Plastic Surgery specializes in advanced breast reconstruction procedures that use the patient's own tissue. Procedures offered include the DIEP flap, SIEA flap, GAP flap, and TUG flap reconstruction. We are In-Network for most US insurance plans. Patients are routinely welcomed from across and outside the USA. Connect with other breast cancer reconstruction patients at www.facebook.com/PRMAplasticsurgery.

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5 Tips To Boost Healing After Surgery

Surgery is stressful enough without having to deal with wound healing complications afterwards. Maximize your chances of healing well by following these 5 tips:

1. Increase pro-healing nutrients in your diet:
Wounds need a lot of energy to heal well. Since energy can only come from food, it is vital that patients eat as healthily as possible especially before and after surgery. Crucial nutrients for wound healing include protein, zinc and vitamins A and C.

So what are the best things to eat? Meats, nuts, beans and dairy products are great sources of protein. Carrots, tomatoes, sweet potatoes, spinach and apricots are great sources of vitamin A. Citrus fruits and green leafy vegetables are great sources of Vitamin C. Yogurt, green peas, beef, oysters, black beans and crab are great sources of zinc.

2. Drink plenty of water:
Patients must also stay well hydrated before and after surgery by drinking plenty of water. Moisture is needed for normal wound healing. Dehydration causes the skin and soft tissues to lose moisture and this in turn can delay healing.

3. If possible get to a healthier weight:
The importance of healthy nutrition is really emphasized by the link between obesity (Body Mass Index [BMI] over 30) and complication rates after surgery. Obese patients have much higher rates of infection, wound healing problems (breakdown of wounds), hematomas (blood collections), and seromas (fluid collections) compared to non-obese patients.

Obese patients also have a thicker subcutaneous adipose layer with a poorer blood supply. Blood flow to the healing tissues is therefore less robust and the amount of vital nutrients and oxygen reaching these tissues are far less than in non-obese patients. This poor blood flow compounds the negative effects of poor nutrition. If possible, losing weight before surgery will only decrease the risk of complications.

4. Stop smoking:
Smoking can also really impact healing. The nicotine in cigarette smoke causes blood vessels to shrink, so again tissues do not receive enough of the nutrients and oxygen required for healing. At best, this can cause the wound healing process to take much longer. At worst, smoking can cause wounds to breakdown. Unfortunately, many smoking-cessation products will also increase the risk of healing problems because of the nicotine they contain!

Cigarette smoke also contains carbon monoxide. This combines with your blood cells preventing them from carrying oxygen and effectively lowering the level of oxygen in the blood. Since oxygen is vital for healing, it is crucial to quit smoking before and after surgery to decrease the risk of healing complications.

5. Exercise:
Another good thing to do?... Exercise. Regular aerobic exercise improves healing after surgery and boosts the immune system. Start with walking and progressively build up to more of a sweat once given the "all-clear" by your surgeon.

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Dr Chrysopoulo is a board certified plastic surgeon and microsurgeon specializing in breast cancer reconstruction. He is in-network for most major US insurance plans and routinely treats patients traveling from across the US for breast reconstruction. To schedule a consultation please call (800) 692-5565 or email patientadvocate@PRMAplasticsurgery.com. Connect with Dr C on Twitter and Facebook.

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