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Every woman who has had or will have a mastectomy for breast cancer should be offered the opportunity to consult with a plastic and reconstructive surgeon. We help navigate reconstruction of the absent or distorted breast as well as the opposite breast to achieve symmetry.

When a woman’s cancer necessitates axillary lymph node dissection, we can perform a surgery called LYMPHA (Lymphatic Microsurgical Preventive Healing Approach) to reduce the risk of lymphedema. The goal of this surgery is to significantly improve the long-term quality of life in breast cancer patients. Our goal as plastic and reconstructive surgeons is to minimize the psychosocial and physical effects suffered by breast cancer survivors.

While plastic surgery is not considered a part of cancer treatment, we are a part of the breast cancer team because, for many women, it is an essential step in recovering from poor body image, diminished sexual well-being, anxiety and other concerns. Although not always possible, breast reconstruction immediately following mastectomy can almost completely avoid the negative psychological impact of mastectomy on our patients.

Each woman has unique reconstructive surgery goals — some women want enough symmetry to look good while clothed and others want to look good nude. Some women choose to go flat and later notice issues with balance, posture, neck or back pain and choose delayed reconstruction for one or more of those reasons. Fitting a bra can be difficult and some choose reconstruction for that reason.

In October 1998, federal legislation was signed into law requiring insurance companies to cover all stages of breast reconstruction following a diagnosis of breast cancer. The law encompasses treatment of the diseased breast’s reconstruction and any procedure necessary on the opposite breast to restore symmetry. Included also is the treatment of complications such as lymphedema and devices such as breast implants. The legislation also covers previously treated breast cancer survivors, so if a woman was treated five or 10 years ago and now wants her breast reconstructed and her opposite side lifted or reduced to match the reconstructed breast, we can do that. It’s never too late. We continue to struggle for coverage for the LYMPHA procedure, but are willing to advocate for our patients.

Whatever women choose, there are many resources and support groups available to guide them. Plastic surgeons specialize in breast reconstruction but also assist our patients in deciding which route would best suit them — whether it be implants, autologous reconstruction (using one’s own excess tissue), breast reduction with lumpectomy or no reconstruction at all. We will help patients navigate with a wealth of information from credible sources and support groups to find their fit.

As a plastic surgeon, I have the unique privilege of getting to know my patients during a really difficult time in their life. I aim to uplift them and smooth their path to normalcy so they can move on from their diagnosis and enjoy their life beyond cancer.

Dr. Kate A. Impastato is a plastic and reconstructive surgeon with Marshall Health and an assistant professor of surgery at the Marshall University Joan C. Edwards School of Medicine.

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