Breast reconstruction surgery can take place either immediately following a mastectomy or immediately following the conclusion of radiation and chemotherapy. Dr. Perkins has perfected the art of reconstruction using three revolutionary, yet versatile, techniques. Dr. Perkins can re-sculpt your breast using your own tissue, an implant, or by using a combination of both techniques.
Breast Reconstruction, my main practice revolves, to a large degree, around breast reconstruction. It’s a very rewarding thing to do. These ladies are on a very long journey, have been through many things. They’ve been run over by a train when they’re told they’ve got breast cancer. That comes into the way we have discussions with them. There’s two times you can do a breast reconstruction: the time of the mastectomy, an immediate breast reconstruction or primary breast reconstruction, or sometimes later down the track usually after they’ve had radiotherapy and chemotherapy. Certainly, a poor lady who’s been told she’s got breast cancer and comes to talk to me about a breast reconstruction, we have to treat them with kid gloves and help guide them through the decisions. There’s basically three ways of making a breast. You can use your own tissue, which is called autologous reconstruction, which usually involves, called a TRAM flap, which is taking the skin and fat and muscle from your tummy, which would normally be thrown away in a tummy tuck. You can use a prosthetically-based reconstruction, which may involve a tissue expander, which is a blow-up prosthesis; or a definitive prosthesis, which are the silicone gel types of prosthesis; or a combination of the both, which is latissimus dorsi flap from the back, and usually we need a prosthesis to add the volume to that. What we’re trying to achieve with whatever form of breast reconstruction we’re using is to normalize the lady’s lifestyle, so she can get up in the morning, put on her normal clothes, get on with her day and not have the fact that she’s had breast cancer dictate her minute to minute activities. “When I bend over, can people see my prosthesis? Can I wear this? Can I do that? Can I do this activity?” That’s a realistic goal for everyone. In my albums, and I have hundreds of photos of pre- and post-operative photographs. I photograph most of the patients in a bra after the reconstruction. If you look good in a bra, you look good in swimmers. And you can wear normal clothes. And I think that’s a realistic goal for everyone. As with all operations, patients are very much individuals. They’re individual in their physical characteristics and they’re individuals in what they’re trying to achieve and what they’re prepared to go to, to achieve that. And so it’s really a case of sitting down and trying to empower the patient with as much information as they want and giving them all the information, and working with them to help them make decisions about what’s the best thing for them under their particular circumstances. Breast Reconstruction is always considered a medical procedure. We’re trying to restore normal anatomy, and it’s not a cosmetic procedure. No matter what form of reconstruction we’re doing, then it’ll be covered by Medicare item numbers and if you’re in a fund by the Medicare. One of the great things of doing breast reconstruction is the amount of support that the ladies get. I do a lot of talks with breast support groups and the breast care nurses and they have a lot of back up and support, and the ladies do very, very well. But there’s no doubt, they’re a very happy bunch of ladies who are able just to get on with their normal life, and that’s what they’re all trying to achieve.