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The Quest for Better Cosmetic Results After Breast Surgery

Jun 26, 2017 11:15AM ● By Digital Media Director

For a woman diagnosed with breast cancer, fighting that cancer is usually her primary focus. It may not be until much later, that she may come to consider and even regret her disfigurement of radical surgery. But Sioux Falls breast surgeon Julie Reiland, MD, says it doesn’t have to be this way. Reiland is helping to lead the national charge to offer women a chance to come out of surgery feeling not just healthy but also whole thanks to breast-conserving oncoplastic surgery.

MED: What led you to begin looking for ways to repair breasts after surgery?

Dr. R: Ever since I got out of residency, I thought, I don’t like these ugly incisions in the middle of the breast.. It hurts me to look at the breast and think that I have disfigured them. Every woman with breast cancer should be able to have an operation that still helps her look their best.

Ninety-eight percent of women with early stage breast cancer are surviving. Why wouldn’t we want them to thrive, too?

MED: Where did you learn to do this kind of repair work?

Dr. R: In 2009, I took a course that really helped me say ‘OK, I can do more advanced repairs of my cancer defects.’ So I started taking out the cancer, reshaping the breast, and going to the other side and making it look even. There are some cases where I know I am going to need a plastic surgeon. But in a woman of average size who doesn’t need a reduction, that is something I am capable of doing. It is all about conserving breast tissue.

MED: Doesn’t leaving some breast tissue behind increase the risk that the cancer will come back?

Dr. R: We know that whether a woman removes the breast or has a lumpectomy and radiation, survival is the same. Removing your breast does not ensure that you are going to live longer. It is true that we can do beautiful things with mastectomies, but it if doesn’t make you better, why do it? And if I am going to save the breast, I want it to be the best looking breast ever.

MED; What impact do you think this can have on a patient psychologically?

Dr. R. A woman doesn’t want to have to get out of the shower every day and see a disfiguring reminder that she had breast cancer if she doesn’t have to. Even equalizing the other breast helps them to forget that they had the surgery. Her breasts look like they belong together and the scars heal.

MED: What are you doing to help bring other breast surgeons on board with this idea?

Dr. R: FIrst, the American Society of Breast Surgeons has asked me to chair a working group of surgeons to see how we can help our patients have better cosmetic results. I will also be putting on courses for them around the country, teaching the two techniques that I use 90 percent of the time. One big key is for women to starting asking their doctor what their results are going to look like. That will help drive it.

MED: There has been some pushback from some in the plastic surgery community. How do you respond?

Dr. R: People are often afraid of new things. But everybody should want a breast surgeon to do a good job. And there are many places in the country where patients do not even have access to a plastic surgeon.  My local colleagues in plastic surgery know that if I have a patient who really needs a plastic surgeon, I’m going to use them. They have been very supportive and the truth is, we need them more than ever.

Dr. Reiland  taught her first oncoplastic breast surgery course at Avera in June.