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Breast Reconstruction Options Abound

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Women facing the decision to have a preventive mastectomy should explore all breast reconstruction options, says Thousand Oaks plastic surgeon Dr. Kouros Azar, adding he's noticed an increased awareness after Angelina Jolie's public announcement.

Thousand Oaks, California (May 2013) — The phased surgical approach taken by actress Angelina Jolie for her preventive double mastectomy is not the only option available to women undergoing breast reconstruction surgery, according to Thousand Oaks plastic surgeon Dr. Kouros Azar (

Jolie's recent announcement about her double mastectomy drew attention to genetic testing that can gauge a woman's risk of cancer. But it also highlighted the decisions women face about breast reconstruction.

"Ms. Jolie's choice of tissue expanders for her breast reconstruction is appropriate for many women," Dr. Azar says. "But for other women undergoing a preventive mastectomy or those diagnosed with breast cancer, my Thousand Oaks practice offers reconstruction options that include having implants inserted at the time of the mastectomy or using a patient's own tissue to reconstruct the breast mound."

What's important, says Dr. Azar, is that women know they have choices, including the choice not to reconstruct their breasts.

"Many women choose immediate breast reconstruction with implants," Dr. Azar says. "This eliminates the need for additional surgery and provides the psychological benefit of minimizing the deformity after mastectomy." But, either because of personal preference or body type, he says, immediate reconstruction isn't always the best choice.

Using tissue expanders does involve additional plastic surgery, says the Thousand Oaks surgeon. By performing the reconstruction in stages using expanders, new skin is actually created in much the same way as during a pregnancy. In the case of breast reconstruction, implants are inserted into the extra space. Jolie's surgeon at the Pink Lotus Breast Center provides a detailed look at the multiple phases involved with the celebrity's care.

Other women choose what's known as autologous flap reconstruction, which means the surgeon uses the patient's own tissue taken from a donor site in another area of the body, such as the abdomen, the latissimus dorsi, or the buttocks. An innovative procedure, called DIEP (deep inferior epigastric perforators) flap reconstruction, involves complicated microsurgery, Dr. Azar says, but it is becoming a preferred method because it preserves the strength of abdominal muscles, requires a shorter recovery, and provides a slimmer appearance.

No matter what a woman ultimately decides, Dr. Azar says, her choice should be based on her preference after discussing all of her options with her physician.

If you or someone you know is facing a decision about breast reconstruction, request a consultation with Dr. Azar, or call his office at (805) 250-0077 to schedule an appointment.

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