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October is Breast Cancer Awareness Month Alain Polynice M.D. F.A.C.S BOARD CERTIFIED PLASTIC SURGEON Breast & Body Specialist Q.I recently had a diagnosis of breast cancer and I am scheduled for a double mastectomy. What are my options for reconstruction A. When considering breast reconstruction, there are two options. The 1st is to use expanders and implants to reconstruct the breasts and, the 2nd option is to use the patient’s own tissues. This is known as autologous breast reconstruction. There are many factors that will affect the choice of reconstruction. An implant based reconstruction usually involves two separate procedures. The first procedure is the placement of the expander which will stretch the tissue and create space for a permanent implant. The second stage will involve removal of the expander and placement of the permanent implant. Some patients may not be a good candidate for implant based reconstruction and these are mainly patients who have had radiation therapy or patients who have a mastectomy on one side and a very large breast on the other side that may cause significant asymmetry. When considering reconstruction using the patient’s own tissues, this can be done with a variety of different flaps. The most common flap is called a TRAM flap which stands for transverse rectus abdominis myocutaneous flap. This is essentially a breast reconstruction that is done using the skin and fat from the lower abdomen. The skin is then transferred to the chest area and a breast is shaped and created using the patient’s own tissues. A skin and muscle flap from the back can also be used. This is known as a latissimus flap but usually this requires using an implant as well. If you are seen in consultation by Dr. Polynice, he will discuss in detail all of these options with you and decide which one might best achieve your reconstructive goals. Q. I just recently had a diagnosis of breast cancer and considering reconstruction. What is the best timing for reconstruction A. When a patient gets a diagnosis of breast cancer, it is very important that she be followed by a team of surgeons and physicians, namely the oncologist, the breast surgeon who would be performing the mastectomy and the plastic surgeon who will be doing the reconstruction. When all of the team members work together, the ultimate results are significantly improved. When the general surgeon and plastic surgeon work closely together, they can devise a much better plan to provide a significantly improved outcome. That is why it is important to have an early consultation with the plastic surgeon so that the patient can be aware of all of the available options and also which option would specifically be better for her. Q.I am planning to have reconstruction following my mastectomy and have chosen to have implants. How do I know what size implants I will be happy with A. At the time of your consultation your physician should not only discuss with you all of the available options but will also take measurements during the examination and do imaging that will allow you to have a very good idea of the ultimate outcome. In my office we use Vectra 3D imaging where a 3D photograph is taken and different implants can then be placed simulating the results that the patient would have following tissue expansion and permanent implant placement. Dr. Polynice is a board certified plastic surgeon who did his training in general surgery at North Shore University Hospital in Long Island and a burn fellowship at New York Hospital-Cornell Medical Center and plastic surgery training at the Mayo Clinic in Rochester, Minnesota. Dr. Polynice also did a traveling fellowship visiting plastic surgeons around the world in order to hone his skills and create the focus his practice has today; mainly breast and body cosmetic and reconstructive surgery. He authored a book to assist patients in making an informed decision, on breast lifts and reductions and what to expect before and after breast surgery. Dr. Polynice practiced for many years in New York City before moving to Upstate New York. ADVERTORIAL 30 HERLIFEnewyork.com
Dr. Gerald C. Benjamin, D.D.S., P.C. What should a patient expect in a dental exam The dental exam is probably the most important visit to the dentist. It is the time of discovery: what do we see and what does it mean At an exam, the dentist should ask a patient if anything has changed in their overall medical health and if any new conditions have appeared in their mouth since the last dental visit; sort of “bring me up to speed on what is going on.” X- rays should be taken if needed and at least once a year. The exam should include a survey of the face to discover anything that could be skin cancer, infection, cysts or tumors. The dentist may feel areas on your face or neck to check for swollen lymph glands which could mean infection or a serious condition. The oral exam should always begin with an oral cancer check of the tongue and back of the throat, and examination of the teeth for obvious tooth decay, broken fillings or chipped teeth. Broken or worn teeth may indicate that the patient’s bite may be ‘off’ and a more thorough investigation may be needed to evaluate how the teeth come together. An evaluation of the gum tissue including probing of pockets must occur at every dental checkup. The exam will then offer suggestions on how to proceed with treatment and whether the general dentist or a specialist should do the work. Why is dental health important for your overall health In recent years, a strong connection has been made between dental health and a person’s overall general health. Heart problems, artificial hips and knees, sleep apnea, low birth weight and brain infections, diabetes and numerous other health problems all have significant relationships to the dental health of the patient. “I don’t go to the dentist because I never get any cavities” is no longer a wise approach to staying healthy. For instance, bleeding gums in a patient who is about to have an artificial hip placed could lead to failure of the new hip because bacteria from the mouth could travel to the new hip through the bloodstream. When should I seek out a dental specialist I am a general dentist who limits my practice to fixing teeth and restoring implants. All other dental problems, such as root canal treatment, oral surgery, gum and bone problems and orthodontics are referred to dental specialists in my office. That does not mean that some general dentists are not qualified to perform root canals or extractions. Every dentist must know their limits AND patients must learn to demand excellence and ask to be referred to a specialist when challenging problems develop. Dr. Gerald C. Benjamin, D.D.S.P.C. is a devoted professional with over 27 years of experience in restorative and esthetic dentistry. He holds a Certificate of Proficiency in Esthetic Dentistry and Clinical Associate Professor, SUNY/Buffalo (visiting). For more information contact Dr. Benjamin at 518-583-1116 or www.benjaminsmile.com. ADVERTORIAL HERLIFEnewyork.com 31
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