Boobie Traps (and Flaps)

While at the plastic surgeon’s office last week, he mentioned something about surgeons in the USA who tend to [over]use  grafts — I got the sense that they use it because it’s available rather than necessary every time.

A cursory search for this information online does not provide many results so I would recommend that if you are considering implants for breast reconstruction, speak to your surgeon about this tissue grafting … I can’t quite remember the exact terminology the surgeon used so I may not be accurate in callng it tissue grafting.

However, I did find the web site for The American Society of Plastic Surgeons that talks about tissue expansion which is not the same as grafting. For those of us who have had a mastectomy (complete removal of the breast), tissue expansion is necessary and I believe would be necessary whether considering implants or one of the aforementioned flaps (Tram, Diep and Lattismus).

One of the documents I was given entitled “Canadian Society of Plastic Surgeons – Joint Position Statement on Lymphoma and Breast Implants” states the following:

“The Food and Drug Administration (FDA) in the United States published a device safety communiction on January 26, 2011 on the association of breast implants and anaplastic large cell lymphoma [ALCL].

ALCL is a non-Hodgkins Lymphoma – a cancer which can occur anywhere in the body and involves the cells of the immune system. The incidence of this type of lymphoma in the breast  is 1/500,000 per year. The estimated incidence of this type of lymphoma in the breast is 3/100,000,000. To put this in perspective, there are 4,000,000 patients who had breast implants inserted between 1998 and 2009 in the United States and 5 – 10,000,000 worldwide.

It is important to note that this is not a cancer of the breast. It has been found in the scar tissue (capsule) that forms around a breast implant and is not associated with any particular type of implant. It is also important to note that these cases are not typical (they are ALK negative) and the outcomes are more favourable than typical ALCL.

The FDA has clearly stated: “If you have breast implants, there is no need to change your routine medical care and folow-up“. They have also stated: “prophylactic breast implan removal in patients without symptoms or other abnormality is not recommended“.

The Canadian Socieity for Aesthetic Plastic Surgery and the Canadian Society of Plastic Surgeons commend the FDA for working to pursue a collaboration with plastic surgeons to develop a registry to gather additional information to better charactierize ALCL in women with breast implants.

Patients are encouraged to read more details on the following websites from the FDA and to contact their plastic surgeons if they have any concerns …”

The document I received does not provide the links, only the name of the links: “FDA Medical Device Safety Communication: Reports of Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants“; and

“Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants: Preliminary FDA Findings and Analysis“.

These are the links I found but cannot guarantee they are the links that would have been provided in the document had they existed.

Yes, cancer is frightening especially for those of us who have already experienced it, but I like my chances with implants over the other options which could leave me with less muscle control in my abdomen or shoulder (Tram Flap, Diep Flap) and still without a breast should they fail … the amount of surgeries alone for the flaps make them less desirable for me personally.

The surgeon wants me to see him again before making a decision — he’s armed me with lots of information and I have lots to think about.

The document provided to me is dated January, 2011.

Take note Richard Simmons … this is one DVD that really should be made.

I started Cancer Exercises (hence the term Cancersizing) a few weeks ago and it has been fabulous! My spirits are high and the mini-physio treatments I get after exercising have also been a great help to my bruised and battered chest and shoulder.

Yesterday was exactly one year ago that I had my surgery and until I started the Cancersize program (that’s not what they call it by the way), I was still very much limited in my mobility with one arm.

I’m not a gym person — I much prefer sports but am still unable to participate to the extent I want — meaning that I’m really competitive and hate feeling limited.

I was a bit skeptical about joining the cancersize class, but have to say it’s one of the most non-threatening and non-judgemental places I have ever been part of — it’s a free 10-week program provided by Wellspring.

There’s approximately 10 of us in each class and it’s a modified interval/circuit training. Each of us were assessed one-by-one before starting, and each session is specifically made for each individual. After 3 weeks, I’m already doing intervals-within-intervals.

I tried Curves once and it was not for me. I’m already a fairly strong person (physically) and found their circuit training too light and they didn’t offer any cardio — that was about 3 or 4 years ago and I’m not sure if they offer it now or not — I remember asking if they have cardio and they said no. How do they expect women to burn calories if there’s no cardio? It was not something I found very useful … and what’s totalling irritating is that as I soon as I figure out how to use a piece of equipment, it’s time to move on to the next piece … and there are nasty women who will breathe down your neck if you don’t move fast enough … but I digress …

Back to Wellspring. There’s also at least 2 or 3 trainers in each class plus 1 student physiotherapist who shadows the trainers. The trainers are also physiotherapists: one of them mentioned that she had completed 7 years of university as her credentials. I looked her up online (of course I did!) and she’s apparently highly regarded in rehab oncology (a guru methinks). You can read more about cancer rehab through Cancer Rehab Inc.

A few days ago I felt a mild migraine coming on and almost didn’t go to the cancersize class … what was my inspiration to get up and go? Miggy on The Biggest Loser. I watched her the night before walk 13 miles 24 hours after having an appendectomy … I thought if she can do that, I can do a few exercises with a little headache … and man, I’m glad I did! I felt much better within a few minutes.

I started watching The Biggest Loser last season, initially because there was nothing else on (um, no tennis probably) and am becoming quite hooked on it. Hmm, I wonder if they accept applications from a cancer bitch such as myself I also received my acceptance for the Cardiovascular Risk Management Program. I don’t have any heart problems: it’s more of a vascular intervention for me and my apple belly … why is it that songs are written about apple bottom women, clothing lines are named after apple bottom butts, but never any apple bellied women? We get no respect!

I’ll have access to dietiticians, nutritionists and exercise programs … I have my first stress test in early March … wish me luck!

Both these programs are free: in Ontario, Canada at least. I recommend asking your doctor about these programs.

PS — yes, there are men in the Wellspring classes (a big wave to Tony!)