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Johns Hopkins Health - It’s Not Too Late

Spring 2012
Issue No. 16

It’s Not Too Late

Date: April 25, 2012

It's Not Too Late

You have options for breast reconstruction, even years after a mastectomy

For breast cancer survivors like Lillie Shockney who have undergone a mastectomy, reconstructive breast surgery can be an important first step to reclaiming their bodies. And yet, for 10 years Shockney resigned herself to a life of wearing breast prostheses that she nicknamed her “boobsie twins.”

Many women don’t know of their breast reconstruction options at the time of their mastectomies. Other women “don’t pursue the discussion of rebuilding their silhouette,” Shockney says, “because they are so focused and fearful of having to deal with a diagnosis of breast cancer.”

For Shockney, a registered nurse and administrative director of the Johns Hopkins Avon Foundation Breast Center, her adverse reaction to general anesthesia ruled her out as a candidate for reconstructive surgery until a new drug became available. Now, she is part of the growing ranks of women opting for what’s known as delayed breast reconstruction.

“It’s important for women to know it’s OK to have delayed reconstruction,” says Michele Manahan, M.D., a board-certified plastic surgeon at Johns Hopkins. “In fact, with the number of techniques available for breast reconstruction, plastic surgeons at Johns Hopkins can really work to tailor what we do to fit the patient’s lifestyle and health. We offer a very individualized treatment plan.”

For example, Johns Hopkins is one of a few highly specialized centers in the nation to offer an advanced technique called microvascular reconstructive surgery that can create natural, lifelike results. Surgeons remove skin and fat from another part of a woman’s body, usually the abdomen, and then transfer it to the chest to create a new breast with the desired shape; a microscope is used to ensure blood supply is nourishing the tissue in its new location.

“For women who want a little more natural feel to the touch as well as a more natural look for their age, this procedure is a good option,” Manahan says.

Another choice is implants made of silicone or saline, or a combination of both, that can be inserted under the chest muscle after a mastectomy.

“An implant-based reconstruction will give you more of a rejuvenated appearance with more fullness in the cleavage area,” Manahan adds.

Many women feel as if they need to finish their breast cancer treatment before they are ready to focus on making educated choices about what reconstruction options work best for them.

“The more information a woman can gain, the better, and getting a second opinion can make her a more educated consumer,” Manahan says. “We are skilled in all aspects of breast reconstruction, and we are able to talk about what might be better or worse for a woman on a very personalized level.”

Did You Know?

  • Breast cancer is the most common cancer in women worldwide, with more than 1.6 million new cases diagnosed in 2010.
  • Mammography is the best early detection tool, with a 78 percent accuracy rate.
  • About 70 percent of breast cancer patients in the U.S. did not know their options for breast reconstruction at the time of mastectomy.
  • Breast reconstruction is required to be covered by medical insurance as a result of a federal law passed in 1998.

To explore your options for reconstructive breast surgery, visit For more information, appointments or consultations, call 800-547-5182.

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