Women who undergo a mastectomy today have far greater options for breast reconstruction than their counterparts did just a decade ago, thanks to dramatic advances.

So say two leading surgeons, Dr. Wesley Francis, Vice President of Surgical Services and practicingphysician from Doctors Hospital, and Dr. Martin Newman, Chair of Plastic and Reconstructive Surgeryfrom Cleveland Clinic Florida.

Their comments came during a media virtual workshop held this month, culling the latest informationfrom Cleveland Clinic Florida and local physicians, surgeons, specialists, and researchers.

Just as breast cancer itself has migrated from a once fearful diagnosis to a disease with a 99% survivalrate if detected early, the options for rebuilding a breast have evolved and today include various naturalsolutions as well as silicone and saline implants.

“We have multiple options including the transplant of your own tissue and implants,” said Dr. Newman.That procedure, called tram flap reconstruction, involves moving similar tissue from one part of thebody up through the abdominal area to the breast to form a new structure similar in shape to that whichwas removed. In the early stages of tram flap development, the tissue and fat were moved under themuscle, an effective, but painful procedure, according to Dr. Newman.

And in those days – even just a decade ago – doctors did not have the ability to turn back the clock inbreast sensitivity. When nerves and muscle were severed during surgery, the tram flap or other implantwas all about appearance.

Now, said Dr. Newman, surgeons can re-sensitize women’s breasts using a nerve graft, and that whilethe procedure is not always successful, it is a significant advancement in breast reconstruction.Dr. Newman said there are also new medications and techniques to help reduce the pain traditionallyassociated with tram flap reconstruction surgery or with implantation.

“We can reconstruct the breast with the tissue expander and implant above the muscle, we know that itis less painful. We also know that there are medications available today that werent available even 10years ago that can be injected into the surgical site that will keep the area not pain-free but will certainlylessen the pain for several days following surgery when the pain is the worst. We've also developedindwelling catheters that can be placed into the operative site where we can drip local anestheticnumbing medicine for a period of days. So, there have been a lot of advances in managing post-operative pain and discomfort.”

According to Dr. Francis, the advances in reconstruction options are serving to make women more likelyto opt for preventative mastectomies.

“When you remove both breasts, that reduces your risks, basically, by 99 percent,” he said, a critical andpotentially life-saving decision in The Bahamas where there is an unexplained extraordinary highincidence of the BRCA gene mutations indicating a genetic predisposition toward cancer.

“More women who are informed and they know that risk, they opt for that (preventative mastectomy)and I believe that they do that because they are aware of the possibilities of immediate reconstruction,”said Dr. Francis.

Both surgeons agree on key points. Regular self-exams, annual mammograms and early detection arecritical but once it comes time to consider breast removal whether for a diagnosed breast cancer case orpreventative measures, what happens following that removal has come a long, long way in a very shorttime. There are more options than ever and less expectation of pain, making recovery more manageableand a re-sensitized breast after-life more likely.

“For anybody who is considering mastectomy a consultation with a board-certified plastic surgeon iscertainly a wise choice,” says Dr. Newman. “It’s always good to be informed and know there areoptions.”