Dr. Nirav Savalia has been selected by Hoag Memorial Hospital Presbyterian to serve as Director of Oncoplastic and Aesthetic Breast Surgery.
The Medical Director of Hoag Breast Center, Dr. Melvin Silverstein, is pleased with the appointment of Dr. Savalia, noting, “Dr. Savalia is a highly skilled, dedicated surgeon who understands the complexity of cancer treatment from a physiological, psychological and aesthetic standpoint. He is a champion of women’s health and is a great leader. We are excited to have him direct our efforts at Hoag.”
Hoag Health Network, which covers Orange County, treats more than 27,000 inpatients and 379,000 outpatients on an annual basis. The network includes two acute-care hospitals, seven health centers and 10 urgent care centers. In its 2016-2017 edition, U.S. News & World Report named Hoag one of the Best Regional Hospitals, and Becker’s Hospital Review named Hoag one of the “100 Great Hospitals in America” in 2016. Continue reading “Hoag Names Dr. Savalia Director of Oncoplastic and Aesthetic Breast Surgery” »
For many breast cancer survivors, breast reconstruction is an important part in the healing process. In fact, a recent study has found that the procedure is becoming more common among breast cancer patients. Here, Newport Beach plastic surgeon Dr. Nirav Savalia looks at the findings in detail. Continue reading “More Women Choose Breast Reconstruction After Mastectomy” »
Many women struggling with their breast cancer diagnosis think that a mastectomy is their only option for complete tumor removal. However, a lumpectomy can be an extremely effective method of removing cancerous tissue completely without sacrificing your entire breast. It’s important to clear up the main misconceptions about lumpectomy before you make any final decisions about your breast cancer treatment.
1. Lumpectomy Can’t Be as Effective
This is one of the most common misconceptions about lumpectomy that I hear from my patients. While mastectomy can be an extremely effective method of tumor removal, with modern developments in lumpectomy techniques and with the help of a qualified team of medical specialists, lumpectomy can now be just as effective at removing cancer as a full mastectomy.
2. Lumpectomy Is Only for Small Tumors
Women with larger tumors have historically not been considered candidates for lumpectomy. However, oncologists and oncoplastic surgeons alike have since recognized that cancer treatment before surgery can reduce the tumor size enough in the right patients to qualify them for lumpectomy. Using a customized approach of radiation therapy before and after lumpectomy, I am frequently able to fully remove larger tumors from the right candidates while preserving as much existing breast tissue as possible.
3. Lumpectomy Always Results in Unnatural Breast Contours
Many women fear that lumpectomy always results in unnatural breast contours. However, by combining a lumpectomy with reconstruction in oncoplastic surgery, I work with a team of medical professionals to address both medical and cosmetic concerns simultaneously without compromising on aggressive cancer removal. With an oncoplastic approach, it is possible to preserve your natural breast shape after lumpectomy.
Whether women with breast cancer decide to pursue breast reconstruction surgery is a personal decision that should be made for the right reasons. In my practice, I encounter many women who elect for breast reconstruction for a number of reasons, with one of the primary reasons being psychological. Breast reconstruction following either a mastectomy or a lumpectomy can offer significant psychological and emotional benefits to cancer survivors, making the choice for breast reconstruction about much more than appearances.
1. Feelings of Normal and Symmetrical Breast Appearance
One of the primary benefits of breast reconstruction is that the patient can once again feel that her breast appearance is back to normal and symmetrical. After breast reconstruction, women can feel confident wearing fitted tops, bathing suits and other clothes without being self-conscious about the appearance of their breasts.
2. Visual Reassurance of Health and Wholeness after Cancer
Moving on from illness is a powerful period in anyone’s life, and in the case of breast cancer survivors, many women feel that it’s important for them to have visual confirmation of their own health and wholeness after cancer. My breast reconstruction patients don’t need to feel as if they sacrificed their bodies, their femininity or identities in the struggle against cancer.
3. Positive Feelings Over Conserving Natural Breast Tissue
In the case of a lumpectomy, my patients often feel positively about the fact that as much natural breast tissue as possible was conserved. A lumpectomy allows women to keep more of their breast tissue, assuring patients that their reconstructed breast is not artificial, but rather, a natural part of their body.
Large tumors (those with a diameter greater than 5 cm) are regarded as requiring a full mastectomy due to the challenges of reshaping the breast tissue following a lumpectomy. Although there is an increasing trend to use radiation therapy first to shrink the tumor to a more manageable size before removal, extreme oncoplasty takes this concept one step further by performing lumpectomy even in women who would be traditionally considered mastectomy candidates.
Research into Replacing Mastectomy with Lumpectomy
Recently, some colleagues and I conducted a study on extreme oncoplasty in order to determine whether it was possible to replace mastectomy with lumpectomy.
While not every woman would be a candidate for this option, most women would prefer to preserve as much natural breast tissue as possible. As an oncoplastic surgeon, an emphasis on breast conservation is one of my top priorities also.
To this end, we looked at over 60 women who would normally be classified as mastectomy candidates, and performed a lumpectomy with immediate reshaping of the natural tissue instead. In comparison to nearly 250 women who were standard lumpectomy candidates, we saw the same low rate of recurrence (1.5 percent) at the 24-month follow-up.
Conserving Natural Breast Tissue
Historically, mastectomy was viewed as the “safer” treatment choice for breast cancer, as it was thought that a lumpectomy wasn’t sufficient to fully remove all cancerous cells. However, research shows more and more that conserving natural breast tissue by performing a lumpectomy instead can be just as effective.
Oncoplastic surgery ensures a beautiful final contour by reshaping the breast, and bypassing the need for implants as part of breast reconstruction.
Whether a woman chooses to undergo breast reconstruction surgery can be a highly personal decision. In my practice, I encourage breast cancer survivors to feel comfortable making their own decisions on reconstruction without pressure from family, friends or doctors.
However, a wealth of outdated misconceptions still pervade the modern day conversation about breast reconstruction and any associated risks, which may stop some women from pursuing reconstruction surgery even if it might be a positive choice.
Decades ago, not nearly as much was understood about breast reconstruction, including if the reconstructive process could affect the ability to detect cancerous cells or the potential rate of complication. Doctors once widely believed that breast reconstruction would interfere with cancer detection and result in high rates of complication.
However, multiple modern studies conducted over a 20-year period documented no increase in cancer recurrence with breast reconstruction and no delay in diagnosis of new malignancies. There was also no increased rate of complication.
Benefits of Reconstruction
Breast reconstruction also offers women many advantages. Many women find it easier to move on from their illness with reconstructed breasts that allow them to retain a sense of femininity and wholeness. With advancements in breast reconstruction techniques, reconstruction results can appear more natural than ever. I maintain a customized approach to reconstruction that takes special care to meet the specific goals and needs of each patient.
Many women feel that breast reconstruction provides them with the opportunity to reclaim power over their bodies after overcoming illness. Whether reconstruction is immediate or delayed, women can move on from disease with breasts that look natural and allow them to maintain their original figure without added concerns over previously held misconceptions.
As the newest generation of silicone gel breast implants, gummy bear implants offer several advantages for cosmetic breast augmentation as well as for reconstructive breast surgery. Although no single approach is best for every patient, I do find that there are a few factors of gummy bear implants that can particularly benefit my breast reconstruction patients.
Gummy bear implants are well-known for their teardrop shape that mimics the natural breast, with more volume towards the bottom and a gentle slope at the top of the implant. Women with only one breast to reconstruct may find that the gummy bear implant is closer to their existing breast shape, allowing for more reasonably symmetrical results. Women can also choose to have implants in both breasts in order to enhance their figure further.
The highly cohesive silicone gel filling of gummy bear implants feels very similar in texture to natural breast tissue, which makes the ideal breast implant for use in patients after undergoing mastectomy. Breast reconstruction patients often have little to no existing soft tissue in the breast area and may be concerned about attaining results that feel natural. With gummy bear implants, masking the implant underneath the extra coverage of natural breast tissue isn’t as necessary for a natural-looking final outcome.
A Customized Approach
A variety of results are possible with gummy bear implants, and a skilled breast reconstruction specialist should work closely with each individual patient to develop a plan that best meets her needs. I customize my approach for every patient in order to choose the best implant—gummy bear or not—for their goals, as well as the right balance of volume, height, width and projection.
In my practice, I see a lot of patients who are concerned that their breasts are showing their age. Growing older naturally leads to changes in reproductive hormones that dictate the tissue and structure of breasts. The result is that, over time, your breasts begin to lose their firmness and fullness. While this process is completely natural, many women understandably wish to reverse these signs of age. Here are three tips for maintaining full, youthful-looking breasts.
When it comes to the aging body, it’s important to eliminate as many factors as possible that could do further damage. While the fact that that cigarette smoking is bad for your health may be common knowledge, did you know smoking can also be bad for your breasts? Smoking cigarettes has been directly correlated with premature sagging. This is one habit to cut out that your body will thank you for!
Wear Supportive Bras
Are your bras giving you the support you need? A bra that fits properly may be the simplest and most effective solution for slowing the downward decline of breast tissue. Not only can a well-fitted, supportive bra help you look great, some extra support now can also help prevent further sagging down the road.
Consider a Breast Lift
If your breasts are sagging considerably, consider the benefits of a breast lift. I often perform this procedure on women who are concerned with fallen breasts. With a lift, the breasts are elevated and reshaped to give your figure a more youthful, perky appearance.
Aging breasts are a natural part of life, but with today’s surgical techniques, there’s no reason to let sagging breasts bring down your self-esteem. Consider these suggestions to help you look as young on the outside as you feel on the inside.
Facing breast cancer and a subsequent mastectomy can be a very emotional process, and patients can often feel confused and overwhelmed by the different options for breast reconstruction. It’s important to remember that there is no one best method of reconstruction, and there are pros and cons to each approach. Here’s a closer look into the facts behind common breast reconstruction methods to help you understand the primary differences.
Tissue flap reconstruction is a method of rebuilding the breast using skin, fat and muscle from a donor area of the patient’s own body. With the flap method, much of the reconstruction can often be accomplished at the same time as the mastectomy, although follow-up procedures will likely be necessary in order to achieve a properly positioned, natural-looking breast or to complete nipple reconstruction.
Using a breast implant to recreate the breast is a fairly simple procedure that requires less surgery time and a shorter recovery than flap-based procedures. Implant-based breast reconstruction can sometimes be entirely performed at the time of the mastectomy. In other cases, only the initial step of placing temporary tissue expanders can take place. Tissue expanders are used to create enough space in the breast pocket for the final implant,.
A Combined Approach
Another option is to combine the best of both reconstruction methods in order to create the new breast. In this combined approach, a smaller implant supplies the primary foundation while muscle and tissue add another layer of coverage for a very natural final result. This method eliminates the need for tissue expanders while at the same time limiting the amount of additional tissue and muscle that need to be donated from elsewhere on the body.
Most of us associate breast reconstruction with a mastectomy, or full removal of the affected breast as part of cancer treatment. However, advances in cancer treatment allow for oncologists to perform lumpectomies in more cases. If you’ve only undergone a lumpectomy, is reconstruction surgery really necessary?
A New Emphasis in Breast Cancer Treatment
The old philosophy regarding breast cancer was that the safest approach was for surgeons to excise a significant amount of existing breast tissue to ensure that all cancerous cells were removed. Doctors hoped that this aggressive strategy would help prevent the potential for recurrence, especially when combined with additional treatments like chemotherapy or radiation.
These days, many oncologists and reconstructive surgeons are focused on preserving natural breast tissue after a breast cancer diagnosis instead. This is due in part to improvements in technology that allow for earlier detection and treatment of breast cancer in general, but also reflects the more modern approach most oncologists take in using nonsurgical treatments, like radiation or chemo, to shrink malignant growths enough that a lumpectomy can be performed rather than a mastectomy.
Reconstruction after Lumpectomy
Women who have a lumpectomy can still benefit from reconstructive surgery. Even though it’s less invasive than a mastectomy, a lumpectomy still requires tissue removal and can leave behind noticeable contour irregularities. Reconstruction may be as simple as reshaping your breast tissue to correct contours, or may include fat transfer augmentation or even a small implant to restore lost volume. My specialty is in performing oncoplastic reconstruction, in which I team up with the cancer surgeon to perform immediate reconstruction, with the goal of saving as much natural breast tissue as possible.