Recently, Dr. Chen was invited to sit down with lifelong friend, fitness expert and motivational speaker, Ana Cabán, to record an episode for her latest podcast, Your Inspired Life. For more than two decades Ana Cabán has had a strong reputation among health/fitness industry experts for her distinctive style. She has sold over 4,500,000 of her award-winning bilingual fitness DVDs. Touted “a star Pilates instructor” by InStyle magazine and “the fitness guru to propel you into shape” by Martha Stewart Radio, Ana has appeared as the go-to fitness & lifestyle expert in print publications, including Health, Fitness, Pilates Style, Latina and O Magazine. Her passion lies in inspiring women to improve their health, wellness and lives.
Ana now hosts an inspirational podcast to help motivate women to design their second act and offers tools and permissions to live it. See link below and listen to Dr. Chen and Ana discuss Dr. Chen’s personal journey into medicine and what motivates her to help make women feel whole again after mastectomy. She provides tips on how others can find happiness and inspiration to achieve their life passions as well.
For more information about Dr. Constance Chen and her specialty in breast and body restoration, click here. To learn more about Ana Cabán, click here.
By Dr. Constance M. Chen
A diagnosis of breast cancer is devastating at any time, but it can seem impossible to sort out your best options in the middle of a global pandemic. When healthy people everywhere are already overwhelmed with survival, what are the options for a woman who has just been presented with a cancer diagnosis?
Fortunately, as much as life has changed during this time of social distancing, the basic issues of cancer treatment remain the same. Patients need to evaluate their disease with the help of their oncologists to decide upon the optimal course of therapy. Women need to strengthen their immune systems via diet, exercise, and mental health. They may want to explore groundbreaking metabolic approaches to cancer treatment. And social distancing may even help protect patients who are trying to heal and recover from the stresses of cancer treatment. Finally, breast cancer patients should take this time to pause, and realize that they do not need to accomplish all of their long-term goals immediately. Specifically, breast reconstruction can take a back burner to oncologic treatment without any lasting compromise to the ultimate aesthetic outcome.
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By Dr. Constance M Chen
Among women who opt for reconstruction after losing a breast to mastectomy, 80% undergo reconstruction with implants. Many women see implants as the quickest, simplest reconstructive option. Their other choice – natural-tissue reconstruction – requires a more complex surgery and longer recovery time. However, studies have shown that the risk of cosmetic and health problems with implants in the first few years is significant and the risks increase over time. Implants aren't expected to last forever. Most have a ten-year warranty although many will have to be removed before that.
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By Dr. Constance M Chen
Enhanced Recovery After Surgery (ERAS) is an evidence-based, patient-focused protocol that reduces hospital stays, minimizes postoperative pain, and speeds overall patient recovery after surgery. Frankly, ERAS has transformed the mentality of many health providers who used to just accept the status quo.
For breast surgery patients, we have implemented ERAS to put people on the “fast track” to recovery. ERAS programs can include the following:
● Enhanced patient preparation and education prior to surgery;
● Greater use of advanced anesthesia protocols;
● Removing Foley catheters and tubing within 24 hours after surgery to minimize infection risk and facilitate recovery;
● Resuming solid food immediately after the operation;
● Improved postoperative fluid management;
● Better pain control; and
● Fewer postoperative complications.
Almost all of our patients are up and walking 24 hours after surgery. Since they are not dependent on opioids for pain beyond the immediate postoperative period, they have shorter hospital stays overall.
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By Dr. Constance M Chen
Many people who have seen a woman’s chest after mastectomy have been exposed to the bold horizontal line that marks the spot where the breast existed before it was amputated. The preoperative markings for a traditional mastectomy look like an eye drawn on the breast to indicate the area of skin that will be cut out with the nipple-areola complex in the middle where the iris of the eye would be. The breast tissue is removed through this large opening. Cutting out this football-shaped section of skin permanently flattens the three-dimensional shape of the breast - even after breast reconstruction, especially if the breast reconstruction is performed using breast implants. Although this is the design of a traditional mastectomy, it is possible to preserve the shape of a normal breast with a little bit of foresight. By using plastic surgery techniques, the breast surgeon can do her mastectomy through a different incision that preserves the skin envelope of the breast so that a natural breast shape with projection is maintained after breast reconstruction.
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By Dr. Constance M Chen
Just before the holidays, I ran into a colleague who is the chief of plastic surgery at a major cancer center in our area. He told me that 8 patients in the last 3 months had presented to him with anaplastic large cell lymphoma (ALCL) after breast reconstruction with breast implants. ALCL is a extremely rare cancer of the immune system, and questions have been raised about whether the incidence is higher in women undergoing breast reconstruction with breast implants. The incidence of ALCL in the breast is 3 cases of ALCL in 100 million women (0.000003%). In 2011, the U.S. Food and Drug Administration (FDA) first noted that the incidence of ALCL seemed slightly higher in patients with breast implants, but it was still very rare even in this population to the tune of 60 cases of ALCL worldwide in 5-10 million women (0.0006-0.0012%). At the time, many healthcare professionals believed that the incidence of ALCL in women with breast implants might have even been overestimated, because some of the data collected may have been duplicate cases.
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By Dr. Constance M Chen
Women undergoing mastectomy must make decisions about breast reconstruction: whether, when, and how to have breast reconstruction and, crucially, who should perform the surgery. Often, women are referred to a plastic surgeon by their breast surgeon and assume that all of their options will be presented. In reality both mastectomy and breast reconstruction have come a long way, and not all plastic surgeons are able to offer all reconstructive options. Cutting-edge innovations can be life-changing, but patients often have to do some extra research to educate themselves to find the right solution for their problems.
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By Dr. Constance Chen
Tens of thousands of people each year achieve dramatic weight loss by undergoing bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery, in 2017, 228,000 people underwent surgery to restrict the amount of food the stomach can hold or reduce the absorption of nutrients or both. Surgical techniques vary according to the needs of individual patients. Some procedures are reversible; some change the hormonal environment in the gut in ways that reduce appetite and enhance feelings of fullness; some reverse the mechanism by which obesity causes type 2 diabetes.
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By Dr. Constance M Chen
Bariatric surgery delivers life-changing benefits for many people each year. In 2017, the American Society for Metabolic and Bariatric Surgery estimates that 228,000 people underwent weight loss surgery. While bariatric surgery can improve underlying physical and emotional health, the dramatic change in body size due to weight loss can also leave patients with excess skin that causes its own new problems.
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By Constance M Chen
For many women who have lost one or both breasts to mastectomy, achieving the ideal breast reconstruction may take time and patience. While it is tempting to opt for short-term quick fixes, the reality is that breast reconstruction after mastectomy should be considered a process rather than a single procedure. Even with the most advanced techniques and superior surgical skill, small follow-up adjustments can help improve outcomes. Women should know that many issues with size, shape, and symmetry after an initial breast reconstruction can be addressed to help a woman’s breasts look more normal again, and these rehabilitative procedures are also covered by insurance.
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By Dr. Constance M Chen
Women undergoing breast reconstruction after mastectomy have many options. The gold standard of breast reconstruction is natural tissue breast reconstruction, in which a woman’s own tissue is used to reconstruct the breast. Unlike implant-based breast reconstruction, a restored breast made of your own tissue is soft, warm, and grows or shrinks as you gain or lose weight. While natural tissue breast reconstruction produces the best aesthetic result and the highest levels of patient satisfaction, the biggest concern for patients tends to be the donor site, as there are additional scars from where the tissue is taken to reconstruct the breast.
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By Dr. Constance M. Chen
The goal of breast reconstruction after mastectomy is to restore symmetry – to create a breast with the shape and softness of the original that is in proportion with her opposite breast as well as the rest of a woman's body. Matching a reconstructed breast to the existing natural breast may not be possible in a single surgical procedure, however. Follow-up modifications may be necessary to achieve the desired symmetric result.
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By Dr. Constance M Chen
Breast reconstruction recreates a breast mound either with implants or with the woman's own tissue. In either case, nipple reconstruction can be performed in a separate surgery from the original breast reconstruction. Modern techniques in mastectomy and breast reconstruction offer women many options. Many women are candidates for nipple-sparing mastectomy, in which the nipple is preserved during the mastectomy. For women whose nipple has been resected a more traditional type of mastectomy, however, it is possible to surgically reconstruct the nipple to recreate a complete breast.
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By Dr. Constance M Chen
More than 2.5 million women in the United States have had breast cancer. Many of them were treated with a combination of surgery, radiation, and sometimes chemotherapy that has removed or damaged lymph nodes and left them vulnerable to upper extremity lymphedema, a condition that can be disfiguring, painful and profoundly impair quality of life for breast cancer survivors.
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By Dr. Constance M Chen
The American Cancer Society estimates that more than 268,000 new cases of breast cancer will be diagnosed in 2018. These women will be treated with various combinations of surgery, radiation, and chemotherapy that will leave them vulnerable to a range of side effects, one of which, lymphedema, might not show up until months or even years later. Lymphedema is characterized by swelling, usually of the arm, caused by removal or damage to the lymph nodes during cancer treatment. When lymphatic fluid can't drain properly, it backs up and causes swelling. We can't predict who will develop lymphedema but we can take steps to minimize risk and with early diagnosis and care of the affected arm.
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By Dr. Constance M Chen
Mammography is a specialized imaging system that uses low-dose x-rays to detect and diagnose breast cancer in its earliest stages when it is most treatable. Before the discovery of x-ray technology, most breast tumors could be detected only when they were large enough to be felt. Over many decades, advances in breast imaging have made it more effective and more efficient, reducing the radiation dose and providing greater contrast that makes it easier to 'see' through breast tissue and detect abnormalities. Regular, high-quality mammograms, along with clinical breast examination, remain the gold standard in screening for breast cancer.
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By Dr. Constance M Chen
In 2017, almost 400,000 women underwent surgery with breast implants - whether for cosmetic breast augmentation or for breast reconstruction after mastectomy. Despite significant improvement in implants since they were first introduced in the 1960s, however, studies by the implant manufacturers have shown that within seven years, 50% of women with breast implants will undergo another operation to fix problems with their implants.
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By Dr. Constance M Chen
A diagnosis of breast cancer profoundly impacts a woman's life. In addition to coping with overwhelming emotions, she must make important choices about treatment and all of its implications. One of those is the financial ramifications of her illness, particularly if she will need surgical treatment of her breast. She will need to learn all she can about her insurance coverage. Will the breast surgeon, the anesthesiologist, the hospital, the lab be covered? What about procedures on the healthy breast to ensure symmetry? And what if she elects to have breast reconstruction at a later date? Fortunately, all insurance companies in the United States are required to cover breast reconstruction if mastectomy - which includes partial mastectomy (i.e., lumpectomy) - is also covered, so any woman undergoing surgical treatment of her breasts should be aware of her rights.
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By Dr. Constance M Chen
The American Cancer Society estimates that more than 268,000 new cases of breast cancer will be diagnosed in 2018. But although the rates of breast reconstruction continue to increase, a 2014 study found that less than 40% of women who undergo mastectomy elect to undergo immediate reconstruction. (http://bit.ly/1yHmckj Journal of the American College of Surgeons, December 6, 2014.) Many women feel that breast reconstruction improves their quality of life. And while there are geographical and socioeconomic disparities that prevent all women from having equal access to care, there is also a lack of information that enables outdated misconceptions to persist. In order to deliver the best possible care, we must put these myths to rest and provide comprehensive information that helps each woman make the decision that is best for her.
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By Dr. Constance M Chen
In the United States, only 30% of women who undergo mastectomy also undergo breast reconstruction. Of those women who undergo breast reconstruction, about 80% decide to undergo breast reconstruction with implants. Most women undergo implant-based breast reconstruction because it is simpler, scars are limited to the breasts, and the recovery is often faster immediately after surgery. Over the long term, implants may cause more problems than natural tissue breast reconstruction, but implant-based surgery is often easier for women in the short term.
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