Below, you will find more details about the most common procedures performed by Dr. Seagren. In addition to surgery of the breast, she also incorporates lymph node surgery when indicated. For patients receiving chemotherapy for breast cancer treatment, Dr. Seagren places port-a-caths and of course, happily removes them for you at the completion of your treatment :)
* Surgical procedures for the treatment of breast cancer, including reconstruction and any associated procedures of the contralateral healthy breast for symmetry, are covered by most health insurance policies. Woman's Health and Cancer Rights Act
total nipple skin-sparing mastectomy
Dr. Seagren creates a small incision, in the infra-mammary fold (natural crease under the breast) or less commonly, along the border of the areola. Through this hidden incision, she is able to remove all of the breast tissue and nipple tissue, while preserving the entire skin envelope of the breast, including the nipple skin. This procedure is somewhat different from the common nipple-sparing mastectomy, in that the nipple tissue (which contains the terminal end of the milk ducts) is removed. Only the skin of the nipple remains, thus, her procedure is called a total nipple skin-sparing mastectomy, rather than the common nipple-sparing mastectomy. This is an oncologically superior surgery because the milk duct tissue underlying the nipple skin has been removed. Due to Dr. Seagren's extensive experience and special techniques, she is able to offer this technically advanced surgery to her patients without the concern for increased nipple or skin would complications. In fact, Dr. Seagren's nipple and/or skin flap loss is 0%.
If you have been told by your physician or surgeon that you are not a candidate for "nipple-sparing" surgery, we encourage you to contact Dr. Seagren for a second opinion case review. We routinely perform nipple-skin sparing mastectomy with immediate reconstruction for women who have been denied these advanced breast surgery techniques from other providers.
Dr. Seagren believes that immediate reconstruction should be an option for all women. The surgical outcomes, both cosmetically and from a cancer standpoint (breast cancer treatment or breast cancer risk-reduction) depend on the experience and expertise of your surgical team. The key to success, is knowing how to select the best procedure for the unique individual and her particular set of circumstances. Some women are candidates for DTI (direct to implant) reconstruction, in which the final implant is placed at the time of mastectomy. Some women are better served with placement of a TE (tissue expander) at the time of mastectomy. This is a temporary implant that can be filled with saline during surgical follow-up visits. The TE will be removed and replaced with an implant (i.e. silicone or saline breast implant) or autologous tissue (i.e. DIEP flap, TRAM flap, fat-grafting) for final reconstruction.
the Origami procedure
Dr. Seagren's signature surgery is an advanced surgical approach for women who choose to have a "nipple-sparing" mastectomy but also want to have a breast reduction. Currently, these women are either denied immediate reconstruction or are told they cannot have a "nipple-sparing" procedure. This is due to the fact that when a "traditional" breast reduction is combined with a "nipple-sparing" mastectomy, all of the blood-supply to the skin is disrupted, leading to major wound healing complications. However, the Origami Procedure uses a special technique in which the skin envelope of the breast is folded and tucked, in just the right places, to both decrease the volume of the breast and re-create a natural breast shape. Depending on the unique characteristics of a woman's breast and her desired size/shape, this procedure alone can accomplish the breast reconstruction or is combined with an implant and/or fat grafting to achieve the final look.
Breast conservation surgery (BCS) is also known as "partial mastectomy" or "lumpectomy". With BCS the cancer is removed while the remaining healthy breast tissue is left in place. When a woman is a surgical candidate for mastectomy OR lumpectomy, this almost always means that there is no survival difference between the two options. Therefore, her choice is personal, and is based on her own personal value system. The decision should also be personalized by her surgeon. This means that her medical history, family history, cancer diagnosis, tumor biology, lifestyle, occupation, genetics, etc. should be considered by her breast surgeon and integrated into the discussion at the time of consultation.
Dr. Seagren offers a unique approach to BCS. We call this the Hidden-Scar Lumpectomy. During this procedure, Dr. Seagren carefully selects an area of the breast for the precise placement of the incision, taking into account, the location of the tumor, volume of the tumor, your breast shape and size, distance between the incision to the tumor, how the breast incisions (both visible on the surface AND invisible within the breast tissue) will best heal, and any addition factors such as personal health or planned post-operative treatment (i.e. radiation therapy). This small incision can be "hidden" along the areola border, within the axilla (armpit), or within the natural crease (inframammary fold) under the breast .
breast lift or Breast reduction
Women who choose BCS (i.e. lumpectomy) may also decide to have a breast reduction or a breast lift at the same time. Many women with macromastia (i.e. abnormal enlargement of breast tissue) have endured chronic neck, back, and shoulder pain for many years. Both the reduction of breast volume and lifting the breast mound to a more anatomically appropriate level will help realign one's posture and relieve chronic pain. Whether a full breast reduction (i.e. reduction mammoplasty) is performed or just a small breast lift (i.e. mastopexy), the use of these aesthetic techniques at the time of lumpectomy is a safe approach that offers many women the benefit of the cancer treatment surgery in combination with a cosmetic surgery.