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Seroma After Abdominoplasty
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Question: In a society where image is everything, the news of breast cancer can be
devastating. A mastectomy can leave a woman with low self-esteem or poor
body image. Or, it can leave a woman feeling fine, overwhelmed with relief
that the cancer is gone.
What arises is a question of medical ethics. Are plastic surgeons preying
upon the vulnerability of women facing mastectomy? Are breast
reconstruction surgeries necessary or do they pose more risk than benefit?
Should a woman have the right to choose the surgery, knowing the risks
involved? Are surgeons bound to inform patients of all risks and are they
following that practice?
The issues have been raised, leaving legislators looking at a rainbow of
gray trying to find black and white. Is there a clear answer?
Answer: While breast reduction and enhancement surgeries have been available for
decades for cosmetic reasons, the heart of the most recent controversy
concerns a bill started with good intentions. The Women's Health and
Cancer Rights Act of 1998 granted a cancer victim the right to have
medical insurance pay for breast reconstruction following a mastectomy.
The procedure had been elective. According to figures from the American
Society of Plastic Surgeons (ASPS), a total of 29,607 breast
reconstruction surgeries were conducted in 1992. In 1998, the year of the
bill's passage, that number increased to 69,683 and to 82,975 in 1999, an
increase of 180 percent from 1992 and an increase of 19 percent from 1998.
"Sandra," a local resident who asked that her real name not be used, said
she doesn't think that increase is coincidental. She is one of several
women who, after being diagnosed with breast cancer, underwent a
mastectomy and breast reconstruction surgery which turned out badly. She
said she was railroaded into the Tram Flap surgery by an unethical plastic
surgeon who presented her with little information about the possible side
effects.
She said the Tram Flap surgery is a drastic, life-altering surgery which
she would never have chosen had she been better informed. The procedure
takes tissue and muscle from the abdomen, stretching it to the chest to
form a new "breast."
She noted that undergoing the procedure would preclude a person from being
able to carry a baby because the abdomen could no longer support a growing
fetus. Hernias are common in those who have had this surgery, and necrosis
(the death of tissue moved to the breast area) is also a possibility.
Missing abdominal muscles and permanent numbness in the operation site
leave those who undergo the procedure unable to do sit-ups or perform
other movements which would require those muscles. She said women are
being kept in the dark -- as she was -- about these after-effects.
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