Bringing Healing Closer to Home for Breast Cancer Patients

As part of an ongoing effort to expand access to specialty care in the Concho Valley, Shannon is excited to bring reconstructive and plastic surgery services to San Angelo. In addition to aesthetic plastic surgery, John McFate, MD, board-certified reconstructive and plastic surgeon now offers breast reconstruction at Shannon.

The addition of breast reconstruction at Shannon is meeting a long-unmet need for breast cancer patients and survivors in the Concho Valley.

“At Shannon, bringing in breast reconstruction alongside the team of oncologists, radiation oncologists and surgeons has helped fill in the ‘missing piece’ for breast cancer care here. On top of patients in active treatment, we’re providing delayed reconstruction for patients who didn’t have that option during their initial surgeries,” said Dr. McFate.

Until recently, patients seeking breast reconstruction traveled to areas like Austin, San Antonio, Houston or the Metroplex. According to Dr. McFate, the time and stress of lengthy treatments and follow-ups come at a cost for patient satisfaction and wellbeing.

“Creating access to breast reconstruction surgery in San Angelo, especially at the same time as a mastectomy, has a huge advantage for patients.”

There’s limited comfort for patients while traveling – it’s very hard to take the patient out of their normal environment and expect them to recover well or get better results.

Having reconstructive surgery here allows patients to be at home and have their families and our specialists support them through the experience, so they heal better.”

As part of breast cancer treatments at Shannon, Dr. McFate offers implant-based breast reconstruction, which uses silicone implants or temporary tissue expanders to recreate the volume of the patient’s breasts after tissue is removed during mastectomy. Reconstruction can be accomplished in stages through inpatient and outpatient procedures, meaning patients can tailor their treatment schedule to meet their individual needs.

Immediate reconstruction takes place within the same surgical procedure as a mastectomy, reducing the overall time the patient needs to recover. Dr. McFate works alongside Shannon’s surgical team to place implants or tissue expanders directly after the diseased tissue is removed. This kind of reconstruction allows patients to reach their desired volume and appearance with less delay.

“Doing immediate reconstruction right after mastectomy allows the patient to come out of surgery seeing a similar version of their breast volume. I’m able to do this within the same procedure as the mastectomy, when the breast borders and tissues are still elastic and flexible, so we don’t have to undo any skin tightening like we would with separate surgeries. Patients often want to deal with treatment and ‘move on’ afterwards while they recover, and immediate reconstruction makes that possible,” McFate explained.

Delayed reconstruction of the breast involves placing implants or tissue expanders in the breast pocket after mastectomy has been completed. For some patients, tissue expanders placed within the prepectoral space above the chest muscle can be filled with fluid over time to stretch the remaining skin over the breast and make room for a silicone implant.

“Delayed reconstruction of the breast provides a lot of options for patients with breast cancer,” said Dr. McFate. “Depending on progression of the disease and if there are other treatments planned, like

radiation, patients may opt to start reconstruction with tissue expanders. Once the skin and tissue around the breast has expanded to match the patient’s preferred size, we can place the final silicone implant to complete the reconstruction.”

Previously, patients undergoing a mastectomy followed by radiation were not considered candidates for breast reconstruction. However, modern techniques for delayed breast reconstruction are making reconstructive surgery more accessible for a wider range of patients.

“The hard-and-fast rule was if you had severe skin changes from radiation, or you had to begin radiation after mastectomy, reconstruction wasn’t on the table. There’s lots of data that says otherwise, and I think our strategy of planning for reconstruction as part of the treatment process is unique. Sometimes the muscles and skin of the chest lose their elasticity because of radiation, which can complicate reconstruction, so we may recommend staging a gradual change around a patient’s treatment schedule alongside the oncologists if we can’t create the look we want in one immediate surgery.”

Planning for breast reconstruction as part of the overall treatment of breast cancer provides emotional and physiological benefits for patients. Addressing the aesthetic concerns can help patients find normalcy and rebuild their confidence after difficult treatments.

“My goal with reconstruction is not just to ‘replace what was lost’ for a patient, but to improve on their appearance and make the experience better.”

“We aren’t limited to restoring the original breast size – we have patients who always wanted to go smaller or larger than their natural look, and we work toward their ideal appearance.”

For Dr. McFate, working to support breast cancer patients carries personal weight. After witnessing his own mother’s battle against breast cancer in his childhood, he found a renewed purpose in helping support patients facing the same struggles.

“It’s a full-circle moment to go from being family of a patient to a provider who can support patients like her,” he said. “Patients come in for consultation, and I can empathize with them in the toughest times of their lives and celebrate when they reach the other side of it. It’s a blessing that we can not only focus on removing the disease but also help patients regain their dignity and identity after treatment.”

For more information about oncology care (including breast reconstruction) at Shannon, visit www.ShannonHealth.com.