Cutting Edge Recovery - One Woman's Journey

Mainely Newspapers, Inc. | March 2005 |

Laura Simpson Moy, a breast cancer survivor, wants women to know there are alternatives to reconstructive surgery other than implants.

If there's one thing breast cancer survivor Laura Simpson Moy wants women to know about reconstructive surgery, it's that there are options out there.

"There's other procedures available to women that aren't in Maine and may better suit many women's needs," Moy said. "Plastic surgeons may not necessarily want to tell you about them because they like to keep a lot of the business in Maine."

Her search for treatment landed Moy in Louisiana to find a doctor who could reconstruct both of her breasts without using artificial implants such as saline and silicone, alternatives she had tried before.

After discovering a lump in the front of her right breast in 1993 at the age of 33, Moy, who currently works as the executive director of Biddeford's Zoom Turnpike Express, went to the doctor and was diagnosed with the first stage of breast cancer.

Moy opted to have one mastectomy because she was told the cancer was in its early stages and was 97 percent curable. But after the operation, she wasn't happy.

"Right after that, I looked in the mirror and said this looks terrible," Moy said, adding that she decided to have a second mastectomy for preventive and aesthetic reasons.

She was faced with many options for reconstructive surgery and was told by area plastic surgeons that implants were safe, so she went ahead with procedure, instead of another process called the TRAM flap.

The TRAM flap is an operation that takes stomach muscles and tunnels them up through the chest, according to Moy, then later "pops" them out in the form of a breast. That wasn't Moy's first choice, because she said, the procedure takes everything but one percent of your sit-up muscle.

Moy's first round of implants were made of saline, or salt water and felt hard and uncomfortable. She then made the switch to silicon implants and those turned out to be somewhat softer, but still didn't feel real or like her own.

Four and a half years after her diagnosis, Moy went into see her plastic surgeon for a check-up and a pink spot, or local reoccurrence, was found on her skin, prompting a round of chemotherapy and radiation.

"This time they didn't want to fool around," Moy recalled. "They wanted to do radiation and I was really weary."

Moy's doctors decided to move forward with the radiation without removing her silicone implants, an action that accelerated the rate of scar tissue and had adverse affects on her body.

At that point, Moy decided to strike out on her own to find an alternative to implant reconstruction. "I had enough," Moy said. "I just started to look at other ways to do this. No one around here knew much about it." It was within the last year that Moy describes things as getting "asymmetrical."

That is when she found the DIEP flap procedure and its founder Dr. Bob Allen of the Center for Microsurgical Breast Reconstruction in New Orleans, Louisiana.

"When I was looking around at the landscape for breast reconstruction in the 1980s, the choices were very limited," Allen said. "It was the TRAM flap or implant."

According to Allen, who has performed more than 1,600 operations since 1992 when he first started the procedure, the TRAM flap process is more exciting to the plastic surgery community than to the women involved.

"It was euphoria," Allen said. "But the poor patients [suffer] severe pain and there is a significant bulge or outright hernia and weakness. So we were trying to come up with a better way."

The DIEP flap procedure, or Deep Inferior Epigastric Perforator, is a process of opening up the belly, grabbing its excess fat on top of the abdominal muscle, extracting veins and moving it all to the breast area for reconstruction.

The biggest difference between the TRAM flap and the DIEP flap, according to Allen, is that the DIEP flap leaves the abdominal muscle and takes only the excess fat and blood vessels. "The muscle was taken as an innocent bystander," Allen said of the process.

According to the Microsurgical Breast Reconstruction website, "flap" is a plastic surgery term referring to the tissue that will be transferred.

A large, horizontal scar around the abdominal area and a recreated belly bottom are results of the procedure.

"Sensory nerves have the ability to regenerates over time," Allen said noting the blood network will start to rebuild itself shortly after the
operation. "Most people get some feelings back. Over time the results tend to get better and better."

Allen, who said the cost of the procedure is dependent upon a patient's insurance plan, costing roughly around $2,300 when the procedure is covered. But, under federal law, according to Allen, insurance companies are required to cover reconstructive surgery in cases like Moy's.

"Now, I have two soft breasts that look like breasts and feel like breasts," Moy said adding that she never fully accepted her implants as her own. "I'm sure there are women who differ from me."

It has only been six weeks since Moy has had the DIEP procedure and said although the first 10 days after the operation she had experienced some pain, she was able to walk around the day after her surgery. Now she is painfree.

"I think when a woman loses a breast she loses a lot more than a breast," said Moy. "When a man has prostate cancer treatment, when he loses his sexual or urinary function, he loses more than that. People need to look for the frontier sciences and participate in finding the best fit for themselves because they are there." "If I had known then, what I know now, I would have gone that route and saved myself a lot of suffering," Moy said.

By Liz Gold, Senior Staff Writer
Posted Week of March 27 - 31, 2005

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