I chose to become a plastic surgeon because of my passion for reconstructive surgery - as a medical student, I always thought that the best part about plastic surgery was having the opportunity to help fill a "hole" or help put the pieces back together after an accident or cancer. Because of these ideals, breast reconstruction still forms a significant part of my practice. Every day, I hear stories from women about how breast reconstruction has changed their lives - patients tell me, "I didn't feel like a women before," or "I feel whole now," or "now I can take my kids to the pool." I have had patients who have told me they never allowed their husbands to see them naked after their mastectomies or others who are brought to tears after seeing the results of their reconstruction.
But I am also aware that the vast majority of American women who undergo a mastectomy will not have a breast reconstruction. Breast reconstruction may not be the right option for every woman, but for many, it is a life-changing procedure. This year 227,000 women will be diagnosed with breast cancer. Seventy percent of those women will be unaware of their reconstructive options. In other words, the focus will be on cutting out the cancer, not surviving it, not healing from it and certainly not rebuilding after the cancer is gone. This reality comes in spite of a federal law requiring health insurers (including Medicaid and Medicare) to cover breast reconstruction procedures. This 1998 law also mandates that insurers cover procedures on the opposite breast to achieve symmetry.
In 2011, Canada launched the first BRA Day (Breast Reconstruction Awareness Day). This year, the American Society of Plastic Surgeons and The Plastic Surgery Foundation have joined forces with the Canadians to initiate BRA Day USA. BRA Day will occur annually on the third Wednesday of October (October 17, 2012) to raise awareness about breast reconstruction. The mission of BRA Day is to "develop and advance an internationally recognized day that promotes awareness and access to post-cancer breast reconstruction surgery." Thus far, twenty countries are participating and more than 100 local events are planned around the U.S.
In contrast to those patients who may not be aware of their options, I also see many women who feel guilty or ashamed about wanting breast reconstruction. Many patients will come in for a consultation to discuss breast reconstruction, and they may say, "I'm not vain," or "my husband says he doesn't care if I have breasts," or "I feel guilty for wanting reconstruction, after putting my family through so much already." Breast reconstruction is not something that women should be ashamed of for wanting or feel guilty for having. It is not vanity. It is about recovery and healing. One of my patients showed the results of her reconstruction in my waiting room by raising her shirt. She and her husband say that it (breast reconstruction) changed her life.
To increase awareness about breast reconstruction, award-winning singer/songwriter Jewel will lead the charge here in the United States as our national spokesperson. Jewel has released a song in honor of breast reconstruction to celebrate women's ability to persevere and rebuild after the cancer. She is also performing a charitable concert in New Orleans on Oct. 29. All proceeds will be donated to the Breast Reconstruction Awareness Fund and will fund charity care in communities nationwide, support breast reconstruction research, and raise public awareness.
I encourage everyone to discuss breast reconstruction because it is an integral part of the recovery process after cancer for many women. October is Breast Cancer Awareness Month, and there are a number of activities this month aiming to fundraise for breast cancer research and raise awareness about detection and prevention. BRA Day is unique because breast reconstruction closes this loop on breast cancer. As we try to raise awareness about both breast cancer and breast reconstruction, we need to share our experiences. In my practice, I have found that my patients want to talk to other women who have had reconstruction - this need has led total strangers to meet, discuss, and share their experiences. BRA Day is another opportunity to share those experiences with the world.