Summary: When it comes to surgery of any kind, and plastic surgery in particular, age is definitely something to pay attention to. There’s some evidence to suggest that age doesn’t have a huge impact on the rate of complications overall—especially with more cosmetic procedures—but the age of the patient can change the type of complications you might see. And plastic surgery is certainly one of those areas that appeals to patients both young and old. However, when it comes to reconstructive surgery, you might tend to find more older patients—especially in terms of breast reconstructive surgery. So, from Minneapolis to Clear Lake, TX, breast reconstruction surgeons are taking a long hard look at complications from surgery—and at some recently published research.
Not Always the Young
We usually think of cancer as something that strikes later in life (when we think of cancer at all… sometimes we’d rather not think about it). That’s understandable. Cancer can be a particularly troubling topic. Unfortunately, it’s not something that will also wait until your waning years to strike. Sometimes you get cancer when you’re young, and this is even true of breast cancer. That’s not to say that you have equal chances of developing breast cancer when you’re 20 as you do when you’re 60. Research seems to suggest that chances increase especially later in life. That’s why yearly mammograms are recommended after age 40. And, of course, the earlier the cancer is detected, the more successful the treatment usually is.
A significant amount of women want to begin the breast reconstruction process as soon as possible. That’s sensible—reconstructed breasts can mean the final reclamation of your normal life. It’s a way of starting over, of getting your identity back. Interestingly, when we think of breast reconstruction surgeries, we tend to envision younger patients. At least, the marketing does. If you go to any plastic surgery website, you can look at smooth skinned, youthful models just about forever, but it’s hard to find examples of older patients. This doesn’t necessarily set plastic surgery apart—marketing is marketing, after all. And it’s hard to blame plastic surgery providers for giving patients images of what they want.
The Complications of Age
There should, however, be attention focused on older patients. Especially because there’s a perception out there—shared by patients and non-patients alike—that older patients are at increased risk for complications. This perception can even encourage some women to forego breast reconstruction altogether, which can be crippling for women who consider reconstruction vital to resuming normal life. This is especially tragic given that current research does not support the notion that older patients are more susceptible to complications after a breast reconstruction procedure.
Indeed, new research published in Plastic and Reconstructive Surgery suggests that in patients over 65, there is no appreciable rise in complications due to age when it comes to breast reconstruction procedures. The study, authored by Mark Sisco, MD, of NorthShore University HealthSystem, looked at over 40,000 women who had undergone various breast reconstruction procedures. When Dr. Sisco looked at overall complication rates, there was no statistically valid change between the age groups (over 65 and under 65). The only difference was in a certain type of complication. It seemed that those patients over 65 seemed to have a higher risk of venous thromboembolism, a blood-clot related complication. The women in the 65 year old age group had a higher risk of VTE complications—but knowing that helps surgeons prepare for it accordingly. And, of course, patients should be counseled accordingly.
Plastic Surgery and Breast Reconstruction
It’s also worth noting that, while we use “breast reconstruction” in a pretty monolithic way, it’s actually a collection of procedures. Not only do patients have to consider procedures that pave the way for breast reconstruction (expander implants, for example), but they also have to consider what type of implant they want. There are artificial implants and natural implants (taken from donor areas on the body). If you select artificial implants, you must make decisions about size and shape, not to mention whether you want silicone or saline implants.
Things aren’t much easier if you decide you want a natural implant. Most modern natural implants are derived from donor tissue. Which means that plastic surgeons will take some tissue from your own body—sometimes muscle, sometimes fatty tissues, often a combination of the two—that most closely resembles your breast tissue. But human bodies can be wildly different, so while there are some common techniques for using donor material (DIEP flap, for one), this can also be incredibly problematic. So there are a great many different techniques out there, and every woman (with the help of her surgeons) must decide which is right for her).
Patient Choices and Good Results
Which is a long way to say that this can be a particularly stressful and troubling time
for patients. Surgery is always an intimidating and concerning prospect, doubly so during this moment in one’s life. Surgeons can do much, however, to alleviate those concerns simply by being forthright with information. The more information a patient has, the more guidance, the more successful those outcomes tend to be. Because of this research, surgeons now have more information to disseminate, and that can help patients make far more informed decisions. Ultimately, it wouldn’t be surprising if that leads to a higher satisfaction rate for those patients.
After all, breast reconstruction is often the first step towards reclaiming your normal life. But it’s also definitely a big step. The more help patients get, the better.