Duke Raleigh Hospital

FOR SANJAY DALUVOY, MD, plastic and reconstructive surgeon at Duke Raleigh Hospital, the beauty of his specialty lies in its ability to improve lives in multiple ways. "Plastic and reconstructive surgery isn't defined by lifesaving procedures—it's built on life-changing procedures," says Dr. Daluvoy, who joined Specialists in Plastic Surgery in summer 2014 and is on sta„ at Duke Raleigh. "Correcting tissue deformities can assist patients functionally, but more importantly, it helps them overcome the emotional consequences of defects, which can be even deeper than the physical e„ects." Removal of one or both breasts to treat breast cancer can be scarring not just physically but emotionally as well. "Breast reconstruction is about helping women feel whole again in mind and body," Dr. Daluvoy says. "I see my role as the first step in the healing phase of the cancer journey." A SOLUTION FOR EVERYONE Breast reconstruction doesn't always require surgery. Patients may elect to wear an external prosthesis with a bra. For those who prefer a surgical solution, however, Dr. Daluvoy and Specialists in Plastic Surgery o„er two types of reconstructive procedures at Duke Raleigh: • Implant-based procedures typically use tissue expanders placed immediately after mastectomy to enlarge the pocket of skin the breast once occupied so the surgeon can insert an implant several weeks later. Patients visit the surgeon several times between the mastectomy and implant placement so the tissue expanders can be inflated gradually. • Tissue flap procedures use tissue taken from elsewhere on the patient's body to rebuild the breast. Dr. Daluvoy performs pedicled flap reconstruction, a technique in which he harvests tissue from locations near the breast, such as the abdomen or back. "The type of reconstruction a woman chooses should depend on her goals and her definition of normal," Dr. Daluvoy says. "Once I learn what those are, I can develop very specific and personalized treatments to help patients have the best and most comfortable experiences possible." If a disease-related defect is damaging your self-image or quality of life, a plastic and reconstructive surgeon may be able to oˆer a solution. To find one, visit dukeraleighhospital.org and click "Physicians." NORMAL Breast reconstruction can play an important role in emotional healing following mastectomy. Reconstructing Considering Breast Reconstruction? If you are, take these three factors into account before making your decision: • Goal: Why do you want to have breast reconstruction? What do you hope to achieve with the procedure? This is an intensely personal decision that you should make based only on your wishes. Your plastic and reconstructive surgeon can help align your expectations with an appropriate surgical option. • Method: Your choice of reconstruction technique may depend on your age, health, course of breast cancer treatment, availability of tissue elsewhere on the body to use in rebuilding the breast and the results you wish to achieve. • Timing: The decision of when to have breast reconstruction may depend on a number of factors, including whether radiation therapy is necessary—radiation may harm a newly restored breast—the surgical technique you choose, or your personal schedule. Winter 2015 HEALTHY FOCUS 3

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