Mastectomy and Immediate Single-Staged Skin-Sparing Breast Reconstruction

A Breast Cancer diagnosis is devastating and the idea of a mastectomy is often just as difficult to accept. While your primary goal is to rid your body of cancer, it can be hard to imagine ever getting back to feeling “whole” again. Part of a complete recovery is restoring confidence in how you look and feel.

Dr. Joseph Rucker performs the new skin-sparing, single-stage mastectomy and immediate reconstruction which preserves, in some cases, the nipple and areola as well as the breast skin. 

The benefits of this technique are:

• One surgical procedure for both the mastectomy and reconstruction.
• One recovery.
• Patient's skin envelope is preserved.
• Usually only one overnight hospital stay required.
• No increased risk of recurrence.
• Better cosmetic result after reconstruction.

The Procedure: On the surface, your natural breasts are preserved. Inside, your tissue is completely replaced with an implant. This state of the art procedure involves the cooperation of a cancer surgeon and Dr. Rucker acting as a team, along with your oncologist. 

Until now, mastectomies involved flaps, expanders, tattoos and scars. Skin and nipple-sparing mastectomy offers an option that is less severe and more cosmetic. By retaining the shell of your natural breasts and using an implant, the results often resemble a breast augmentation rather than a reconstruction.

Insurance Coverage: Single or double mastectomy? A federal law was passed in 1998 requiring all health insurance companies to cover reconstruction of the breast on which mastectomy has been performed. Additionally, it covers surgery and reconstruction of the other breast to produce a symmetrical appearance.  Because of this, women with a higher risk of developing breast cancer, and who formerly might have considered a single mastectomy now elect to have both breasts removed and reconstructed.

Risk of Recurrence: Skin-sparing mastectomy has been advocated as an oncologically safe approach for the management of patients with early-stage breast cancer that minimizes deformity and improves cosmesis through preservation of the skin envelope of the breast. Extensive research has been done regarding this procedure when compared with mastectomies that remove all the tissue, skin and nipples. The result? The new skin and nipple-sparing mastectomy in no way contributes to recurrence. In addition, careful review of scientific research over 20 years found no proven link between breast implants and auto immune or other systemic diseases, nor do they inhibit future cancer detection.

Candidates for Procedure: Many, but not all, patients are candidates for a skin-sparing mastectomy. Your choices may be limited by your pathology or prior surgeries. However, this new option has made women with the BRAC gene and those at high risk for breast cancer consider a skin and nipple-sparing mastectomy prophylactically - removing the tissue as a potential target. Others considering lumpectomy, which can be disfiguring, can now confidently opt for removal of all tissue while preserving and enhancing their natural breasts. These patients leave the hospital not only with their shape and contour intact, but the gift of peace of mind, knowing that all of the breast tissue has been removed.

Philosophy: Dr. Joseph Rucker, a board certified plastic surgeon with advanced training in breast reconstruction techniques, approaches reconstruction no differently than an elective cosmetic procedure. His keen aesthetic sense makes his goal to leave every woman looking even better than before their unfortunate diagnosis. Working closely with a cancer surgeon and your oncologist, Dr. Rucker will help determine if you are a candidate, considering your individual treatment plan and overall health.  

To view a short video on this subject go to: http://www.youtube.com/watch?v=zUXv2RWny6A.

40 year old female with advanced premalignant breast disease and also with a strong family history for Breast Cancer. She requested bilateral mastectomies and immediate single-stage bilateral breast reconstruction.

1 month after bilateral skin and nipple-sparing mastectomies and immediate reconstruction.

Doctor, What Size and Type of Implant would you Recommend?

When choosing a breast implant, there are two major factors one must consider (1) what size implant is best for me and (2) what type of implant should I choose. The following information is meant to guide you in making an educated decision

IMPLANT SIZE: While there is no specific chart that will display exactly what size implant should be used, most surgeons will have a general suggestion for each of their patients. The surgeon must make a determination based on the cup size that the patient desires as well as the body size of the patient. Generally I offer the suggestions listed below:

• Small statured women (<5'3") with an A cup requesting a C cup. My implant range suggestions are between 280cc to 380cc
• Medium statured women (>5'3") with an A cup requesting a C+ cup size. My implant range suggestion is between 380cc and 480cc
• Large statured women (>5'8") with an A cup requesting a C+ cup to a D cup. My implant range is between 480cc and 540cc

IMPLANT TYPE: When it comes to implant type, I personally think the saline filled implant and the standard silicone gel filled implants will be obsolete within the next two years. This is due to the many benefits of the revolutionary Sientra "Gummy Bear" Implant. The benefits of the Sientra implant are so pronounced that it has become my implant of choice due to the following reasons:

• There is a smaller chance of a leakage of gel into the body if a rupture is to occur
• Has a natural feel similar to the gel filled implant
• There are multiple shapes and sizes offered
• The cost is very comparable to the standard gel filled implant
• Some studies suggest that there may be less of a chance of scarring around the Sientra implant

With these suggestions and information in mind, it is important to remember that a consult with your plastic surgeon is highly recommended to determine your personalized needs. For more information or to set up an appointment for a consultation with Dr. Rucker, please call our offices: 715-832-1774. All inquiries are welcome and can be answered by an experienced Rucker MD staff. 

Why Trust a Plastic Surgeon with your Skincare Needs? Dr. Rucker is about to tell you!

How to easily treat Marionette Lines

Marionette lines are long, vertical lines that start at the corners of the mouth and extend downwards towards the chin. They are visible on a person's face as landmarks for general expression. However, for some, these lines deepen or turn downward and may create a cosmetic concern. To improve these lines, I would recommend a filler introduced in the following manner: 

1. A direct placement of the filler of your choice in two planes beneath your marionette lines will diminish the problem

2. I would also place a small amount of filler on the underside of the upper lip near the corner. This will roll the lip up nicely to produce more of a smile while also reducing the deepened marionette lines. 

3. This is a 5 minute procedure with minimal to no downtime. 

Six Tips to Minimizing Dark Under-Eye Circles

Dark circles can be blamed on multiple factors including heredity, hormone levels, sun exposure, stress, aging, a lack of sleep and most commonly- allergies. An important thing to note about dark under-eye circles is that here is no perfect way to prevent them, only minimize them once they are visible. However, contrary to what you may think, dark circles cannot be remedied by skin lighteners because the darkness is not caused by skin discoloration, rather a shadowing of the skin.

In order to relieve the darkness around the eyes, there are various methods you can use to minimize the appearance of them.

• Using powerful peptides such as Enza Essential's Eyebright Anti-Puffiness Gelee will cool and sooth the appearance of puffy bags while increasing cell turnover, leaving you with a brighter, more youthful appearance.
• Dermal Fillers can be used in order to plump the area around and under your eyes which reduces the intensity of shadowing. 
• Because allergies are the number one cause of dark circles, it is important that you have identified what you are allergic to and have proper allergy medication to minimize any potential reactions.
• Wearing sunscreen, particularly an SPF 30 or greater, will help to minimize unprotected sun exposure and the effects of aging from the sun. 
• Applying ice packs or cucumbers directly on the dark circles at nighttime will sooth and minimize the dark circles caused by puffiness.
• Lastly, the Pelleve Wrinkle Reduction System is a treatment that will help to tighten and brighten your face while also increasing collagen production that will work against the skin's natural aging process.

Although there is no way to completely prevent dark circles from appearing, there are multiple ways to reduce the shadowing that occurs. By using the methods listed above, you can successfully mask those embarrassing signs of aging, lack of sleep and stress before anyone has time to notice them. 

Winter Skin Care

The combination of dry air and holiday stress can prove to be a nightmare for your skin. As with any other season, you will have to adjust your daily routine accordingly to keep your skin fresh and renewed. The following are tips to help you rejuvenate your skin and look your best for the winter season.

• Don't Skip the Toner- Applying toner will normalize the skin's pH level, misting your skin throughout the day will allow the toner to absorb excess oil and keep you looking fresh.
• Curb Your Cravings- Be sure to limit sugar intake. When your body processes sugar, it turns into glucose which can destroy collagen and your skin's elasticity. Eating fiber-rich foods can help ward off hunger and your sweet tooth.
• Exfoliate Twice a Week- Dead skin and bacteria left on your face can irritate your acne and leave scarring. Be sure to slough it off with a gentle exfoliator.
• Watch the Blow Dryer- The extreme heat and extended use of a blow dryer facing your neck can break capillaries and over time, leave them permanently broken. 
• Use Lukewarm Water- When rinsing your cleanser, avoid water that is too hot or too cold. Your skin is very sensitive and not being careful with temperature could cause irritation and break capillaries. That means shower water temperature can also be damaging if it is too hot. 
• Use an Oatmeal Based Scrub- Abrasive scrubs and exfoliants are too harsh on your skin during winter. Milder, oatmeal-based facial scrubs can unplug the oily pores. 
• Avoid products that use mineral oil or petroleum- Mineral oil and petroleum, both derived from fossil fuel, may dog your pores and prevent your body from flushing out toxins through your skin, leading to breakouts. Be sure to check the ingredients on all your skin care products and cosmetics. 
• Drench and Hydrate- With dehydrated and cracked skin, be sure to add moisture with deep-hydrating creams and facials. Also, don't forget to stay hydrated yourself. Be sure to drink at least 8 glasses of water per day to maintain a radiant complexion. 

By following these tips you will ensure your skin stays healthy and protected through the cold, snowy weather. You can do it- keep your skin you love, even in the harshest winter months. 

Pellevé®: A Breakthrough in Anti-Aging

It’s an inevitable evil, and it happens to us all: with each increasing year come new wrinkles. We’ve tried it all- creams, medications, even surgeries in hopes of minimizing wrinkles and reducing age. However, Rucker M.D., Enza Medispa has taken initiative and began using a new procedure in their offices: the Pellevé® Wrinkle Reduction System. Here we look to introduce and explain this new procedure and why it is important to the Rucker M.D., Enza Medispa and its patients.

What is Pellevé®?

Pellevé® is a unique wrinkle reduction system with various benefits including minimizing wrinkles, tightening and smoothing the face, and creating a younger, brighter complexion. Pellevé® does this through a non-invasive and nonsurgical treatment.

How is Pellevé® different from other wrinkle remedies?

Dr. Joseph Rucker M.D. describes what he sees as the top three benefits of Pellevé® that no other wrinkle reduction treatment can offer:

1.   An appreciable wrinkle reduction

2.  A painless procedure

3.  No downtime

What can I expect to experience while undergoing the procedure?

Rucker M.D., Enza Medispa patient feedback will tell that the Pellevé® experience is calming and enjoyable. “It feels like a warm facial, and when it gets too hot for me, they move on. It’s never too uncomfortable. It’s relaxing; I even dozed off a few times.”

How long until I start to see the effects of Pellevé®?

Immediately- Rucker M.D. Patients have expressed their surprise at how quickly they could feel the treatment working on them. “It was immediate and the results were amazing. I loved the tightness and I loved the fullness.” “My face had this healthy glow; [it] felt tighter and firmer. I noticed around my eyes right away that the crow’s feet weren’t noticeable.” And when combined with Enza Essential’s topical wrinkle reduction serum, the Tri-Peptide Cell Activator, your immediate results will be enhanced.  

With your immediate results, you may notice a slight depletion of tightness a few days following treatment. This is normal. With time and follow-up treatments, you will begin to feel a permanent re-tightening of the skin.

What are the side effects?

One of the benefits of Pellevé® is that there are very few side effects to this procedure. As mentioned earlier, it is a non-invasive treatment, meaning no downtime is necessary. You will be able to go out in the sun, apply make-up, and get back to your daily routine immediately following treatment. Some patients may experience mild swelling and redness; however this typically goes away within 2 to 24 hours.

Is it effective?

Dr. Joseph Rucker, M.D. stands by his efforts to ensure patient comfort and satisfaction by incorporating Pellevé® into his practice. Pellevé® successfully passed all of his following criteria:

1.   Research shows its benefits

2. A waiting period to review the long term effectiveness of the technology

3.   My own personal use of the technology

For more information or to set up an appointment for a Pellevé® treatment, please call our offices: 715-832-1774. All inquires are welcome and can be answered by an experienced Rucker M.D. staff.