✼ Breast Cancer Reconstruction
Breast reconstruction should be an integral part in the discussion of treatment and plan of breast cancer patient who is undergoing a mastectomy. Patients should have a consultation by a plastic and reconstructive surgeon prior the oncologic surgery to discuss the different types of reconstructive surgery and to individualize not only the oncologic treatment but also the timing of the reconstructive procedure.
The method of breast reconstruction is divided into two types: autologous (one’s own tissue such as muscle/fat/skin) vs. tissue expander/implant reconstruction. Autologous breast reconstruction is done with transfer of tissue with its blood supply like pedicled TRAM flap or disconnecting the blood supply and reconnecting it at a different site (micro vascular surgery) like free DIEP flap. Each has its own risks and benefits. Tissue expander reconstruction is less tasking on the body and allows a quicker recovery. However, requires multiple small procedures. A “balloon” like device is placed to either stretch the skin or maintain the skin until a permanent silicone cohesive gel implant can be placed. Both of these reconstructive procedures at the end of the treatment involve reconstructing the nipple and areola.
Dr Kahng is also one of the few reconstructive plastic surgeons who offer a one stage implant reconstruction to patients with certain types of breast cancer that do not require radiation. Also this is ideal for patients who have a strong family history or who test positive for the breast cancer gene undergoing prophylactic nipple sparing mastectomy to prevent breast cancer. Dr Kahng uses a permanent cohesive silicone gel implant along with an acelluar dermal matrix (Alloderm/Strattice) sling.
The length of the procedures, the number of procedures, recovery time, and hospitalization has to be considered and like a cosmetic procedure, breast reconstruction also has to be individualized. Therefore, Dr Kahng will give recommendations after the consultation, to tailor the surgical treatment after consideration of the overall cancer treatments (chemotherapy, radiation)
✼ Labioplasty and Vaginal Wall Reconstruction
Due to the process of child birthing and hormonal changes, the external and internal anatomy of the vaginal area is changed. The external genitalia (labia minora) may acquire excess skin, causing discomfort and the birth canal can also be stretched and cause urine leakage. Sometime labial enlargement is congenital. Labioplasty to reduce the size of the labia minora and vaginal reconstruction is necessary to restore the anatomy and re suspend the bladder. These procedures can be covered by your insurance depending on the plan.
✼ Hand Surgery
Dr Kahng provides an extensive comprehensive care for patients with hand problems. Procedures performed by Dr Kahng are as follows: simple laceration repairs to the fingers/hand, repair of complex tendon lacerations, carpel tunnel release, trigger finger release, treatments for De Quervain’s tenosynovitis, and treatments for Dupytrene’s contracture. Hand/occupational therapists are integral part of hand rehabilitation to achieve a normal function and Dr Kahng will arrange the therapy with your insurance carriers.
✼ Scar Reconstruction
Scar management is a vital component of plastic surgery because of the significant variation in scarring. Patient’s ethnic background can predispose them to bad scarring where it is from elective or non elective surgery. Scars can cause functional problems in particular over joints causing limitation in the range of motion. Dr Kahng will provide many options in scar management from noninvasive to invasive procedures. Scars take up to 1 year to mature and remodel and in that process, silicone tape therapy and intra lesional steroid injection can be utilized. Surgical scar excisions/revisions can be done if refractory to initial treatment and especially if limitation of range of motion of a joint.