Breast reconstruction
Introduction
Elizabeth Anderson is a 26-year old single mother of two from Swansea. During weekdays, she’s a teacher at a local nursery while at night, she’s a club dancer. Her mother and maternal aunt both of whom were Southampton natives were on separate occasions diagnosed with advanced breast cancer. Although her aunt’s cancer went on remission, her mother wasn’t very lucky as her cancer had metastasised and she succumbed to the disease in July 2014. Alarmingly, Anderson’s elder sister and her daughter were recently diagnosed with breast cancer too. It seems cancer is deeply rooted in Anderson’s maternal side of the family. She, therefore, decides to consult an oncologist and gynecologist both of whom advised her to undergo a double mastectomy as she was highly likely to develop breast cancer as well. After much anxiety and hesitation, Anderson finally consented but the surgical procedure left her traumatized. Her self-esteem as a young beautiful woman with no breasts is at an all-time low especially given the fact that she had high hopes of finding a partner to marry her. Her flat chest has also dented her social image. She has tried to wear baggy dresses and blouses but to no avail. Early this year, she decided to approach a psychiatrist who after evaluating her mental condition recommended she undergo augmentation mammoplasty as a surgical remedy for her depressive mood. Anderson believes this procedure will not only erase her shame and improve her self-esteem but it will also make her feel whole as a woman. To guarantee her confidentiality, the hospital will employ the confidentiality, integrity, and availability (CIA) triad in its information management systems. That means healthcare professionals attending to her will have limited information access due to the principle of least privilege. In other words, the receptionist, the pharmacist, and the finance officer will not have access to her surgical procedure details which will only be accessible to the surgeons and the caring nurse. Similarly, the surgeons will not have access to her home address or her billing information which could be used to track her down her residence or family. In other words, every healthcare professional will not as little as necessary about her.
In terms of surgical procedure, the surgeon will employ the skin-sparing mastectomy technique to save enough skin for breast reconstruction. The procedure will commence with a tissue expander. Here, the surgeon will insert the device under the skin that the mastectomy surgeon left behind. Alternatively, the surgeon may extract a flap from the abdomen, thighs, back, or buttocks for breast reconstruction. After the surgery, the patients will periodically visit the surgeon for him to gradually fill this device with saline. When the chest tissue will finally heal and relax allowing for the void, the surgeon will remove the device and in its place, insert an implant. Throughout the procedure, the surgeon will employ the acellular dermal matrix to provide support for the device and then the implant. Finally, the surgeon will have to reconstruct the areola and the nipple when he’s satisfied that the breast mound’s position anchored on the chest wall is now stable. If the mastectomy was nipple-sparing, the surgeon may attach Anderson’s real nipple. However, he can alternatively extract fragments of the reconstructed breast’s skin and reconstruct a nipple. Or he can recommend a tattoo expert competent in a 3D form of nipple tattooing