Q&A with Dr. Sanjay Azad: Breast Reconstruction

Dr. Sanjay Azad
Dr. Sanjay Azad, Plastic Surgeon, answers questions about breast reconstruction as part of the breast cancer patient journey. Dr. Azad will be speaking at Breast Reconstruction Awareness (BRA) Day on October 16th from 6:00-8:30 pm at the Prince Arthur Waterfront Hotel.

Breast reconstruction is part of the journey for many breast cancer patients, but it’s not as commonly discussed part of the journey like screening, diagnosis and treatment. Dr. Sanjay Azad, Plastic Surgeon in Thunder Bay since 2013, wants to build more awareness about breast reconstruction, and answers some basic questions about reconstruction post-treatment.


Q: What is breast reconstruction? Where does it fit in a cancer patient’s journey?

Breast reconstruction is the process of creating a breast with either a prosthetic or body tissue that looks as close to a natural breast as possible.  A patient can start thinking about breast reconstruction right away, but obviously there is a lot going on initially. Reconstruction can be done either immediately, at the time of mastectomy or lumpectomy, or it can be delayed and done once chemotherapy and radiation therapy are complete. It is never too late for reconstruction.

Q: What are the main types of breast reconstruction?

The main types of reconstruction include implants, back muscles and tummy tissue, fat grafting and resection-reduction procedures. We offer all breast reconstruction options in Thunder Bay, except for the type that uses tummy tissue, which is done in larger centres (i.e. Toronto or Winnipeg).

Q: How is breast reconstruction tailored to the individual?

When it comes to choosing which type of procedure, I work with my patients to make a decision that is best for them. My interest is in improving the quality of life of my patients after breast cancer treatment. The fact that the breast is missing is a huge physical and psychological change to a woman as breasts are intrinsic to womanhood. It is very important for women to know that there is hope to feel complete and satisfied with their body image again.

Q: What is the typical process for reconstruction?

Breast reconstruction is a multi-stage procedure. It starts with a consultation, and once we have assessed the situation, we determine if the patient is suitable for prosthetic or body tissue reconstruction. Multiple factors are taken into account, including: health status, underlying medical conditions, smoking history, available of body tissue etc.

An example of a process after a mastectomy is: an initial operation where the foundation is laid with prosthesis or body tissue and sometimes a combination of the two. After a minimum of six months a ‘tidying up’ procedure is done, which sometimes requires lifting or reducing the other breast. This operation is where the nipple is reconstructed over the breast mound which has been created.

The final procedure of nipple tattooing is done a minimum of three months after the operation.

With lumpectomies, we perform fat grafting to improve contour and softness of the breast, particularly because these patients have had radiation.

Q: What is nipple tattooing?

Nipple tattooing is a process of medical tattooing for the pigmented area of the nipple and areola. This is done by someone who has been trained to tattoo nipples after reconstruction because there are many factors to take into account and implants close by to consider. It should be done properly with some plastic surgery oversight to make the procedure safe.

Q: Is breast reconstruction covered by OHIP?

All procedures related to breast reconstruction are covered by OHIP, including nipple tattooing. It is really important for women to be aware of this. There are options and there is coverage.

Q: What is BRA Day?

Breast Reconstruction Awareness (BRA) Day takes place October 16th from 6:00-8:30 pm at the Prince Arthur Waterfront Hotel. This is a free event hosted by the Canadian Cancer Society, in partnership with Thunder Bay Regional Health Sciences Centre and the Breast Cancer Support Group, which promotes education, awareness and access for women considering breast reconstruction.

BRA Day will feature health care professionals, like Dr. Azad, and women who have had different forms of reconstruction and those who have not had reconstruction will be speaking and sharing their stories. For more information, or to register for the event, visit: www.bra-day.com.