Angelina Jolie – Scarless Breast Augmentation Surgery

In a May 14, 2013 article entitled “Angelina Jolie Reveals She Had Preventive Double Mastectomy After Discovering Cancer Gene,” Fox News reported the movie star had opted to undergo the procedure upon learning that she carried a gene that doctors estimated gave her an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer (go to: goo.gl/5JHBP). Ms. Jolie’s personal physician followed up on May 16, 2013 with a blog post entitled “A Patient’s Journey: Angelina Jolie” that details Ms. Jolie’s diagnosis, condition, and treatment (go to: goo.gl/LD1RK)

“I’d advise every one of my female patients to read the blog post,” says Dr. Simon Ourian, Medical Director of Epione Beverly Hills. “It does an excellent job of explaining the role of BRCA genes on breast and ovarian cancer and the initial diagnosis and treatment plan phases. As an aesthetic physician, for the sake of my patients I appreciate the detailed accounting of the initial surgery all the way through breast reconstruction with implants.”

According to the Fox News report, Ms. Jolie completed three months of surgical procedures from February through April of this year. The process began on February 2, 2013 with a procedure known as a “nipple delay” to confirm the nipples are safe to maintain, an important aesthetic and psychological consideration for many mastectomy patients. It was a nine week process from that first procedure to Ms. Jolie's third and final operation to reconstruct her breasts withimplants.

“I appreciate the amount of effort and resources that is dedicated now to achieving natural-looking final results,” says Dr. Ourian. “I’m very grateful, honored really, when I’m called upon to perform laser scar revision on post-mastectomy patients.”

Dr. Ourian has been a pioneer in laser technology and non-invasive aesthetic procedures including Restylane, Juvéderm, Radiesse and Sculptra. These treatments are used for the correction or reversal of a variety of conditions such as acne, acne scars, skin discoloration, wrinkles, stretch marks, varicose veins, cellulite, and others. More information about breast augmentation can be found on Epione’s website.

Angelina Jolie's Breast Surgeon Speaks Out

The plastic surgeon who performed Angelina Jolie's recent breast reconstruction is speaking out, calling for a team approach to breast-cancer treatment, with plastic surgeons involved from the time a woman is diagnosed with cancer and is considering her treatment options.

Dr. Jay Orringer, who practices at The Renaissance Medical Center for Aesthetic Surgery Inc. in Beverly Hills, Calif., will speak about the team approach, or "the breast team," today (Oct. 16) at a doctors' meeting in Hollywood, Fla.

"A woman has the right to speak with not just the breast surgeon, but also a plastic surgeon, to understand the various treatment options and their implications," Orringer said.

The breast team would include the general surgeon, medical oncologist, radiation oncologist and gynecologist, Orringer said. Also, psychotherapists, support groups and physical therapists may be important members of the support team.

A plastic surgeon can help women understand how different treatment options affect the quality of breast reconstruction, Orringer said. [6 Foods That May Affect Breast Cancer Risk]

Generally, there are two approaches to treating breast cancer. In breast-conserving surgery, the tumor is removed, and radiation therapy is applied to the breast. The second method involves removing the breast altogether, which is called a mastectomy.

If a woman chooses to conserve the breast and undergo radiation therapy, there will be permanent changes to the breast tissue and the chest wall, Orringer said. If she subsequently requires a mastectomy because of a new cancer, the quality of breast reconstruction would be diminished.

"What I would like to avoid in the future is a woman coming in for breast reconstruction after previous radiation therapy, and saying, 'I had no idea about the implications of the radiation I had,'" Orringer said.

Orringer was part of a team of physicians who cared for Jolie when she had a prophylactic mastectomy to prevent breast cancer. Jolie carries a mutation in the BRCA1 gene, which significantly increased her risk of developing breast cancer, she wrote in an Op-Ed in the New York Times in May.

About 12 percent of women in the general population will develop breast cancer sometime during their lives. But the risk for women like Jolie, who carry a mutation in either the BRCA1 or BRCA2 genes, is much higher.

Women at high risk for breast cancer may choose to undergo "active surveillance" and get tested regularly. Another option is to remove both breasts, a procedure called a prophylactic double mastectomy, which can reduce the risk of developing breast cancer by approximately 90 percent.

Newer surgical techniques, including skin and nipple preservation and scars that resemble cosmetic approaches, are improving aesthetic outcomes.

"The idea of a scar that goes across the chest is increasingly becoming a scar of the past," Orringer said.

Moreover, a plastic surgeon could discuss the timing and techniques of reconstruction. There are generally two categories of breast reconstruction: using an implant,or borrowing fat tissue from another part of the body. Each has its pros and cons, Orringer said.

Depending on the patient's general health and the nature of the tumor, the reconstruction surgery could be done either at the time of the mastectomy or be delayed if other treatments are anticipated.

An immediate reconstruction may also diminish the sense of loss for the patient, as she awakens knowing the reconstruction has already begun, Orringer said.

"A woman is the captain of her own health care team, and the doctors involved should be co-captains with her, working with her to help achieve the best outcomes," Orringer said.