First Date … Dr. West


TUESDAY

DOCTOR DAY #1

Dr. Justin West

It’s December 3rd and I’m meeting Dr. West for the first time.  Yup, that’s him in the above picture. Dr. West is the plastic surgeon who will make me look as good as new.  If you are going to be a plastic surgeon and spending your day telling women they’re going to be losing their breast(s) [and in my case doing so in front of my husband and kids] you would do well to have an awesome sense of humor and a way with words.  Dr. West has both.  He is quite the charmer while giving you medical details no women really wants to hear.  OK ladies … I’ll state the obvious … he is way too cute.  That said, he changed my entire outlook on my treatment plan.  I think I’ve made it clear, I will not do chemo therapy and prefer to have a double mastectomy.  The tumor scare in the other breast seven years ago was the beginning of this drama and now I wish to preclude a repeat of this current nightmare.

You may want to quit reading at this point if you are easily embarrassed – we’re talking boobies.  Simply put, this is what this is all about – so get real.  The doctor assured me I’m not large chested.  He supported his observation with a classic line, something like I do this for a living and have seen a lot of boobs … you’re not big dear.  So the context for his point was his prescription that includes doing a breast reduction and not the double mastectomy I had mentally and emotionally settled on.  Dr. West was explaining how his technique would leave me with body-appropriate “C-cup” and a high likelihood that I would not need to buy $3.00 pasties.  I’m a perfect candidate for breast reduction and a lousy candidate for a double mastectomy with breast reconstruction, he says.  Why I ask.  The doctor carefully explained that no prosthetic company makes a breast implant that fits me.  So ya, I may not have big boobs according to the doctor, but the manufactures don’t exactly think I’m typical enough to routinely manufacture off-the-shelf replacements.

The doctor’s description of what would be my double mastectomy and reconstruction surgery was mind numbing.  A  5 -8 hour micro-surgery including transplanting stomach skin and fat (which I have) and reconnecting blood vessels and so on, followed by 5 – 8 days in hospital recovery, followed by 7 months of routine checkups, complicated by another 7 likely visits to the ER with ad-hoc cellulitis infections including risks of going septic, followed by life-long visits every several of years to surgically adjust things.  Compare this to the doctor’s prescription for breast reduction.  An out-patient procedure which is followed by several months of manageable discomfort and typically routine visits to make sure things are working OK; and typically a low risk of sloughing off desirable body parts.  I’m listening!

Nothing is free in life as the saying goes.  The protocol for breast reduction includes doing pre-op chemo therapy.  It’s a rather new protocol which includes a recently approved miracle drug that reduces the size of HER2 Positive cancer tumors.  Assuming my body reacts as the clinical trials indicate this drug in conjunction with two others has shrunk tumors to the point surgeons use markers to locate the breast tissue they need to remove.  The breast reduction protocol in my case has the cancer surgeon removing small areas of tissue with the plastic surgeon coming in next – tag your it – to remove lots of breast tissue and then surgically removing and shaping my skin to fit the new size.  As with any surgery there are risks, but the risks here would be hugely lower than the major surgery required if I stick to my original plan.

But chemo therapy!  I’m uncertain at this point.  The chemo doctor is up next.  We see him tomorrow.  Regardless of my final choice in surgical and treatment plans, I can’t finish here without saying thank you to President Clinton and Congress for passing legislation giving women the right to proportional reconstruction surgery after or along with cancer surgery.  What a blessing!

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From his bio, “Dr. Justin West was born and raised in Orange, CA. Dr. Justin West received his Bachelor of Arts in Biology from Pomona College in Claremont, CA followed by his medical degree from Jefferson Medical College in Philadelphia. Dr. Justin West then attended the prestigious six-year residency program in Plastic and Reconstructive Surgery at Georgetown University Hospital in Washington, DC. There Dr. Justin West trained under surgeons renowned for their accomplishments in aesthetic and reconstructive surgery, cosmetic facial surgery, peripheral nerve surgery and advanced wound care and limb salvage.During his training, Dr. Justin West’s clinical research was published in several textbooks and national journals. During his final year at Georgetown, he received the highest score on the national plastic surgery resident examination. After residency, Dr. Justin West pursued fellowship subspecialty training at the distinguished Manhattan Eye, Ear and Throat Hospital where he received advanced training in cosmetic surgery under the direction of internationally recognized experts. He focused on cosmetic surgery of the face, and body, and was involved in teaching plastic surgery residents from New York and Cornell University.Dr. Justin West is the Director of Plastic and Reconstructive Surgery at Breastlink in Orange County. His many years of training have prepared him to offer the latest techniques in both implant and flap reconstruction of the breast, including specialized procedures such as the deep inferior epigastric perforators (DIEP) flap.”

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