I am compelled to make some of the information from a tweet chat about breast reconstruction options after mastectomy available. The chat was made possible through the collaborative efforts of the author, Terri Coutes and the American Society of Plastic Surgeons (ASPS) on February 22nd of this year. It is important because of the fact that it was done completely through social media and illustrates the importance of this medium in reaching men and women who might not be reached through other avenues. To read the complete outcome of the effort, you can go to (www.plasticsurgery.org/news/plastic-surgery-blog/breast-reconstruction-tweet-chat-and-the-value-of-social-media.html).

“Monday evening, February 22, 2016, was a much anticipated #bcsm tweet chat for me. I reached out to Dr. Deanna Attai in late 2015 when she was requesting topics to cover for the upcoming year. I asked for an evening of discussion about breast reconstruction options after mastectomy. I have been diagnosed with breast cancer twice and had a very successful experience using my own tissue to reconstruct my breast, DIEP flap surgery. Breast Reconstruction advocacy and educating other women about the topic is what I do now so I was delighted when Dr. Attai put us on the schedule. From there I began to “circle the wagons” for support.

I reached out to the social media specialist at the American Society of Plastic Surgeons (ASPS) to see if they would be interested in participating and adding to the discussion. They put their expert plastic surgeon and current president of ASPS, Dr. David Song, front and center as the specialist on the topic to partner with me for the evening.

The purpose was to provide more education and information to those who could join us for the tweet chat. We set up a telecom to plan the topics and went over the basics of the tweet chat. We strategized about the best way to promote the event and which social media platforms to use for that.

It was important for me to have the ASPS representatives in the discussion because they were an impressive force behind the passage of the Breast Cancer Patient Education Act. This was a bill that was passed into law on December 18, 2015, as an education campaign to inform and educate women and men about their breast reconstruction options. We promoted the chat as planned and on the evening of February 22nd, we all sat poised, with fingers in “tweet position” ready to begin discussion.

When the “fastest hour on Twitter” came to an end I admittedly had to ask myself, “Did I tweet out enough information?” I truly sat back during the discussion at one point and just let the comments and questions fly and felt like I could have been doing more. It wasn’t until I looked at the summary of the conversation provided by Dr. Attai on Symplur the next day that it all fell into place for me. I realized how much I didn’t see that evening as I was furiously trying to keep up with the tweets. It gave me a lot of satisfaction to see what was discussed, what I missed during the actual session and how multi-faceted the topic of breast reconstruction after mastectomy truly is.

Here is a brief summary of key items covered and some of the comments that were shared.

Complications of breast reconstruction:

Smoking! A big no-no when it comes to reconstruction surgery. You’ve just got to stop before, after and hopefully for good.

Possible Infection rates: One participant remarked she had 6 surgeries, due in large part to an infection. Although she was told about outcomes she didn’t feel fully informed about complications. She said when those complications popped up, “it was really hard”.

A Stage IV patient weighed in about the possibility of reconstruction when you’re faced with metastatic disease. Caution was given from one physician stating that it is still controversial as it must be evaluated on a patient by patient level. Hope was given by another physician stating that it is an option even for patients with mets and offered that studies have been shown to increase quality of life. It was important that the disease be stabilized and the patient is in good enough health for the reconstruction.

Radiation therapy was labeled by one as a “wild card”. It can affect outcomes both before and after reconstruction whether using implants or autologous flaps (your own tissue to reconstruct the breast).

The timing of reconstruction was a hot topic. It was mentioned more than once that breast cancer is rarely an emergency situation. A majority of the time, surgery and the research to plan reconstruction is something that can wait for both women and men. Many stated that patients felt rushed into a decision because of the stigma, “the cancer needs to come out now”. It is sometimes perceived as more of a “mental emergency” than a “medical emergency”.

It was important to note that reconstruction rarely is one procedure. Revisions and repairs often required more than one surgery and sometimes multiple surgeries to achieve desired patient outcomes.

Insurance concerns loom large for many. Some facilities don’t use certain insurance providers which lead to roadblocks for some patients.

Travel is often times required to get to a qualified plastic surgeon or to find one that carries your insurance.

Some women try to get all necessary surgeries done in one year so that they do not have to pay their deductibles and meet their out of pocket two years in a row. It is not possible for some to plan that way due to continued adjunctive therapy or further tests/scans prescribed for the breast cancer diagnosis.”

For the complete outcomes of the tweet session go to (www.plasticsurgery.org/news/plastic-surgery-blog/breast-reconstruction-tweet-chat-and-the-value-of-social-media.html)

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