What types of breast oncology surgeries does Dr. Olaya do?

Dr. Olaya performs wire localized excision biopsies, partial mastectomies, also known as lumpectomies, bilateral mastectomies, sentinel lymph node dissections, and axillary lymph node dissections. And works with the radiation oncologist to provide intraoperative radiation therapy.

What is a partial mastectomy?

A partial mastectomy, also known as a lumpectomy, is a surgical procedure that removes part of the breast tissue that has cancer and a small rim around it in hopes to prevent reoccurance.

What is a nipple-sparing mastectomy?

A nipple-sparing mastectomy is a procedure that removes all breast tissue but spares the skin, areola and nipple. A biopsy of the underside of the nipple is also taken at the time of surgery to ensure that cancer is not involved in the nipple.

What is a sentinel lymph node dissection?

A sentinel lymph node is the first lymph node that filters fluid draining away from the area of the breast that contained the breast cancer. If cancer cells are breaking away from the tumor and traveling away from the breast via the lymph system, the sentinel lymph node is more likely than other lymph nodes to contain cancer. The idea behind sentinel node dissection is this: Instead of removing 10 or more lymph nodes and analyzing all of them to look for cancer, remove only the one node that is most likely to have it. If this node is clean, chances are the other nodes have not been affected. In reality, the surgeon usually removes a cluster of two or three nodes — the sentinel node and those closest to it. (definition from breastcancer.org)

What is involved in a sentinel lymph node dissection?

Before going to the preoperative area, you will have a scheduled appointment at the Radiology department at either St. Joseph Outpatient Pavilion or St. Joseph Hospital. At this location a radiologist will inject a radioactive dye into the area around the tumor. This dye is then taken up by the lymph nodes closest to the tumor, called the sentinel lymph nodes. Later, while in surgery, Dr. Olaya will use a tracking device, called a neoprobe, to detect which lymph node has the greatest uptake of the dye, which will be the sentinel lymph node. The sentinel lymph node and the nodes closest to it will then be excised and sent to pathology.

Who needs an axillary lymph node dissection?

Axillary lymph node dissections are indicated for patients who have known axillary disease preoperatively (prior positive biopsy of axillary lymph nodes) and for those with positive sentinel lymph nodes. Similar to a sentinel lymph node dissection, radioactive dye and a neoprobe are used to trace the lymph nodes from the site of the tumor to the axilla, or underarm, and are dissected at the time of surgery.

Why should I have a breast reduction/lift before mastectomy?

For women with larger breasts, reconstruction (placement of implants) after a mastectomy can be challenging. The blood supply to the skin and nipples can be greatly affected when a large amount of breast tissue (mastectomy) is removed, therefore by reducing a portion of the breast at a time, the skin and nipples can adjust to the change and reduce the risk of becoming necrotic (dying as a result of lack of blood/oxygen). Another benefit of a breast lift before a mastectomy and reconstruction is that the nipples and areolas can be positioned to a more central position, rather than sagging or pointing down. Lastly the size, shape and position of the breast after breast reduction/lift and post mastectomy reconstruction are generally more cosmetically appealing.

This does mean a two stage surgery, requiring at least 3 months of healing between part one and part two.

What are some of the reconstructive options?

Dr. Olaya’s goal for her patients are to undergo as few surgeries as possible, therefore her most common reconstructive option after a bilateral or lateral mastectomy is immediate reconstruction with implant(s).

Other reconstructive options include latissimus flap reconstruction, fat grafting or placement of tissue expander. Tissue expanders generally require a second procedure at a later time, in order to replace the expander with either a silicone or saline implant. This type of delayed reconstructive procedure may be necessary when the skin and tissue are fragile, limited or lacking enough blood supply to retain an implant.

Please call our office to schedule an appointment to discuss your options.

What if I have a history of breast cancer and do not like my reconstruction?

You are entitled to revisions if you do not like the appearance of your breasts after breast reconstruction or mastectomy! Dr. Olaya specialized in a variety of reconstructive surgeries. The amount and health of your skin and tissue covering the breast, as well as size and shape of remaining breast(s) will determine the options for surgery. As the patient you have a say in what size you’d like to be, the height, position and shape of your breasts and what type of implants are used or not used. Please call our office to set up an appointment with Dr. Olaya to discuss your options.

What is Breast Augmentation?
Breast augmentation is also referred to as breast enlargement. During an augmentation procedure, the breasts are enlarged, reshaped, or restructured in an attempt to make them look more full, firm, and youthful. The patient has a choice of shape and size when it comes to implants. Implants are manufactured using saline, silicone, or other materials. During a breast augmentation procedure, small incisions are made into the skin and pockets are made to hold the implant. The breast implants may be placed either under or over the pectoral muscle.

What are the Benefits of a Breast Augmentation Procedure?
Breast augmentation procedures offer many benefits to individuals who want to restore or rejuvenate their appearance. After a person has lost an excessive amount of weight or even due to simple aging, the breasts may begin to lose their form and begin to sag or droop. Breast implants can uplift and restore a more equal, round appearance to the breasts, making them look fuller and more youthful. A breast augmentation surgery can restore a woman's self-confidence and offer her a renewed sense of self.

How Long is the Recovery Time for a Breast Augmentation Procedure?
The recovery time will generally depend on where the breast implants are placed during the procedure. If they are placed above the muscle along the surface of the chest wall, the recovery time may be as little as four to six weeks. If the doctor chooses to place the implants below the muscles of the chest wall, it can increase the recovery time.Dr. Olaya will evaluate each patient's situation and the discuss the options with the patient to determine which placement is the best option.

What is a Tummy Tuck?
A tummy tuck procedure, also known as an abdominoplasty, is performed to tighten and tone the tissues and skin of the stomach. A tummy tuck is often performed for several reasons. The procedure can remove unwanted fat along the abdomen and tighten the abdominal wall, which can be especially useful after multiple pregnancies. It also reduces excess sagging skin for those who have undergone an immense weight loss.

How Does Liposuction Work?
Liposuction works by removing excess fat with a surgical suction technique in areas where it tends to accumulates in large quantities. These areas include the abdomen, thighs, buttocks, hips, and lower back. During a liposuction procedure, the doctor maps out the treatment area and then makes an incision. A long wand is inserted through the incision and is used to break up and suction out the fat. Liposuction is used on larger areas of fat where laser procedures can be used to eliminate smaller pockets of fat in harder to reach areas.

What is SculpSure®?
SculpSure® is a body contouring laser procedure that targets the fatty deposits that seem to get passed by when it comes to exercise and liposuction. The laser targets hard to reach areas that are smaller and more remote than the larger sections targeted by liposuction and abdominoplasty procedures. SculpSure® is non-invasive and offers very few side effects. The procedure lasts approximately 25 minutes. Initial results are apparent after the first three to six weeks, while the final result will be noticeable after three or four months. The results of a body contouring procedure are long lasting and will not have to be repeated unless the person gains more weight.

What Techniques are Involved in Body Contouring?

Body contouring uses several techniques to address various areas of the body. For the arms, thighs, chin, hips, lower abdomen and other hard to reach areas, procedures like SculpSure® are used to remove excess fat and define the area. Abdominoplasty procedures are used to eliminate any unwanted tissues, including fat, excess skin and soft tissues throughout the abdominal areas. Liposuction is also used to eliminate fatty deposits, but this is primarily used on larger areas of the body, such as the outer thighs, abdomen, and back. These body contouring procedures can be used together or separately to enhance and tone a patient's body, especially in many areas that are hard to reach and that remain untouched by exercise and physical activity.

How many moles, lesions or biopsies can I have removed in one visit?

For the health, safety and comfort of the patient, we allow only two skin excision procedures in one visit.

Does Dr. Olaya do Mohs surgery?

No, Dr. Olaya does not do Mohs surgeries. But we can refer you to a few surgeons who do specialize in this procedure.

What are my restrictions after a skin excision procedure?

Generally, Dr. Olaya allows her patients to take a shower 24 hours after the procedure and workout the next day, without restrictions. The only restriction she asks of her patients is not to submerge the incision in ANY body of water, this includes pools, jacuzzis, bath tubs, lakes and ocean.

What can I do after the skin excision procedure to improve the appearance of my scar?

The best way to prevent scarring is to keep your new incision out of the sun! Apply sunscreen, wear sun-protective hats and clothing, and stay in the shade when possible. Dr. Olaya also sells BIOCORNEUM cream which prevents and minimizes the appearance of hypertrophic (red, raised) scars. BIOCORNEUM also contains SPF 30, and should be applied twice a day.

What are Injectables?
Injectables include collagen stimulators, neurotoxins, and dermal fillers that are capable of reducing the signs of aging and restoring the skin to its youthful vibrance. Dysport® uses a neurotoxin to relax the muscles in various portions of the face, releasing wrinkles and smoothing the skin. Restylane® uses hyaluronic acid to fill in hollowed areas that appear on the face. Hyaluronic acid is a naturally occurring substance that keeps the skin looking full and firm. As a person ages, acid and other elements in the skin that help to maintain its youthful appearance, begin to diminish. By using dermal fillers and other types of injectables, Dr. Olaya can "turn back the clock" and dramatically reduce the signs of aging.

Do Dermal Fillers Have Side Effects?
The side effects associated with dermal fillers are usually minimal. Warmth, redness, itching, skin irritation and mild swelling are common near the injection site. The area may also be tender to the touch and slightly discolored. Each patient can react differently to the treatment. Some may have no side effects at all, while others may have a moderate swelling and skin sensitivity. For the first few days after the procedure, the tissues near the treatment may feel extremely firm, but this should dissipate within a few days after the procedure. It is usually attributed to swelling under the surface of the skin and will soften as the body becomes used to the filler.

How Long Does a Dermal Filler Treatment Last?
Dermal fillers can last anywhere from three to six months. Other fillers can last up to a year under the right circumstances. Several elements will play a role in how long a dermal filler treatment lasts. The kind of filler being used and the age of the patient are two of the biggest factors. The health, original texture and tone of the skin are also important. If a person has naturally strong skin, the use of dermal fillers may result in longer-lasting treatments. In fact, repeated treatments can help to build the skin's foundation of collagen to the point that the length of time between procedures can be extended by several weeks.

What is Involved in a Laser Hair Removal Procedure?
During an ICON® laser hair removal procedure, hairs are targeted with an intense beam of light, that degrades the hairs at their roots. Hairs that have been lasered will often return after three to four months but will be much thinner and lighter than in the past. After so many sessions, the hair may not return at all. Hair removal procedures can last anywhere from 30 to 60 minutes, depending on the size of the targeted area. ICON® laser hair removal procedures are non-invasive and produce very few side effects. During a hair removal session, the patient does not need any anesthetic or other types of sedation.

How Many Treatments are Needed?
Laser hair removal treatments can show a dramatic reduction in the coarseness and color of a hair after only one treatment. Finer hairs will be the first to be eliminated. Hairs that are coarse and dark may require several treatments before they begin to lighten and appear less coarse and rigid. While complete hair loss cannot be guaranteed, laser hair removal treatments can provide lighter, finer hair after two or three treatments. The rate at which the hair grows back will depend on the hair itself, as well as the patient. Frequency and timing of treatments depends on the location of the hair and its growth pattern cycle. Each patient will respond to the treatment differently causing the hair to return much slower in some cases, with no hair growth in others.

Will the Hair Eventually Grow Back?
With most laser hair removal procedures, the hair will eventually grow back, especially if it is very dark and coarse. The finer the hair that is being treated, the longer it may be before it returns. In some cases, the hair may become so fine that it eventually stops returning, although this is not always the case with every person.

What is a Breast Lift?
A breast lift is a surgical procedure in which the structure of the breasts are altered to correct sagging and drooping. A breast lift is similar to a breast augmentation procedure, but instead of enlarging the breast through the use of implants, Dr. Olaya lifts or raises the breasts to a more natural height, making them fuller and more firm. During this process, the areolas and nipples are also adjusted to compensate for the new height. A breast lift is often recommended after a woman has had several pregnancies and breast fed her children. Sagging breasts may also be the result of excess weight loss or aging that has weakened the breast tissues.

How Long is the Recovery Time for a Breast Lift Procedure?
Recovery time is variant from patient to patient. It typically takes six weeks for the skin and tissues to heal.The breast size, and the depth and extent of the reconstruction may add to the patient's healing time. If the patient follows their instructions concerning rest, lifting restrictions and proper wound care, the healing time will go smoothly. In many cases, a patient may choose to have a breast lift procedure performed in conjunction with an abdominoplasty or other types of cosmetic procedure. Dr. Olaya may adjust the length of the recovery time so the patient can heal sufficiently before resuming regular activities.

What is Involved in a Facial Rejuvenation Procedure?
There are many different procedures that are used during facial rejuvenation. Eyelid surgeries, neck lifts. She also has options for less invasiuve options such as: dermal fillers and botox. Each option works to rejuvenate the tissues and restore original form and function. Facial rejuvenation procedures help to correct abnormalities in the structure of the face as well as enhance the tone and texture of the skin and soft tissues that are often adversely affected by aging. As the skin begins to age, it loses its ability to stretch or move freely and return to its normal position. With decreased collagen production, the skin no longer has the support it needs to be youthful and vibrant.

How Effective is a Rejuvenation Procedure at Reducing the Signs of Aging?
A facial rejuvenation procedure may not be able to permanently reduce the signs of aging, but it can slow down the process and provide temporary support. Facial rejuvenation procedures that involve the use of dermal fillers can provide temporary relief by increasing the amount of collagen and elastin the body produces. The additional collagen helps to firm and tone the skin, reducing sagging and the appearance of wrinkles and lines. This procedure creates a smoother surface with fewer imperfections. Facial rejuvenation techniques, like the ICON® laser, can help to lighten blemishes and discolorations,or at a different setting it can encourage the body to produce more collagen.

What Other Procedures are Used for Facial Rejuvenation Besides Surgery or Injectables?
The ICON® laser system is beneficial for individuals who don't want to pursue more invasive methods. Lasers can offer a wide variety of benefits for individuals who want to rejuvenate their skin and restore a more youthful looking appearance. They can tighten the surface of the skin, as well as tone the underlying tissues. Techniques that encourage the production of collagen and elastin help to firm and strengthen the tissues. Lasers can also lighten skin discolorations and eliminate small scars and wrinkles. Pelleve® is a laser that uses radiofrequency waves to help stimulate the production of collagen and strengthen the underlying tissues of the face and other areas of the body.

Do Injectables Offer Long Term Results When it Comes to Wrinkle Reduction?
Injectables like Restylane® and Dysport® can provide dramatic results when used to help reduce the appearance of wrinkles. Wrinkle reduction techniques take many forms. In most cases, the results of an injectable treatment can last anywhere from three to six months (Botox®) or six to nine months (Restylane®). The duration of an injectable treatment will also depend on several outside factors that include the patient's age, level of damage to the skin, and how many treatments they have already received. If a person has received several treatments in the past, the results will begin to last longer with each additional treatment they receive.

What are the Benefits of a Face Lift?
Individuals who choose to receive a face lift do so for several reasons. A face lift not only eliminates the signs of aging, it can also boost a person's self-confidence and self-esteem. When a person feels good about their outward, physical appearance, they tend to take better care of themselves in other ways. Face lifts can eliminate unwanted tissue and restore firmness and texture to the surface of the skin, reducing the effects of sun damage and slowing down the aging process. A face lift procedure can last for several years providing longer lasting, more sustained rejuvenation over and above dermal fillers.

Are Lasers Effective at Reducing Wrinkles?
Lasers can play a role in the reduction of wrinkles and other imperfections. Pelleve® is a laser that uses radiofrequency waves to help stimulate the production of collagen and strengthen the underlying tissues of the face and other areas of the body. The ICON® laser also works to reduce the appearance of wrinkles, fine lines, blemishes, and other imperfections. Through the use of RF or radiofrequency waves, lasers can perform many rejuvenation procedures without ever breaking the skin. They also provide maximum benefits when it comes to wrinkle reduction with a minimum of risk.