San Diego Breast Reconstruction doctors
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Tom J. Pousti, MD
San Diego Plastic Surgeon
8851 Center Drive Suite 300, San Diego |
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5 answers |
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Steve Laverson, MD
San Diego Plastic Surgeon
477 North El Camino Real Suite D-304, Encinitas |
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4 answers |
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H. Michael Roark, MD
San Diego Plastic Surgeon
9850 Genesee Avenue, Suite 130 Ximed Building, La Jolla |
3 answers | |
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Paul E. Chasan, MD
San Diego Plastic Surgeon
1431 Camino Del Mar , Del Mar |
2 answers | |
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Gary H. Manchester, MD
San Diego Plastic Surgeon
3720 Fourth Avenue, San Diego |
2 answers | |
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Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
9834 Genesee Ave Ste 311, La Jolla |
2 answers | |
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Antoine A. Hallak, MD
San Diego Plastic Surgeon
16766 Bernardo Center Drive Suite 109, San Diego |
2 answers |
Recent Answers
I am 35, having a unilateral mastectomy, no chemo, no radiation. I've received two different opinions from board certified plastic surgeons about reconstruction - one said tissue expander (delayed) will achieve symmetry and no Lat flap technique is necessary, the other indicated a Lat Flap with implant(immediate) will achieve symmetry best and the delayed tissue expander option will result in a flat breast. Is this true - how do I choose?
Without more details it would be difficult to give you specific advice, but you might consider these principles in making this decision:
1. Delayed reconstruction is associated with a lower complication rate.
2. Placement of a tissue expander is a simpler operation, with no donor site involved.
3. The latissimus dorsi flap is a more complex operation, with a longer recovery, but has the advantage of a potentially better result.
4. Delayed reconstruction will sacrifice some of the skin of the breast, which may result in central flattening of the reconstructed breast.
I'm 35 years old and in two weeks, I'll have Mastectomy of left breast and immediate Breast Reconstruction with implant-expander. The PS told me that my right breast (the good one) needs just 2 cm lift which he will do with crescent lift. The second option is to put a small implant and increase size a little bit.
What do you think? Which procedure would have the best result (more symmetric breasts) in my body (my chest is skinny as you can see in the pic) for now and in the future? Thank you in advance.
Operating on the other breast for symmetry is very commonly performed following mastectomy. However, a sound principle would be to address only the breast that needs to be operated on at this time, and to defer any surgery on the unaffected breast. One may have to accept a period of breast asymmetry during this process. There are two good reasons for this:
1. Only after completion of the mastectomy and implant reconstruction will one truly be able to estimate the volume and shape of the left breast.
2. There is a significant number of young breast cancer patients who opt for contralateral mastectomy. This is always the patients' decision to make. A mastopexy should not be performed until a thorough discussion regarding the risks and benefits for contralateral mastectomy has been completed. Here I would advise you to consult with your medical and surgical oncologist as well as your plastic surgeon.
im a B 34 and i want to be flat chested (but then you will look like a guy!) i dont care i want them gone there miserable i hate it i dont see myself as a girl anyways, i have been considering this for 2 years now and my mind isnt going to change can i please get an idea on the price
Thank you for the question.
I have taken care of several patients in the past 2 years who have wanted to be as flat-chested as possible. sometimes these patients undergo surgery as part of a “transition” process ( gender identity). Often, it is helpful for my standpoint, for patients to have undergone a period of counseling to ensure that their decision is a well thought out decision etc.
During breast reduction surgery is important to maintain the blood supply to all the breast tissue and the nipple/areola complexes. The blood supply to the nipple areola complexes are maintained via a “pedicle”. If this pedicle is made to small or narrow in the quest to achieve a very small breasts, the blood flow to the nipple/areola may be compromised resulting in a ischemic nipple/areola and complications that are potentially difficult to treat.
Sometimes, when patients are very clear about their goals to achieve a very small breast size (almost flat), then it is best to do the breast reduction procedure in 2 stages. This allows the breast tissue and nipple/areola tissue to acclimate to the decreased blood flow during the first stage before further reduction is performed.
It will be important to select a plastic surgeon carefully. make sure you select a well experienced board-certified plastic surgeon and see lots of examples of his/her work.
Costs for surgery will depend on the specific practice; often, costs are determined after consultation, during which time a specific plan is determined.
Best wishes.
