Fairfield Breast Reconstruction doctors
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David Greenspun, MD, MSc
New York Plastic Surgeon
77 Lafayette Place Suite 302, Greenwich |
51 answers | |
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Tito Vasquez, MD
Southport Plastic Surgeon
2600 Post Road Suite 206, Southport |
6 answers | |
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Alfred Sofer, MD
Fairfield Plastic Surgeon
33 Miller Street, Fairfield |
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Harvey J. Bluestein, MD
Fairfield Plastic Surgeon
325 Reef Rd. Suite 105, Fairfield |
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Wilfred Brown, MD
Fairfield Plastic Surgeon
260 East 66th Street, New York |
Recent Answers
I had a lumpectomy and re-excision on one breast about 8 weeks ago. I am currently having chemotherapy and am scheduled to begin radiation in April. The area around the incision is flatter than before, and I am concerned that after radiation the area will become even flatter and be cosmetically unacceptable. Assuming that my post-chemotherapy mammogram is fine, is it possible to have plastic surgery to correct the depression before radiation? I know that after radiation, it may be too late.
There are real pros and cons to correcting lumpectomy defects prior to surgery. One of the main problems of reconstruction or breast surgery prior to radiation is that it can delay therapy aimed at abolishing any remaining potential cancer cells. Now that you are already 8 weeks post lumpectomy, reconstruction at this point will delay therapy even longer. Therefore in your situation, I would recommend completing your radiation and waiting until your surgeon recommends that you are ready for a delayed reconstruction.
on march 4th 11 i stopped smoking by using the patch. one month before my surgery on 6/7/11 i stopped the patch and was nicotine free. on november 22 11 i had my 2nd surgery to shape the reconstruction breast and breast lift on the other one. three weeks ago i started smoking 0-3 cigarettes per day. i am so scared that i am going to ruin my reconstruction that i bought the nicotine gum to help me stop. according to these sites i shouldn't even be using that, when would it be safe to start again?
In general, I encourage my patients to stop smoking at least 30 days before surgery, and 30 days after if they are not able to quit completely. Obviously it is preferable to quit smoking completely, but I understand this is very very difficult. I explain to my patients that smoking behaves similarly to diabetes and its effects on blood vessels and healing. Smoking has direct toxic effects on the blood vessels responsible to providing good circulation to healing tissue. In the end, the risks of smoking are far outweighed by the benefits of good, safe surgical outcomes and a healthy lifestyle. Lastly, smoking substitutes such as nicotine gum can be nearly as toxic as smoking since nicotine is a major contributor to these toxic effects.
In Aug. 2011 I Had a Nipple & Skin Sparing Bilateral Mastectomy. I'm Very Fortunate to Have Been a Good Candidate for This, but I keep having a recurring infection(red, draining & PS used term skin thinning but no fever)in rt breast after 2 tries w/bactrim PS arrated area & replaced skin expander so I could start chemo & it did well. I just finished my 3rd chemo treatment(I'm half way through but still have a yr of Herceptin)the infection has returned & looks worse. PS put me on clindamysin hcl & doesnt seem to be helping so far (3rd day) & I'm afraid the infection will spread to other areas. Should I be concerned?
Treating a potentially infected implant/tissue expander with antibiotics demands close observation, which I am sure your surgeon is doing. Are you aware if you also had an allograft placed during your reconstruction? Another possibility is a condition called "red breast syndrome" which is still a poorly understood reaction that occurs with allograft. In any case, these signs and symptoms are still assumed to be infection until proven otherwise. A relatively new condition that is a frequent cause of implant infections is called a "biofilm," which occurs in either cosmetic or reconstructive breast surgery. A common source of biofilm infections is bacterial contamination from the nipple ducts. Biofilms are very difficult to treat due to the inherent properties of the bacteria as well as the presence of multiple organisms. Unfortunately you may not be a candidate for further implant reconstructions. Are you a candidate for an autologous reconstruction (i.e. your own tissue)? If so, this may be an alternative solution to reconstruct your breasts.
