Jupiter Breast Reconstruction doctors
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David Bogue, MD
Boca Raton Plastic Surgeon
660 Glades Road Suite 380, Boca Raton |
45 answers | |
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David Rankin, MD
Jupiter Plastic Surgeon
641 University Blvd Suite 103, Jupiter |
2 answers | |
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Kim Edward Koger, MD
Palm Beach Plastic Surgeon
4600 Military Trail Suite 202, Jupiter |
Recent Answers
For tissue expander-to-implant reconstruction following bi-lateral nipple sparing mastectomy for breast cancer, what is a typical follow up schedule starting right after the surgery for exchange to final silicon implants? I understand that healing issues could change the timing and number of post-op visits, but barring serious problems, what is the ideal number and timing over the following weeks and months? Or even years? What might it be for later revision later surgery, if necessary?
Every surgeon differs in their postoperative routine. I perform a large number of breast reconstructions with expanders and implants and my schedule is the following:
- Week 1: 1-2 visits in the first week post-surgery for first drain removal, mastectomy flap check, and monitoring.
- Week 2: Second drain removal and first fill of the expander.
- Weeks 3-?: Weekly fills of the expander until desired volume is achieved. Overfill the following week then wait for 4-6 weeks for pocket maturation.
- Earliest exchange is ~12 weeks, later for longer fill times or chemo/radiation.
After the exchange, the visits certainly space out more:
- Postoperative day 1 - Evaluate for early complication (hematoma). Assess symmetry, position, patient questions.
- Week 2 - Wound check, evaluate for contour issues, fluid, etc.
- 1 month postop, 3 month postop, 6 month postop, then yearly follow up.
- MRI (if gel implants) at 3 years, then f/u every two years afterwards.
As always, every surgeon is different and complications lead to more frequent visits. I probably see my patients more than most surgeons, but I find it leads to a better educated patient and a better result at the end. Hope this helps!
Nearing the end of a year long ordeal with breast cancer, reconstructive surgery. I have had the nipple reconst done approx 4 weeks ago and I am concerned that are going to have too much projection. I hate "headlights" so just a little projection or even texture is fine with me. My fault for not getting more information from my doc. What can I do without killing the tissue of the nipples to get them to shrink or reduce the projection. I use 4x4 gauze pads with holes in them for protection.
At 4 weeks, the nipples are likely to continue to shrink. The nipple reconstruction procedure always makes the nipples over-projecting. This is because the nipple will flatten as the scar matures inside the nipple. An over-projecting nipple is very easy to correct, however increasing projection in a flat nipple is extremely difficult. If the nipple projection is still too much at 8-10 weeks, then a simple office procedure can correct it.
2 weeks post nipple reconstruction after bi-lateral mastectomy, How long does it take to heal before tattooing can normally be done? How long does the pain last? I am having some shooting pain on out part of breast and some overall pain in both breasts. I did pull a muscle that I keep re-injuring before the nipples were done, I cannot pick up anything over a 1 lb without causing pain in the outer part of my breast. Can a MD help with this or what other type of doctor should I use? Ice vs heat?
Tattooing of the nipples and areolas typically occurs 6 to 8 weeks following reconstruction. The nipple reconstruction needs to heal before the tattoo is applied. As for muscle pain, evaluation by your surgeon is appropriate. You need to be careful with the application of heat or cold if the overlying skin is still numb from the mastectomy as you could injure your skin.