Palm Beach 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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Steven Schuster, MD
Boca Raton Plastic Surgeon
1905 Clint Moore Rd. Suite 101 , Boca Raton |
23 answers | |
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Tim Abou-Sayed, MD
Palm Beach Plastic Surgeon
1620 S Congress Ave Suite 100, Palm Springs |
5 answers | |
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David J. Levens, MD
Coral Springs Plastic Surgeon
1725 University Drive Suite 300, Coral Springs |
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2 answers |
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David Rankin, MD
Jupiter Plastic Surgeon
641 University Blvd Suite 103, Jupiter |
2 answers |
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!
I had a prophylactic mastectomy with expanders put in 6 weeks ago and I keep forgetting to ask my doctor about scar massage. My incisions have completely healed and the scabs have fallen off. How soon should I have started massage? Do I need to do scar massage if the doctor is just going to break up or remove scar tissue during the exchange for implants? I was wondering if I should just do the scar massage after the second surgery instead. Also, how long should I do physical therapy for?
Dear Jess, hopefully this finds you well on the way to healing. I really doubt you need scar massage at this time. The constant pressure of the expander will work even better than massage. Now after the second stage you may need to do scar manipulation, but I would wait until after this is done and you discuss it with your plastic surgeon. Good luck, Dr. Schuster from Boca raton
I am a medical librarian trying to find the answer to a question for one of our physicians. He is asking me to find information on the use of tissue expanders for breast reconstruction in women who have pacemakers. I can't find anything in PubMed or Google. I have asked a couple of manufactures, but I don't know if they will reply. Do you know where I can get information about this? Thanks.
To the best of my knowledge, there is no contraindication. My concern is more the reason for the pacemaker and to make sure this is done in the appropriate setting with anesthesia having seen the patient well in advance and a cardiology clearance as well. Usually the expanders are much lower than the pacemaker and should not cause a mechanical problem.