Boston Breast Reconstruction doctors
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Stephen Delia, M.D.
Boston Plastic Surgeon
20 Tremont St Bldg. 3, Duxbury |
9 answers | |
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Mark B. Constantian, MD
Nashua Plastic Surgeon
19 Tyler St #302-304, Nashua |
8 answers | |
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Daniel Del Vecchio, MD
Boston Plastic Surgeon
38 Newbury Street Fifth Floor, Boston |
2 answers | |
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Brooke R. Seckel, MD
Boston Plastic Surgeon
131 Old Road Nine Acre Corner - Suite 700, Concord |
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1 answer |
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Kimberley O'Sullivan, MD
Boston Plastic Surgeon
14 Denton Road, Wellesley |
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.
It is certainly possible to have a breast deformity after lumpectomy, even though it is considered breast conservation surgery. There are a variety of plastic surgery reconstructive procedures that may be of help including transfer of tissues used in postmastectomy breast reconstruction as well as fat grafting. In many cases, however, it would be preferable to have radiation first and see how the tissues respond to the radiation and then tailor the reconstructive procedures to the resulting deformity after the initial lumpectomy and radiation therapy.
I had a radical double mastectomy in 1974. I've had 11 surgeries on left side due to adhesions, rupture, scarring. I'm 68. I have small saline implant now that is surrounded by adhesions, scarring. It is almost under my arm. My pain is unbearable. I want the implant removed. Isn't it necessary for the surgeon to remove every adhesion and all the scar tissue? Surgeon told me he only wants to slip the implant out. I don't have a picture. I hope my question is clear.
We have seen in reconstruction cases where fat grafting is used for volume replacement that pain from chronic scarring (radiation) improves dramatically. This is anecdotal information, but may suggest that fat transplantation has some regenerative effect on pathologic tissue. In your case, an option is to remove the implant and have several sessions of fat grafting. This would probably remodle and help soften up our scar tissue instead of excising it. Excising scar creates more scar- a sometimes visious cycle.
Best Regards,
Dr Del Vecchio
bostonbreastcenter.com
After my implant surgery I did not have an inframammary fold on the side that had cancer. I was told that because both breasts did not have the same issues that in order to achieve symmetry in concurrent bilateral surgery that I would need repositioning surgery. What causes the loss of the inframammary fold?
In the course of a mastectomy, it is possible , the infra mammary fold, may be dis inserted in an effort to remove the breast tissue. This may vary with the general oncology surgeon doing the mastectomy.
Prosthetic breast reconstruction in many cases is done in 2 stages. The first stage utilizes a temporary implant and serves to expand the tissues and establish a reasonable breast mound shape. The second stage may serve to fine tune contour irregularities, address asymmetries (including reestablish the IMF, as needed) and replace the temporary device with a permanent implant. Keep in mind, this is all RECONSTRUCTIVE surgery and serves to restore body shape and as such may never be perfect as opposed to cosmetic surgery which may be viewed as refinements.
