Omaha Breast Reconstruction doctors
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Kelly Gallego, MD
Sioux City Plastic Surgeon
2800 Pierce Street Suite 101, Sioux City |
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6 answers |
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David Finkle, MD
Omaha Plastic Surgeon
4911 South 118 Street, Omaha |
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2 answers |
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Richard J. Bruneteau, MD
Omaha Plastic Surgeon
8900 West Dodge Road, Omaha |
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John J. Edney, MD
Omaha Plastic Surgeon
8900 West Dodge Road, Omaha |
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John J. Heieck, MD
Omaha Plastic Surgeon
8900 West Dodge Road, Omaha |
Recent Answers
My ps does the nipples at the same time of the exchange surgery, from the expanders to the silicone implants. Is this ok? I know my surgeon has a great reputation, but I've heard most Dr's do the nipples at another time. What are your feelings on this? And what input do I have as far as the ending results of the size and shape of the nipples? Meaning, is this totally in the Dr's hands?
It is certainly true that some plastic surgeons prefer to perform nipple reconstruction at the same time as the implant placement is done. I think most choose to wait until the patient has healed from the implant surgery. My preference is wait three months before performing the nipple reconstruction. I think this allows me to obtain more symmetric results. Since I usually do the nipple procedures in the operating room, it also gives me the opportunity to revise any unsatisfactory results of the prior surgery. There really is no right way or wrong way though. It's more just a matter of preference.
I had a right mastectomy in March of this year and was planning on having immediate reconstruction; however, one of the lymph nodes had a tiny bit of cancer in it so they did not do that. I did have radiation and completed that in June, but did not require chemotherapy. I am planning on having a TRAM flap and having my left breast reduced and lifted to match the right one (I wanted to be smaller). Would it be reasonable for me to plan on having this done next March or April? I have been very diligent about putting Aloe gel on my radiation site, am getting my strength back (even stopped working to speed my recovery) and am working out about 4 times a week (I'm 57). I want to get this done and move on with my life. I am VERY self-conscious about going out with the "one breast" and wear big shirts to camoflauge, and only wear the bra & prosthesis when line dancing as it is very uncomfortable. I would appreciate any help you could give me - thank you! Pam Murchison
Adjuvant radiation after mastectomy is a vital part of our armentarium in adequately treating breast cancer. Numerous studies have shown that in certain patient groups locoregional recurrence can be reduced and survival increased. However, it has also been clearly shown that radiation has a detrimental effect on immediate breast reconstruction outcomes regardless of whether a tissue expander or flap are used. Thus, most plastic surgeons prefer to perform delayed reconstruction in instances where radiation is indicated. In regards to the timing of the breast reconstruction, there is some difference of opinion. Most plastic surgeons feel comfortable with operating a minimum of 3-6 months after radiation treatment. There are some who prefer to operate earlier (6-12 weeks) after the completion of treatment. It's probably best to discuss the timing issues with your plasticesurgeon to better understand their rationale. A TRAM flap breast reconstruction is an excellent option for most patients who have undergone post-operative radiation treatment.
For patients over 70 years of age who have a mastectomy, will Medicare cover reconstructive surgery at an older age?
Medicare certainly covers breast reconstruction for patients who have had a mastectomy for breast cancer. The Women's Health and Cancer Rights Act of 1998 (WHCRA) mandates that any insurance company or third party payor that pays for breast cancer treatment is also compelled to pay for reconstruction, as well as for surgery on the non-cancer side is necessary for symmetry.
