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Help with Choosing Method for Breast Reconstruction, Lift and Implants?

asked 2 years ago by Faithandhope in Connecticut
Latest answer by Fredrick A. Valauri, MD
Question viewed 1,072 times
Tags: age 45-54, breasts, stomach, female, 090-109 lbs, breast cancer, fat, mastectomy, plastic surgeon

I need to make up my mind regarding breast reconstruction, with breast implants and breast lift. I have gone to different plastic surgeons. I am 50 years old and weigh 104 lbs. I have no fat in my stomach.

I had a mastectomy in January followed by radiation. I would like to have reconstruction on one side and a definite lift on the other. One doctor says do the one step latissimus dorsi with implants on both sides; the other says do a deip flap muscle sparing. Who is right?

11 answers to Help with Choosing Method for Breast Reconstruction, Lift and Implants?

Breast Reconstruciton

No body is right or wrong. It all depends on what you want from the surgery and what you are willing to go thru. One is a shorter recovery and the other is a very big surgery with prolonged hospital stay. The diep flap is complicated and will take anywhere from 6-10 hours depending on who is doing it. The other the lat flap will be faster and shorter recovery. The lat is somewhat a compromise of a surgery given the history of radiation. You just have to decide what you are willing to... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

After radiation and mastectomy, plan for a flap

Hi Connecticut, I agree with others in that after mastectomy with irradiation, you require some kind of "flap". A flap refers to any piece of tissue moved from one area of your body to another. The basic list of donor sites are abdomen (TRAM, DIEP), back (latissimus), upper thigh (TUG), and butt (SGAP). If you are thin, you may not have enough fat in any one area to make up for a whole breast, and you will have to go for a flap + an implant. Of all of the flaps listed above,... more

Lisa B. Cassileth, MD
Beverly Hills Plastic Surgeon

Breast reconstruction in irradiated breast

All options are available to you 1. implant only-limits are that you will only be able to place a small implant 2. Tissue expander, then implant- would make it possible to get a larger implant but the use of implants has higher risks of wound problems and capsular contractures in irradiated tissues. 3. Latissimus with implant-Very good option for this situation. At your weight you may not have enough skin and fat from the belly to recreate the breast 4. DEIP/TRAM, etc- although this is also... more

John P. Stratis, MD
Harrisburg Plastic Surgeon

Some radiated breasts can be reconstructed with implant alone.

Hi! 1) At 104 pounds, I doubt that you have enough excess abdominal tissue for a DIEP flap. So, without examining you, I would say the latissimus flap sounds better. 2) If there are no radiation changes in your skin, we sometimes do breast reconstruction in radiated patients just with an implant under the chest muscles, without any flaps. We have had good results in selected patients, and of course it is much less invasive surgery. 3) On the other side, you need a breast lift with... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Best type of breast reconstruction

Hi, There really is no one best type of breast reconstruction - the approach needs to be individualized to the patient. A DIEP (Deep Inferior Epigastric Perforator) flap can be an elegant option to reconstruction with minimal morbidity to the abdominal wall and a very natural looking result. If you do not have any fat on your abdominal wall, however, the size of the reconstructed breast may be limited. A one-stage latissimus with implants will allow for a larger reconstructed breast. ... more

Sam Jejurikar, MD
Dallas Plastic Surgeon

Breast Reconstruction Choices

Deciding upon the best breast implant technique is best for you requires a consultation and discussion with a board certified plastic surgeon. This meeting will be provide you with a thorough evaluation and discussion fo the all breast reconstruction optionsoptions, and advise you which might be best for you. There are some general notions to consider. Implant expander technique have a relatively high complication rate. Including infection, malposition of the implant,... more

Fredrick A. Valauri, MD
New York Plastic Surgeon

www.drvalauri.com

Choosing plastic surgeon?

Reconstruction surgery is sometimes very complicated so please make sure you choose a surgeon who is experienced in this area. During your consultation with a board certified plastic surgeon, ask to see before and after photos of actual patients who have undergone cosmetic surgery. The surgeon may provide you with a list of patients you may speak to as a reference for the doctor. To enhance your education regarding the surgeon, you may be introduced to some post-op patients as well... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Breast reconstruction

There are many options ofr recontstruction folowing radiation. Yes, an LD and implant is one, and a TRAM, DIEP, etc. are others. In order to know what is right for you, you would need an exam.

Steven Wallach, MD
Manhattan Plastic Surgeon

DIEP Flap or Implants for Breast Reconstruction after Radiation?

There is no right and no wrong answer here, but you will want to weigh the pros and cons of each approach and decide what will be best for you. In general, you should know that radiation treatment complicate breast reconstruction, particularly breast implant reconstruction. Radiation is especially problematic for women who undergo implant reconstructions, regardless of whether the radiation is administered before or after the implant is placed. Natural-tissue reconstruction has the... more

David Greenspun, MD, MSc
New York Plastic Surgeon

www.davidgreenspunmd.com

Breast reconstruction after Radiation

In your case, neither surgeon is wrong. Both are good options. After radiation therapy, I generally do not recommend an implant only reconstruction. Two options are the LD flap and the DIEP flap.

C. Bob Basu, MD
Houston Plastic Surgeon

www.basuplasticsurgery.com

Radiation treatment usually means you need to use your own tissue to cover the implant for best res

Radiation treatment leads to changes in the skin and tissues which make contracture very likely if you try to reconstruct the breast with an implant alone. Utilizing tissue for your back or abdomen is an excellent option for optimal results - the "right"answer depnds on your preferneces.