Hard decision

John P. Di Saia, MD answers: Mastectomy or Lumpectomy and Breast Implants for ADH?

I have ADH and thinking of getting a Nipple Sparing Mastectomy (NSM), but my doctor wants to do a Lattisimus Dorsi Flap (LDF) with tissue expanders and then have a second surgery for silicone breast implants. I have breast implants that are over the muscle right now and my lesion is right against my chest wall. I don't know if I should do a lumpectomy and new breast implants, or NSM with Alloderm instead of the LDF because I really don't want my back muscle removed. Any suggestions would be greatly appreciated.


John P. Di Saia, MD
25 days ago
By John P. Di Saia, MD - Orange County Plastic Surgeon

Hello Melinda,

You present a difficult question for anyone even a surgeon who can examine you. There are advantages to both your options here:

Expander/Alloderm  - This is lesser surgery and does not involve operating your back.

Latissimus Dorsi Flap - This is more reliable and provides more tissue for reconstruction.

You could always opt for the lesser surgery and use the Lat flap to fix things if they did not work out properly. I hope you do well with your surgery.

Web reference: http://www.CosmeticSurgeryTruth.com
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