I'm BRCA 1 positive and I'm looking to have nipple sparing bilateral Mastectomy. Plus a Total Abdominal Hysterectomy (TAH), and as a gift to myself, a Tummy Tuck. Are these feasible in one surgery?
Combining Mastectomy, Hysterectomy and Tummy Tuck Feasible?
Doctor Answers 4
Multiple Procedures: Do not discount complications
Please take care of the most life threatening issues, first, i.e. your breast cancer. Interview several Plastic surgeons who have active practices in breast reconstruction. You are fortunate to be located in Dallas, where there are many world class providers. Determine whether your reconstruction can be done in tandem with the cancer surgery, (immediate vs delayed) as well as whether your preference is for autogenous (your own tissue) vs alloplastic (tissue expander & implants). If you opt for the former, you can use the "discards" from the abdominoplasty to rebuild your breast mound, by TRAM or DIEP flaps. Be realistic in matching your desired breast mound size with the availability of abdominal spare tissue, otherwise you may need to consider using implants.
With regards to the hysterectomy, which your Oncologist is probably recommending, I think it should be "staged", at least 2-3 months after your breast cancer surgery and subsequent reconstruction. In the meantime, you will need to use contraception. Good luck and take care.
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Combining mastectomy, abdominoplasty and hysterectomy
That is a lot of surgery. I also assume that you may want to undergo simultaneous breast reconstuction. First, address the issues related to BRCA. You can undergo an abdominoplasty at a later date. If you plan to undergo breast reconstruction which would either increase or decrease your bra size, first live with those new breasts and then assess whether the contours of your abdomen fit your chest size or how you would like to define the abdominal area in relation to them.
I understand wanting to gift yourself a tummy tuck, but don't burn that bridge until you know that you are happy with your chest first. If you are planning breast reconstruction (even if it's with implants), wait until you know that you don't need the abdominal skin for your reconstruction (TRAM, DIEP, etc). If you are not having reconstruction, still wait because you may change your mind! Good luck!
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I would assume that you will be having a breast reconstruction at the same time. I would say NO. Way too much surgery, you will be under anesthesia for a long time and then you are combining clean surgeries, tummy tuck and breast reconstruction with a clean-contaminated (not so clean surgery) of hysterectomy.
Too long anesthesia time, not safe.
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