Breast Reconstruction: Q&A

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Exchange Surgery? Concaves After Expanders? (photo)

Have had expanded in now for 5 and1/2 months. Had a prophylactic bilateral mastectomy (BRACA 2 positive) w/o complications. My left expander healed with scarring down in the lower left medial infra mammary area and also I am more concave in the upper left area overlying the implant - my Plastic Surgeon has assured me that he can fix the concavity with grafted fat from my abdomen and that he would break up the scar/ adhesions during the permanent exchange. What happened?

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6 Doctor Answers | Asked by StandingTall

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Exchange Surgery? Concaves After Expanders?

Nothing happened! The healing biologic process is unpredictable so if bilateral reconstruction is being done there can be differences in appearance and results. These differences than can be addressed in further surgical revisions. Hope this helps you understand.

Concavity can be corrected with fat grafting

Placing expanders can be challenging during mastectomy surgery. The expansion process hopefully can be done partially at the time of surgery depending on the quality of the mastectomy. There is a great deal of stress put on the sin that remains after mastectomy. Once expanded typically there is an interval where you can wait and take a brake provided there is no need for radiation treatment. At the second stage or exchange stage the opportunity to correct fold and... more

Breast Reconstruction

When your general surgeon performed the mastectomy the tissue that was removed from each breast was asymmetric which will ultimately create a deficit. When the expanders are placed, as you know they are only temporary. Fat grafting can be done at a later stage (either when you transition to breast implants or when the nipple reconstruction is done) to add volume in any area that a deficit is present. Fat grafting is done using your own fat cells which are harvested utilizing... more

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Breast reconstruction

In Bilateral mastectomy and reconstruction, there would be difference between two breasts mainly because the mastectomy was not 100% the same in both breasts. depending on the general surgeon and how much subcutaneous tissue is removed there would be a difference, The concavity is most probably due to removing more fat. It can be repaired with fat grafts. your plastic surgeon is dealing with whatever defect was created by the mastectomy and each problem needs to be addressed... more

Breast reconstruction

The tissue expanders are placed to expand the skin. They may not expand the same on both sides. Revisions or adjusting of this takes place with implant surgery and may require additional procedures after this as well.

Steven Wallach, MD

13 reviews

Manhattan Plastic Surgeon

Plastic surgery and scar tissues

The bane of all plastic surgery is that despite your surgeon's best efforts and even in the absence of complications, it is still possible for your body to ruin the result with the excess scar tissue it makes. This is not the surgeon's fault, nor yours. It just can happen. Your doctor sounds like he/she has a plan for this but realize that if you make bad scars there is only just so much they can do.

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Breast Reconstruction: Q&A

Exchange Surgery? Concaves After Expanders? (photo)

Exchange Surgery? Concaves After Expanders?