Reconstruction Options for Very Thin Mantle Radiation (30 Yr Ago) Patient with DCIS?

Now 5'3"/~90 lb. Even when 105 I was a B- at most. Bilateral mastectomy, due to my hx & mother's breast CA, set for 3/6/12. Two surgeons gave different recommendations - 1-stage with Alloderm & implant by an MD who has not treated anyone with my hx vs. 2-stage with expanders & implants by an MD who has "done" 6 Hodgkin's patients ~like me. I work full-time and prefer the easiest recovery IF the long-term results are equal. What factors should carry the most weight & what would you recommend.

Doctor Answers 4

Breast recon and mantle radiation.

The easiest and most reliable recon in a radiated field is a latisimus flap with expander. But a plastic surgeon need s to do a physical exam. There are other options.

Brandon Plastic Surgeon
4.0 out of 5 stars 24 reviews

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Breast reconstruction in petite female with history of radiation treatment

Both options sound reasonable.  I have done both expander and direct implant-based breast reconstruction in patients with a history of mantle radiation with success. 

If, by some chance, your tissues are not suitable for implant reconstruction, then you may consider bilateral latissimus dorsi flaps, TRAM, muscle-sparing free TRAM, free TRAM, DIEP, SGAP, or IGAP flaps as alternative methods for breast reconstruction.

Discuss this with your plastic surgeon and seek other opinions if necessary. Good luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 51 reviews

Breast reconstruction

There are many variable stat go into determining the best breast reconstruction for each patient.  It is best to go for consultations and figure out what you think will be best for you.  The two suggested procedures both sound reasonable.  Autologous tissue is another option.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

One stage reconstruction is a good optio in selected patients

I am clear about the indications for the mastectomy. You should get nipple sparing mastectomy if there is no breast cancer. The use of the implant and Alloderm in one stage is a good option is you have small breast and do not plan to go larger.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 67 reviews

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