Breast Reconstruction Q&A
88%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
91 Reviews
Breast Reconstructionbefore & after photos
View Before and Afters

Average Breast Reconstruction Cost: $8,900

Learn about Breast Reconstruction

487 people and 265 doctors are talking about Breast Reconstruction

Get Free Email Updates

Multiple Infections - Should I Remove the Expander or Continue w/ LD Flap Surgery?

asked 1 year ago by Cat1960 in Chicago
Latest answer by Fredrick A. Valauri, MD
Question viewed 353 times
Tags: expander, infection, latissimus flap

I was diagnosed with breast cancer in 2009; had a bilateral mastectomy and LN dissection with reconstruction done during this surgery (expanders placed). Underwent chemo and had radiation to the left breast. In December developed a cellulitis to the left breast took about a month of augmentin and was fine until a few days ago. Again I have pain and redness to the left breast and a fever. Is it time to say this cannot be saved and have the expander removed and go ahead with a LD flap in May?

8 answers to Multiple Infections - Should I Remove the Expander or Continue w/ LD Flap Surgery?

+2

Infection, Radiation and Breast Reconstruction

When radiation is used in the treatment of breast cancer, non-cancerous tissues in the path of the radiation are also affected. Radiation therapy can mean a significant loss of skin elasticity, which can profoundly affect the aesthetic results of breast reconstruction. And because the body’s wound-healing mechanisms are altered by exposure to radiation, complications from all types of reconstructive breast surgery occur at a higher rate. Radiation is especially problematic for... more
David Greenspun, MD, MSc

New York Plastic Surgeon

www.davidgreenspunmd.com

+2

Implant Complication in Irradiated Breast

Based on your history of radiation to the left breast and recurrent infection, I recommend that you consider a tissue reconstruction.   Either a latissimus flap or abdominal tissue transfer would be suitable, depending on what you prefer and are a candidate for.     As far as the immediate issue, it seems that it will be necessary to at least remove the implant and all the capsule.   An informed discussion between you and your surgeon is necessary to chose the... more
Paul S. Gill, MD

Houston Plastic Surgeon
+2

Breast reconstruction and infection

If you have a recurrent infection, you  may have to bite the bullet and have the expander removed and then come back at a later time for a different type of reconstruction or a restart of the TE.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Breast Reconstruction After Radiation and Infection

Based on the information you provided, your best option is to have the breast implant removed, the pocket cultured, and the infection aggressively treated. Once the infection has resolved, and your tissues are soft, then a flap breast reconstruction should be considered. The choice of flap technique will depend on size of the breast that is appropriate for your body and other considerations that will be discussed by the reconstructive plastic surgeon. Flap techniques... more
Fredrick A. Valauri, MD

New York Plastic Surgeon

www.drvalauri.com

+1

Post radiation breast reconstruction.

If you are experiencing a recurrence of your infection, then you may want to consider some form of autologous breast reconstruction (tissue reconstruction without implants).   In addition, you are experiencing these problems on your radiated side.  Remember, your history of radiation will significantly increase your risk of scar tissue formation around your implant. I generally do not recommend placement of final implants after radiation because of an increased risk of... more
C. Bob Basu, MD

Houston Plastic Surgeon

www.basuplasticsurgery.com

+1

Autologous reconstruction following failed implant reconstruction

Once you have failed expander placement, you are limited to undergoing your reconstruction with autologous tissue. these include local flaps such as LD, but also distant flaps, and even less invasive fat grafting.
Arian Mowlavi, MD

Laguna Beach Plastic Surgeon
+1

Infections after breast reconstruction

This is a choice you should discuss with your plastic surgeon. If the radiation has changed your skin and it is becoming infected, then you should consider the latissimus dorsi flap or TRAM flap. Long-term, breast reconstructions with implants after radiation do tend to have more problems.
Karol A. Gutowski, MD

Chicago Plastic Surgeon
+1

Breast Reconstruction

Most failed implant reconstruction is due to the effect of radiation. Two episodes of cellulitis is enough to take the expander out and the capsule, treat the infection then discuss the timing and the options of breast reconstruction. 1: Latismus Dorsi flap with or without implant 2: TRAM flap 3: diep flap or other free flap reconstruction. 4: In some cases fat transfer
Samir Shureih, MD

Baltimore Plastic Surgeon

Ask a question