Unhappy with Reconstruction After Mastectomy?

I had a bilateral mastectomy last year, with tissue expanders and silicone implants. My breasts don't match and one side hurts. The implant moves differently (like it's loose) on the painful side, is below the crease, and an inch lower than the other side. Everytime I bring up the pain and that one side is lower and below the crease, my doc says she is happy with the result. I want them to come close to matching! Am I being unreasonable? If not, how do I get her to address my concerns?

Doctor Answers (12)

Asymmetric breast reconstruction

+2

Perfect symmetry will never happen but it sounds like it might be possible to to more for you.  However, if one side was radiated, there will absolutely never be great symmetry so there are important history details you have not given.  Was one side done for cancer and the other prophylactically?  Was there radiation done to one side?  etc.  If you aren't happy, maybe a visit to another surgeon is in order.


Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast reconstruction revision

+1
You can use your own tissue!

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.

If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 13 reviews

Unhappy with post mastectomy breast reconstruction: consider second opinion

+1

Without an exam or even photos, it is impossible to render an opinion. However, given the fact that you have concerns and don't feel your plastic surgeon is listening to you, I would advise a second opinion.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 44 reviews

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It is not unreasonable.

+1

If you feel that your plastic surgeon is not listening to your concern/needs, you can get a second opinion from another plastic surgeon.  It is not unreasonable to get the second opinion  when you are unhappy and having asymmetry and pain.  

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 37 reviews

Breast reconstruction

+1

As for the appearance, I can not comment because I do not know how they look.  Bare in  mind, no two breasts are exactly the same, so asymmetry to some degree is normal.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Appearance of breasts after reconstruction.

+1

I would recommend getting another opinion. It is far easier to get symmetry usually in someone after a doublke mastectomy rather than a single. Different things can be done to achieve this. 

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 24 reviews

Asymmetry after Breast Reconstruction

+1

It is not unreasonable to desire that your reconstructed breasts "come close to matching." This is much easier with bilateral reconstructions than unilateral ones. However, it may still not be possible. Revising the reconstruction and either lowering or, especially, raising the inframammary crease is quite difficult. The "pain" is something that happens occasionally. It may wear off, or you may be able to do some desensitization and resolve it. If your present surgeon does not think that she can improve you, I would suggest a second opinion from a Plastic Surgeon with significant experience in breast reconstruction. This field has changed much in the last decade and there are some new options.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Unhappy with Reconstruction After Mastectomy?

+1

Reasonable = yes but possibility is another matter. Best to obtain a few in person opinions. Remember "realistic expectations" are paramount in any reconstruction. Best of luck. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Satisfaction after breast reconstruction

+1

While it is impossible to re-create the breasts the way they were before a mastectomy, I do not think you are being unreasonable in bringing up your dissatisfaction. Whether the breasts can be easily adjusted or not is obviously another question. I do not think there is much harm in seeking a second opinion. You may also wish to post some photographs in this forum.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast reconstruction

+1
It is reasonable for you to want to be as symmetric as possible. However there will always be some slight differences. Pain is a concern as well as your statement that one breast is below the inframammary fold.

David L. Abramson, MD
New York Plastic Surgeon
3.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.