Bilateral Breast Reconstruction for unilateral cancer

Bilateral mastectomies for unilateral infiltrating...

Bilateral mastectomies for unilateral infiltrating carcinoma with immediate tissue expander placement. SEVERE pain and muscle spasms started immediately post op and were unrelieved with pain meds +/or muscle relaxants. Plastic surgeon was very aggressive in pushing forward towards swap out but I ended up hospitalized because of intractable pain. Had to have expanders with only 280 and 340 ml volumes removed because Neurology wanted an MRI to rule out a brain leasion as the cause. Plastic Surgeon insisted on doing swap out to implant "to keep what we have already gained" She place 13.5 base/ 375 cc implants ( I had been a 40 D) 5 weeks later one had to be removed elsewhere after she wanted to treat a draining MRSA infection with oral antibiotics only. Pain and spasms on that side FINALLY resolved. She refuses to take out other implant (which has no projection , is hard and has a deep crease in the upper pole) claiming it is perfect and my continued pain and spams MUST be due to some neurologic problem despite the negative Neuro workup and symptom resolution with removal on the other side.

Pre Op Photos

Ok, so I'm fat. Really fat. Those pre- op photos don't hide a thing. But at age 55 and with 4 breast biopsies behind me the girls looked pretty good. Even the right side biopsy site with steri strip looks great (Thanks Dr. Duchini...you are the best)!! I wasn't expecting miracles with reconstruction, and I was even looking forward to getting rid of the roll-y bit that crept under my arm...(it kept getting in my way when I was doing surgery), but even though I am a physician / surgeon I was in no way prepared for how I was going to end up.

Revision procedure #4

Getting really good results. I can't say enough good things about my new surgeon. We are hopeful that another 2 or 3 scar release surgeries will have my chest and arm range of motion fully back to normal
Erie Plastic Surgeon

Please do your research prior to committing to a major procedure with this provider. I knew she had failed her Board Certification exam at least once, but as a professional colleague I believed her when she stated that in order to avoid muscular disfunction from asymmetry which would affect my ability to work as a physician/surgeon that I would need bilateral mastectomies with reconstruction. Unfortunately her reconstruction caused severe pain and pectoral muscle dysfunction that required months off of work and physical therapy. I was told by Dr Figura that she had never seen these problems before, but the physical therapist and second opinion plastic surgeon in Erie both indicated that they were treating multiple patients of hers with similar problems. I developed an infection that was suboptimally managed forcing me to seek care elsewhere, and then she refused to provide and further follow up care, instead blaming me for the poor results and complications. So far I have had an additional 4 surgeries to correct my complications and may require several more. The $100,000 figure above is the insurance reimbursement plus my out of pocket costs for these additional procedures. Dr Figura was paid in full by my insurance (and paid very well...she was reimbursed far more than the surgeon who actually did the mastectomies). Since the corrective procedures have finally eliminated most of my chronic pain and restored most of my arm mobility and ability to resume work, the follow up procedures have been definitely worth it, only the initial reconstruction was not. Please, please, please investigate your alternatives prior to proceeding. I can only blame myself for not obtaining a second opinion, and I live with that regret every day.

1 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
2 out of 5 stars Wait times
Was this review helpful? 1 other found this helpful

Comments (7)

so who is your new surgeon and how did they fix your pocket? did the old surgeon have before and after pictures of her work for you to look at?
  • Reply

I am so sorry to hear of your challenges. You've been through enough emotionally and then you have to deal with this. I witnessed a relative that used an expander during reconstruction...I empathize with your pain. Which part of your treatment was for out of network care? Are you going to get additional opinions and consults? I'm glad to hear you don't have any neurological problems, but hoping you can find some pain (and mental anguish) relief soon. Take care and keep us posted!

  • Reply
Beth is there some way to link my review to the provider? If you search my providers name there are no reviews. I now know of 2 other women with breast reconstruction disasters done by Dr. Figura and would really like to warn anyone else considering her. Also reconstructions are often several steps or multiple procedures and sometimes we change providers. What is the best way todo those posts?
  • Reply
I have linked your doctor for you...thanks for pointing this out! I will get back to about your question regarding the best way to post for multiple procedures and new providers. ;)
  • Reply
Just following up on your question Expander nightmare. Please feel free to submit another review for your next procedure with your new doctor listed. When submitting the review, be sure to click on "I don't remember" for the procedure name so it doesn't get marked as a duplicate review. Also send me a PM so I can make sure our publishing team gets this posted for you!
  • Reply
I had an elective bilateral mastectomy with reconstruction, immediate tissue expanders and you're right. IT HURTS! Those 2 things alone, hurt. I had problems from the beginning as well. I started with saline implants, 300cc. Had them replaced due to my own tissue growing into the valves on the back of the implant. Had them replaced a second time for the same reason. And that was enough to leave them looking like crap. Had them replaced a 3rd time, but they did silicone implants that time. Well silicone implants combined with lots of scar tissue, and unexplained weight loss has left for VERY HORRID looking breasts. Dimpling. Hard around the outside edges plus cleavage edges. Plus with the weight loss, I lost all the fullness on my chest. I dropped all the weight due to an undiagnosed (@ the time of surgery) autoimmune disease, actually 2. I have undifferentiated connective tissue disease, which can kind of be compared to RA or Lupus. Symptoms are severe joint pain and swelling, multiple uncontrolled flare ups per year most of which have resulted in hospital stays on high dose prednisone and pain meds. I take LOTS of prescription high dose pain meds at home. I also have Common Variable Immunodeficiency (CVID). My body does not mount immunity to anything. Even childhood diseases which were vaccinated for, like MMR, I'm not immune too. The flu and pneumonia vaccines don't even work for me, as I've had pneumonia resulting hospitalization 22 times in the past 5 years. I take multiple immunosuppressants which, I know, seems counter productive, and I get an IVIG infusion monthly to supplement my body as it does not make IgG, IgA, or IgM. I stated I had lost weight. A total of 22 pounds. I'm currently 5'10 and 134 pounds. So I look like a stick with softballs. Lop sided soft balls, that is. NOW, I have to get them explanted. With my connective tissue disease, they are far too heavy. I get severe headaches and neck pain due to this. Well, implants cause your chest to concave where the implants were. I posed a question on here a few weeks ago, to the doctors. 1 has answered. It had to do with the explanting. He suggested explanting with body flap, stomach or butt fat, to make implants...there's a name for that, but it escapes me right now. But I don't have enough I don't think. So I'm not sure what my option will be. I see a PS in September. A diff one as now I live in another state. Kind of makes me regret being so proactive. :(
  • Reply

Just checking in to see how you are doing. Hoping you haven't had any flare ups from your autoimmune disorder. I have positive antibodies for RA and Lupus but only occasional minor aches and pains. I'm sorry your situation is much more severe. 

Did you end up explanting this October?  We do have a community that is dedicated to breast implant removal. Hoping you are feeling well with our without your implants. We'd love an update to your review when you have time!

  • Reply