Leo Otake, MD, PhD, FACS

Hello.  You should see your surgeon in follow up where he/she may evaluate you for possible infection or possibility of partial flap tissue loss.  In the absence of this, gentle compression with a sports bra can be helpful to help resolve the seroma-fluid collection which may be draining.  Good luck.

Hello.  It is a federal mandate that breast reconstruction be covered; however, Medicaid coverage varies by state.  You can check with Medicaid to see what your state coverage is.

Procedures such as liposuction can injure the blood vessels crucial to autologous breast reconstruction using abdominal fat. While Coolsculpting may not injure those same blood vessels in the same direct way as in the case of liposuction, your reconstructive surgeon can order imaging studies to not only map out the location of crucial blood vessels but also whether or not they are still functioning properly. 

You have taken the right steps to address your new diagnosis and it sounds like your doctors are diligently looking at biopsies. In the meantime, I would stop any further abdominal fat procedures until the management plan for your breast cancer is clarified. 

Additionally, there are alternatives to abdominal skin and fat that may be used for autologous breast reconstruction including the medial thigh and buttock area. Your reconstructive surgeon can have a detailed discussion with you regarding these alternatives if they are appropriate for you. You should also discuss the timing of the breast reconstruction relative to your cancer treatment plan as well. 

Hello.  Thank you for your question.

You cannot undergo surgery, particularly with general anesthesia, in the middle of your pregnancy.  At the second stage surgery when the tissue expander is replaced with the implant, your surgeon can address the contour irregularities and size discrepancy that you mention.  Alternatively, you may discuss with your surgeon the option for proceeding with autologous tissue reconstruction where your own skin and fat may be used to reconstruct the breast instead of an implant; in this case, make sure that your surgeon has specific training in autologous recon techniques such as a microvascular fellowship to allow for a DIEP flap reconstruction.

Discuss these options with your board certified plastic surgeon while your pregnancy progresses and good luck for your future family!