Had 2 Attempts,5 Mos Apart at Tissue Expanders with Alloderm,both Failed Due to Infection.what Are My Chances w/ Future Surgery?

I Have Had 2 Attempts,5 Mos Apart at Tissue Expanders with Alloderm,both Failed Due to Infection.what Are my Chances at Future Surgery?

Doctor Answers 6

Breast reconstruction

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Sorry about yoru dilemma. More information would need to be gathered regarding why they became infected, but you may want to consider alternatives such as autologous tissue( using your own tissue).

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Need to consider other breast reconstruction options

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Your situation requires more information.  Did you have radiation to the breast as well.  If plan A fails it is best not to do plan A again.   It is possible that some other type of breast reconstruction would be your best option.  Your plastic surgeon is in the best position to understand your medical condition and to help you make a good decision about moving forward.   Wish you the best of luck.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Failed tissue expander reconstruction

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The fact you have had two failed attempts at reconstruction certainly raises some concerns but you still have some options. Bringing in some fresh tissue from your back (latissimus dorsi skin/muscle flap) may improve your chances for a successful outcome, the trade off being a scar on your back. Get at least two opinions from experienced breast surgeons! Good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon

Had 2 attempts, 5 mos apart at tissue expanders with AlloDerm, both failed due to infection. What are my chances w/ future surg

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Hello!  Thank you for your question.  I am unsure what is causing your infection - did you have radiation?  After radiation, you have an increased rate of complications including wound problems, infections, thinning of the tissue, and decreased vascularity to the skin/tissue of the area.  The best method to reconstruct a breast following radiation therapy is with a flap.  The flap, which is skin, fat, and sometimes muscle, will serve to bring in healthy, well-vascularized tissue to the chest/breast area that will significantly ameliorate the radiation issues compounding the problem.  Microsurgical perforator flaps (such as the DIEP flap and SGAP/IGAP flap) are the newest and most-innovative procedures in breast reconstruction today.  As these are muscle-sparing flaps, the pain, morbidity, and complications such as those above, of these procedures are much less.  They are highly-complex procedures that few plastic surgeons performed and consult with one who is well-versed, trained, and skilled in these procedures if you are interested.  

There are many options to breast reconstruction including implant-based and flap-based procedures.  The complication rate with implants following radiation is reported as high as 60-70% in some studies.  Flap reconstruction is usually recommended, but there are several centers who perform implants following radiation with great success and results.  I typically prefer flaps, such as the DIEP flap.  Other flaps are the conventional TRAM, latissimus flap, SGAP/IGAP, and, TUG.  Although you can try expander reconstruction again, it comes with the same risks.  You may consider a flap procedure.

You are a candidate for other procedures, if you are willing to continue with your journey for a reconstructed breast.  Flaps such as those above, including others, are available.  The decision to continue with this will be your decision and what you are willing to go through.  There are risks and benefits with everything that we do in Surgery - discuss the various options with a board certified plastic surgeon who will educate you on all of the options and help you to decided if breast reconstruction or which procedure will be best for you.  Hope that this helps and best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Infection with tissue expanders and Alloderm

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Thank you for your questions. Yes, tissue expanders and Alloderm can be associated with a known infection rate.  If you have failed the same plan twice, then make sure the next plan is not just like the first two. I cannot give you specific recommendations without having seen you or examined you but return to your doctor to see if you are a candidate for any other type of reconstruction such as the use of your own tissue. To be sure that your know all of your options, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Breast reconstruction

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To discuss all the options you have we need a thorough consultation and review of all your previous medical records. Whether you had radiation or not?

then an intellegent discussion can be amde an discuss all your options.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.