I have been told by my breast and plastic reconstruction surgeon that the decision to do direct to implant using alloderm (no expander or months of delay) can't be made until during surgery - why? I am a skin & nipple sparing Mx candidate, & I am happy to stay with my current cup size, a small C. I am fit & 45 and I just want the breast cancer chapter to be Over so I can move on with my life.
November 3, 2013
Answer: What body factors impact expander vs. direct to implant breast reconstruction The advent of skin sparing and nipple sparing mastectomy enables direct to implant reconstruction without the need for expansion.However the implant may cause pressure on the skin flaps compromising the circulationthere is another option without expansion,the adjustable breast implant.This implant can be placed under-filled initially and then filled a few days later once circulation is assuredSee attached link
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November 3, 2013
Answer: What body factors impact expander vs. direct to implant breast reconstruction The advent of skin sparing and nipple sparing mastectomy enables direct to implant reconstruction without the need for expansion.However the implant may cause pressure on the skin flaps compromising the circulationthere is another option without expansion,the adjustable breast implant.This implant can be placed under-filled initially and then filled a few days later once circulation is assuredSee attached link
Helpful 1 person found this helpful
November 3, 2013
Answer: The question is an excellent one. firstly I would like to say I sympathize with you and I appreciate the fact that you would like to get this behind you. I wish you the best of luck in getting this behind you.The use of cadaver skin – Alloderm – and either implants or tissue expander's is an operation in breast reconstruction that has a significant complication rate as well as variable Aesthetic results. It will probably someday be viewed as a less popular way to reconstruct a breast.Having said that, there are probably two body factors that are the most important in determining whether you will wake up with implants or tissue expander these are –1- the size of the opposite breast that the surgeons are trying to match. The larger the breast they're trying to match, the larger the implant they need to use and There may not be sufficient room underneath the muscle or inadequate skin and soft tissue at the time of the mastectomy. This would mandate the use of tissue expansion.2- The clinical status of the lymph nodes at the time of surgery. The higher the likelihood that you might require radiation postoperatively, the more one might lean towards tissue expansion. This is because the expander can be placed relatively empty and gradually increased after you complete your radiation. If you have a permanent implant placed at the time of surgery, and then have radiation, there is a high likelihood you will get a capsular contracture and tense scar around this implant.Now you can go back and reread paragraph two and see why I often ask the same question you asked. The future of breast reconstruction will involve more autologous fat transplantation either alone to reconstruct the breast, or used with implants – composite breast reconstruction. I have attached a link for your review. I hope this helps.Best regards,Dr. DelvecchioBostonbreastcenter.com
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November 3, 2013
Answer: The question is an excellent one. firstly I would like to say I sympathize with you and I appreciate the fact that you would like to get this behind you. I wish you the best of luck in getting this behind you.The use of cadaver skin – Alloderm – and either implants or tissue expander's is an operation in breast reconstruction that has a significant complication rate as well as variable Aesthetic results. It will probably someday be viewed as a less popular way to reconstruct a breast.Having said that, there are probably two body factors that are the most important in determining whether you will wake up with implants or tissue expander these are –1- the size of the opposite breast that the surgeons are trying to match. The larger the breast they're trying to match, the larger the implant they need to use and There may not be sufficient room underneath the muscle or inadequate skin and soft tissue at the time of the mastectomy. This would mandate the use of tissue expansion.2- The clinical status of the lymph nodes at the time of surgery. The higher the likelihood that you might require radiation postoperatively, the more one might lean towards tissue expansion. This is because the expander can be placed relatively empty and gradually increased after you complete your radiation. If you have a permanent implant placed at the time of surgery, and then have radiation, there is a high likelihood you will get a capsular contracture and tense scar around this implant.Now you can go back and reread paragraph two and see why I often ask the same question you asked. The future of breast reconstruction will involve more autologous fat transplantation either alone to reconstruct the breast, or used with implants – composite breast reconstruction. I have attached a link for your review. I hope this helps.Best regards,Dr. DelvecchioBostonbreastcenter.com
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