Extra Skin Left After Prophylactic BM? What Are My Options For Reconstruction? (photo)

Question

I'm 1 mo. post-prophylactic bilateral simple mastectomy; no nodes removed. Prior to surgery, I was a 38DD. I expected to have a flat chest post surgery, but what I ended up w/ was flatness above the incisions & rather large "ridges" of skin below the incisions. Will these ridges flatten out any over time or is this the look a surgeon typically gives women who are undecided about future recon? I also have an extra, fat flap near rt. underarm. Will it flatten out? Exploring possible recon.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question and the photos. Yes, this is a typical look after mastecomy in a women that before surgery has 38DD breasts.  This can be addressed by a plastic surgeon at the time of breast reconstruction if you choose to have reconstruction.

	Also, if a plastic surgeon is involved from the very beginning, there are alternative incision patterns, such as an inverted T skin reduction pattern, that can be used by the plastic surgeon to help alleviate your problem of excess skin and help make things look better.

	
	If you are interested in breast reconstruction, complete all of your treatments that are necessary (chemotherapy and/or radiation therapy) and make sure you have clearance from your cancer doctors (oncologist) to have breast reconstruction. Then, see at least 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.

Steven Wallach, MD · Answer

Too bad to not have a consult with a plastic surgeon before your mastectomies.  It may be a good idea now to go speak with someone about the options.  Leaving the extra skin is OK. If it turns out not to be of adequate quality during reconstruction it can always be discarded. At present since you are early post-op, this tissue is likely swollen and things need to settle down a bit.

Peter A. Aldea, MD · Answer

Many large Plastic Surgery volumes were written on this very topic and the space and time allowed cannot address all of your options.

	Most commonly the ideal Breast Reconstruction begins BEFORE the maatectomy. The breast surgeon and Plastic surgeons cooperate and plan the incision pattern as well as WHICH reconstruction path, out of the many ones available, would be taken. Your health, your future radiation / chemotherapy treatments, your weight, your desire for breast implants VS. use of tissues (and scars on ) other parts of the body are ALL important considerations.

	At this point, you still have a lot of options available to you once the inflammation from the surgery resolves. Ask your breast surgeon give you the names of several Plastic surgeons and visit them, even if you have to pay out of pocket. Once you met them and learned YOUR options, you can decide which option and surgeon you like best. This way, you will be ready to proceed when the tissues soften to complete the reconstruction which best suits your  goals and beliefs.

	Peter a. Aldea, MD

Jeffrey Zwiren, MD · Answer

You certainly have many options for breast reconstruction on a delayed basis.   A consultation with a plastic surgeon will help you understand your reconstructive options.

Kari L. Colen, MD · Answer

If you want future reconstruction the extra skin will be a large help in giving you a more cosmetically pleasing reconstruction.  You can choose many different types of reconstruction bases on your medical problems, body type and need for radiation treatment.  You may choose to do tissue expanders with implants or use your own tissue for reconstruction ( like your tummy).  If you do not want reconstruction then you will most likely want another surgery to remove the extra skin from your chest.

Extra Skin Left After Prophylactic BM? What Are My Options For Reconstruction? (photo)

Answers (6)

Answer: Options for breast reconstruction

Answer: Options for breast reconstruction

Answer: Extra skin is good for future reconstruction

Answer: Extra skin is good for future reconstruction

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Everything you need to know about Breast Reconstruction

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Extra Skin Left After Prophylactic BM? What Are My Options For Reconstruction? (photo)

Answers (6)

Answer: Options for breast reconstruction

Answer: Options for breast reconstruction

Answer: Extra skin is good for future reconstruction

Answer: Extra skin is good for future reconstruction

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.