3 Failed Expanders, what are my options now?

Question

Over 3 years I've had 3 expanders all have "deflated" after the first my surgeon put in an implant that was 1/2 the size of the expansion area which flipped upside down and settled there. Last week my 3rd 6 days post op literally burst my wound and poured every where. So now I'm honestly feeling a little unstable mentally and completely lost on what to do. I must mention I have factor five leiden, but no clots in the last 3 years.

Lewis Albert Andres, MD · Answer

I am sorry to hear of your troubles following your breast reconstruction, after everything that you have gone through.  There certainly still are options for breast reconstruction in your setting.  Have your tissue expanders actually "deflated" or were there wound complications?  Did you have a previous infection or any radiation therapy before or after your breast procedures?  Just a few questions that may have impacted failure in these instances.If in fact, the issue is due to wound complications, as you state in this last occasion, I would highly consider an autologous (your own tissue) breast reconstruction.  By doing such a procedure, it would bring in healthy, well-vascularized tissue to the affected area and significantly ameliorate the complications that you have experienced.  Procedures such as the DIEP, in which your abdominal skin and fat is utilized, may be a great option for you, if you are a candidate for it.  I would discuss this with a plastic surgeon experienced in this procedure if you wish to continue your goal for having reconstructed breasts.  There are other flap procedures that are available as well...regardless, there are certainly options for you, even given your clotting disorder.  Best wishes!  Hope that this helps!

Samir Shureih, MD · Answer

You have a complex medical problem1: Factor leiden V mutation2: 3 tissue expanders failed, the last seems the wound opened and it is either infection, or hematoma or other problem.You need in person consultation and review of all medical records. Review your risk for deep venous thrombosis and pulmonary emboli. Then after thorough discussion you can make an informed decision. The internet and Dr. Google is not the ideal for you.Samir Shureih MD. FACSsshureih@msn.com

Robert Whitfield, MD · Answer

You still have options.Three
basic forms of breast reconstruction exist. You can use your own tissue,
implants or a combination of the previous two techniques. Your own tissue can
be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting.
Implants can be done in one stage or two stage. Two stage reconstructions are
started by placing expanders at the time of mastectomy. Once they expanders are
placed they are able to be inflated as determined by wound healing. The final
time consists of combining any of the above techniques.

If
you are interested in being seen in Austin please give us a call.  I know
this is a difficult time for you.  The majority of my practice is devoted
to reconstruction for women with breast cancer or who are BRCA+

3 Failed Expanders, what are my options now?

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