I had bil skin & nipple sparing mastectomies & reconstruction w/tissue expander & Alloderm on 9/23/15. Can the following be corrected? RIGHT breast: Expander extends too far into axilla; Nipple is not in center of expander pocket; Appears less full/less volume than Lt; Expander too high (higher than Lt); distance from nipple to inframammary shorter than Lt. LEFT Breast: lateral border w/area of skin tightness & adhered to expanders causing puckering fold; Lt breast pulled laterally. Thx!
Answer: All of this can be corrected All of your concerns can be corrected during your second surgery when the tissue expanders are exchanged for permanent implants. It is not uncommon for there to be some asymmetries with respect to position of the expanders, and there are specific techniques that your plastic surgeon can use to ensure that the placement of the permanent implants is appropriate and symmetric.
Helpful 4 people found this helpful
Answer: All of this can be corrected All of your concerns can be corrected during your second surgery when the tissue expanders are exchanged for permanent implants. It is not uncommon for there to be some asymmetries with respect to position of the expanders, and there are specific techniques that your plastic surgeon can use to ensure that the placement of the permanent implants is appropriate and symmetric.
Helpful 4 people found this helpful
November 11, 2015
Answer: Uneven Breast Tissue from Breast Reconstruction The short answer is yes, but you have several things going on. First of all I tell my patients the tissue expander phase is just a rough draft. Lots of things can be done at the second stage to fine tune the pockets and create symmetry. The expanders are simply to stretch skin. Being that said I see some things on you pictures. Your left breast fold is lower than the right and that can be elevated at your second stage to be more even. Next, the fold on the left is because all the breast tissue that was once there is gone and so the skin has not choice but to sink around the implant and your existing chest wall. Sometimes after expansion and pocket modification at your second stage we can get the implant to fill that region out, but not always. The last thing I see about your anatomy is that you are one of those patients whose pectoralis muscles insert widely on the sternum so you have a bit of a gap there. That can not be changed and is your given anatomy. With expansion and high profile implants you may be able to obtain some degree of cleavage, but this is an anatomical characteristic of your body that the surgeon can not change. The good news is you have nipple sparing mastectomies which makes a world of difference with reconstruction from the cosmetic standpoint. I always warn patients however that you must make the mental leap from what you had before to what is possible to create now. Both may be great but very different in the way they feel and look. Managing expectations is the hardest part of this process so that you will not be unhappy when it is all done. I hear patients say all the time they are so happy and know that the reconstruction looks great, but it is not what they expected. So really spend time, even now, talking with your surgeon about what you think you will have for a result and what is actually possible. Good luck on your journey and congratulations on getting through the fight against breast cancer.
Helpful 3 people found this helpful
November 11, 2015
Answer: Uneven Breast Tissue from Breast Reconstruction The short answer is yes, but you have several things going on. First of all I tell my patients the tissue expander phase is just a rough draft. Lots of things can be done at the second stage to fine tune the pockets and create symmetry. The expanders are simply to stretch skin. Being that said I see some things on you pictures. Your left breast fold is lower than the right and that can be elevated at your second stage to be more even. Next, the fold on the left is because all the breast tissue that was once there is gone and so the skin has not choice but to sink around the implant and your existing chest wall. Sometimes after expansion and pocket modification at your second stage we can get the implant to fill that region out, but not always. The last thing I see about your anatomy is that you are one of those patients whose pectoralis muscles insert widely on the sternum so you have a bit of a gap there. That can not be changed and is your given anatomy. With expansion and high profile implants you may be able to obtain some degree of cleavage, but this is an anatomical characteristic of your body that the surgeon can not change. The good news is you have nipple sparing mastectomies which makes a world of difference with reconstruction from the cosmetic standpoint. I always warn patients however that you must make the mental leap from what you had before to what is possible to create now. Both may be great but very different in the way they feel and look. Managing expectations is the hardest part of this process so that you will not be unhappy when it is all done. I hear patients say all the time they are so happy and know that the reconstruction looks great, but it is not what they expected. So really spend time, even now, talking with your surgeon about what you think you will have for a result and what is actually possible. Good luck on your journey and congratulations on getting through the fight against breast cancer.
Helpful 3 people found this helpful
November 8, 2015
Answer: Breast reconstruction All the issues with the position of the tissue expander and the position of the inframammary line and the lateral displacement and position of the nipple can be corrected during the second stage. Preoperative measurements and addressing these issues and how to correct point by point should be discussed in writing with you. You need to choose your surgeon carefully.
Helpful 3 people found this helpful
November 8, 2015
Answer: Breast reconstruction All the issues with the position of the tissue expander and the position of the inframammary line and the lateral displacement and position of the nipple can be corrected during the second stage. Preoperative measurements and addressing these issues and how to correct point by point should be discussed in writing with you. You need to choose your surgeon carefully.
Helpful 3 people found this helpful