Mastectomy, Breast Reconstruction with Tummy Tuck?

I'm a BRCA positive 40 year-old in excellent health, normal weight. I'm having a prophylactic mastectomy with immediate, "one-step" reconstruction (using Alloderm and silicone implants).

Could I have a tummy tuck at the same time? I have lumpy results from a previous abdominal liposcution and a nasty appendectomy scar I'd love to be rid of!

Doctor Answers 18

It could be possible but remember the 6 hour rule

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The answer to this question would depend entirely on the opinion and practice experience of your surgeon. Assuming that you could perform the surgeries in less than 6 hours, it might be reasonable to proceed. If it would take longer than that for your doctors to perform their procedures, it would be wise to separate them. Studies have shown an increased risk of complications from elective surgeries performed that take more than 6 hours to complete.

Can I have A tummy tuck during my Mastectomy procedure?

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Yes, this should not be a problem.  Factors to consider before surgery: 
  • Always select a well qualified board certified plastic surgeon to ensure a better outcome
  • I would suggest you have a thorough medical evaluation prior to the procedure
  • I would suggest that the mastectomy be done prior to the Tummy Tuck Procedure
  • Anticipate a longer recovery period.  (3-4 weeks)
Good Luck

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 22 reviews

Assess risks first

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I am assuming you are getting bilateral prophylactic mastectomies. While it is possible to do the reconstruction and abdominoplasty simultaneously, you should have your surgeons assess the risk of the procedures. From a healing point of view, the incisions and undermining necessary might reduce blood flow to certain areas of the breast and abdomen such that healing may be a factor. Total blood loss from combined procedures may also reduce oxygen-carrying capacity and thus hinder healing and may also place you at risk for needing blood transfusions you might ordinarily not need. In addition, tension placed on the abdomen often will change the position of the inframammary fold that is critical in assessing position of the implants.

Finally, while bilateral silicone implants for bilateral prophylactic mastectomy reconstruction is a sound option, there may be a significant risk of hardening or intolerance to the implants that might make autologous reconstruction a better long-term solution in case of implant failure. Your plastic surgeon should factor this into his/her decision about reconstructive options. Think carefully about choices so you and your surgeon do not get painted into a corner.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Consider different reconstructive options

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There are many different reconstructive options for breast cancer. For patients that are interested in removing abdominal tissue you should talk to your surgeon about using that tissue to reconstruct your breasts. You can get excellent long term results with a very natural looking breast (most would agree more natural than implants) and get the abdominoplasty at the same time.

You should speak to a board certified plastic surgeon who performs all types of breast reconstruction.

In your case I would consider options like a pedicled TRAM or a free TRAM.

Unless you and your surgeon have specific reasons for wanting to use an implant for reconstruction (sometimes size of the reconstructed breast can be a consideration) the above options definitely should be discussed.

Call your doctor!

I hope this helps.

Steven Williams, MD

Tummy tuck with breast mastectomy and implant reconstruction

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Thank you for your question. A tummy tuck can be combined with alloderm/implant-based breast reconstruction.  It is a bigger procedure and may often require a night in the hospital. I would consult with a board certified plastic surgeon in your area to discuss your options in more detail, review if there are any medical reasons to stage the procedure. If they deem you are healthy to have have the combined procedure, then you will only have one recovery.

Prophylactic Mastectomy and Tummy Tuck Combination

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It makes a lot of sense to combine the prophylactic mastectomy and tummy tuck procedures at the same time. Typically I would perform this surgery simultaneous while your mastectomy is being performed by a separate surgeon. This dramatically decreases the operative time, plus you also recover from both procedures at the same time.

Combining surgeries

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As long as you're cleared by your internist for the surgery, you should be okay getting both the breast reconstruction and the tummy tuck at the same time.

Tummy tuck with immediate breast reconstruction

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This sounds like a combination that would be reasonable. Probably the primary concerns are the risk for DVT with PE and your surgeon will likely utilize common prophylactic measures to minimize this possibility.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast reconstruction with tummy tuck

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Using your abdominal tissues in breast reconstruction is a very effective technique. Your plastic surgeon will evaluate your physical condition and determine if you have enough abdominal tissue to re-create your breasts. When they close the wound, they can close it like a tummy tuck. Patients appreciate this reconstruction because it uses their own tissue and can re-contour the abdomen at the same time.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Tummy tuck with breast reconstruction

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I would have to agree with the majority of the surgeons posting on this question. A tummy tuck or abdominoplasty is a significant surgical procedure. To undergo prophylactic mastectomies and reconstruction is typically a 3-4 hour procedure already.

Adding a tummy tuck is too much surgery at one time. In addition, the surgical risks, particularly of a DVT or Pulmonary Embolism increase significantly when combining a tummy tuck with other major procedures.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

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.