One of my Breasts Has a Indent/fold in the Cleavage Area? (photo)

Question

I had a bilateral mastectomy w/ immd recon. After surgery one of my breasts had an fold in the cleavage area. My PS did some repair work during the TE exchange, but it is still present. He says it is because I had "so much tissue" to start with...I was a 36/G cup before surgery. I am 5'3'' and 153lbs. I was expanded to 750cc, but the implant size he used was 700cc. I am unsure why he didn't try to go for 800cc, to use up the space? He tells me anything bigger would look funny.

Darryl J. Blinski, MD · Answer

WOW!! A very nice result in bilateral reconstruction. A fold that can be revised at anytime under local . But you should n=be very happy with the result.

Robert Whitfield, MD · Answer

Final implant choices are based a number of factors but one of the most important is the width.  This prevents crowing in the middle of the chest and conversely to much implant towards the armpit.  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+

Paul Gill, MD · Answer

I see the crease in your breast and if it does not respond to conservative scar and implant massage, I would recommend fat grafting at 3-6 months.  

	In terms of implant selection, it is easier to blame this abnormality on your plastic surgeon over the mastectomy surgeon or even the diagnosis of breast cancer.    Bottomline, there is nothing your plastic surgeon wants more  than for you to look whole and normal again.   However, there are limitations based on anatomy, mastectomy treatment, medical history, and adjuvant therapy that is outside the control of the plastic surgeon, but for which they are often blamed.

	Bottomline, there are numerous variables to take into consideration and an important component of the reconstructive process is an important discussion on realistic expectations.   I make a concerted effort to achieve a realistic goal with each and every patient.    I will also refuse surgery on patients who are not realistic in their goals of recostruction as I do not feel comfortable performing surgery on anyone who is unrealistic on their longterm result.

	I know from experience that not setting clear and realistic goals prior to reconstruction is a recipe for disaster.     The last thing we as plastic surgeons want to do is refuse care to someone recovering from breast cancer.   However, if we find that we cannot realistically meet their goals, it is best to help them find a surgeon who works for them or can tell them that.  I wish you a safe recovery.
	
	Dr. Gill

Curtis Wong, MD · Answer

The folds you focus on can easily be revised with procedures down the road.  As for the size, its standard to put in an implant SMALLER then what you are expanded to.  This is slowly evolving because with textured implants, we are likely to be using implants very close to the expanded size.  And in reality, the difference between the 800 cc implant and the 700 cc implants are millimeters.

Steven Wallach, MD · Answer

A "dent" in this area is likely from the design of the mastectomy flaps and the amount of tissue left on the underside. Sometimes a scar revision and/or fat grafting may help.  Best to be seen in person.

One of my Breasts Has a Indent/fold in the Cleavage Area? (photo)

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One of my Breasts Has a Indent/fold in the Cleavage Area? (photo)

Answers (6)

Answer: Breast reconstruction concerns...

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Answer: Breast reconstruction and "dent"

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Everything you need to know about Breast Reconstruction

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