Adenofibroma removal during breasts augmentation? (Photos)

I have a 12mm/7mm adenofibroma in my left breast. My gyne wants to make an incision right on top of it because I have an almost non-existing areola (so a visible scar). But as I am planning to get a BA in 2 weeks (350cc/overs/under breast incision) my surgeon can remove it but through the areola as the adenofibroma is right next to it, so no detaching the skin from the tissues all the way from the under breast to reach it (scar on the areola). What do you think please? What would you recommend?

Doctor Answers 5

Breast mass excision with simultaneous augmentation

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While the answer to your question is ultimately function of surgeon preference, I would be hesitant to tackle these procedures in a coincident manner. My reasoning is 2 fold:

-This mass (while likely a fibroadenoma) is a suspicious mass mass until proven otherwise. You want to be pathologically cleared before undergoing elective cosmetic breast surgery. Priority #1 must be obtaining a tissue diagnosis and (hopefully) a benign result. Augmentation prior to that clearance can potentially complicate things.

-The fibroadenoma might be accessible via this approach thus camouflaging the scar more effectively. Your small areolar dimensions may limit the ability to place an implant via a peri-areolar approach. Thus an IMF incision would be best. I prefer to delay in cases where there is a need for an accessory incision.

Finally, some patients are prone to FA. A sub pectoral placement is usually safer in patients who may need further percutaneous biopsy in the future.

As always, discuss your concerns with a board certified plastic surgeon.

Adenofibroma removal during breasts augmentation

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I think your plastic surgeon's suggestion is what I would advise for you. I think placing an incision on your breast skin as your gyne suggested would leave a much more visible scar

Two separate procedures.

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The mass is definitely reachable from an incision made along the side of the areola.  Whether your PS or someone else does the removal, that would be the best incision for removal of the mass (I'm saying 'mass' because until the pathologist looks at it under a microscope, the diagnosis is still in question in my mind).

Separately, I'd have the implant placed through an inframammary fold incision.  I don't like exposing the prosthesis to the bacteria that are contained in the breast tissue and will be liberated during excision of your mass.  Furthermore, the diameter of the areola looks too small to safely insert the implant.

Follow the instructions of your plastic surgeon; if he or she is someone you trust, they will give you the best advice.

Removal during breastaugmentation surgery would be my (general) recommendation

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Thank you for the question. A lesion that has been worked up and found to be a benign (such as a fibroadenoma) can be removed during the time of breast augmentation surgery. This is especially true if the lesion is close to the planned incision for the breast surgery.  

Of course, the physicians who know you best will be in the best position to advise you. Best wishes for an outcome that you will be very pleased with. 

Adenofibroma removal during breasts augmentation?

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Thank you for your question.  Personally I would not attempt to remove the adenoma during your breast augmentation.  My preference is to have a breast surgeon remove the adenoma and do histology, allow you to recover and do the breast augmentation had a later date.  Since you are prone to fibroadenoma I would prefer a submuscular implant location to make future biopsies safer.

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