I had a tram flap reconstruction in 2012 and I regret ever doing it. possible to get them removed and have nothing?

Question

After two bouts with breast cancer, I now have one reconstructed breast (tram flap) and the other is "extremely dense" according to numerous pathology reports. I regret ever having the surgery, and now I want them both (breasts) gone. Is this possible? I have had severe anxiety over this for over a year.

Dallas Buchanan, MD · Answer

Thank you for your question. Sorry to hear about your anxiety and concerns. The short answer to your question is yes, because of your history of breast cancer, you can elect to have your normal breast removed and you can also opt to have your reconstructed breast removed as well. Before you go having a reconstructed breast removed, ask yourself what your concerns are. If you are concerned about cancer returning to the reconstructed breast, then you should talk to your oncologist and breast surgeon and make sure you are doing proper surveillance and maintenance. If you have cosmetic concerns regarding your reconstructed breast, you need to talk to your plastic surgeon about how to make that better. If on the other hand, you have decided that you would rather have no breasts at all, then that is your choice to make also. I would just hate for you to make a decision you regret because of something that can be fixed, improved, or resolved with other methods. Hope this helps!

Ali Sadeghi, MD, FACS · Answer

I am sorry you are suffering complications of a TRAM flap construction. At this point you should focus on finding a board certified plastic and reconstructive surgeon specializing in microsurgery to help you understand the complications and how to move forward. There are options available to you to Reconstruct and restore you body but this is not widely available. Good Luck and I hope this helps.

Curtis Wong, MD · Answer

Your anxieties are certainly appreciated.  You can certainly have a mastectomy and removal of your TRAM but if your defect is especially large, a skin graft may be needed to close the resultant defect after removal of the TRAM.  Assuming your TRAM is satisfactory, you can have a mastectomy and reconstruction of your other side rather than simply having them removed.  Determine what your concerns and goals are and see your surgeon for options for helping you achieve your goals.

Anthony J. Taglienti, MD · Answer

Thank you for your question. I am sorry to hear you are having anxiety over this. Put simply, yes, both the reconstructed breast and your native breast can be removed. There are many women who choose not to undergo breast reconstruction after mastectomies. The decision is very, very personal.  If you decide later down the road to have reconstruction, you may be a candidate for implant-based or autologous (same tissue), but it would have to come from elsewhere and not your abdomen. I would suggest following up with your breast surgeon, and your plastic surgeon to get more advice, and to hear all of your options. Best of luck!

Nicholas A. Flugstad, MD · Answer

With a history of breast cancer and breast reconstruction, you have options. It sounds like you still have one natural breast and you would like it removed. This is certainly one of the choices and is something to discuss with your breast cancer doctors (the ones that perform mastectomy, chemotherapy, radiation). Many patients wish to get rid of all their breast tissue and have the peace of mind that comes with that. From your post, it sounds as if you are unhappy with your breast reconstruction as well. There are several possible options to improve or replace your reconstructed breast. This would require more details, and in person consultation. Best wishes.

Kelly Killeen, MD, FACS · Answer

I am sorry you are having such anxiety.  It is absolutely possible to have a prophylactic mastectomy and have your reconstructed breast removed.  I think it sounds like you need to consult with a plastic surgeon to find out what you dislike about your TRAM, and if there is any way to revise.  There are many options for reconstruction and revision, and I am sure you will be able to figure it out with your surgeon.

Robert Whitfield, MD · Answer

Yes you can have your breast reconstruction revised.  Based on what you have described you can have a reconstruction revision.  The techniques offered would be based on your activities that you enjoy and you physical exam.  I have been referred several patients who are unhappy with their reconstructions.  Each one requires and indue plan.

Sara Yegiyants, MD, FACS · Answer

I am sorry to hear you regret your decision to have breast reconstruction.  It is absolutely possible to remove the reconstruction and have prophylactic mastectomy on the contralateral side. Please consult with a breast surgeon regarding the mastectomy and a board certified plastic surgeon regarding removal of breast reconstruction. Best, Dr. Yegiyants

I had a tram flap reconstruction in 2012 and I regret ever doing it. possible to get them removed and have nothing?

Answers (8)

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