Is it Normal for the Surgery to Remove Expander is Separate from the Surgery to Repair Inframammary Fold?

My doctor had to set up separate surgery to repair loss of inframammary fold after surgery to remove expander. He says that sometimes this is necessary. I feel that he should have seen it at time he removed expander and fixed it then so that I would not be charged for another surgery. Please advise

Doctor Answers 6

Breast reconstruction

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Sometimes when the expander is removed and an implant is placed, the fold looks ok on the table, but after several weeks, the fold position may have changed and this needs to be corrected.  It does not happen often but it certainly can happen.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Two step surgery

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sometimes after removal of the expander for breast reconstruction the inframammmary fold does not end up exactly where we would like it.  it is not unusual to have a touch up surgery.  this does not mean that anything was done wrong

Jonathan Saunders, MD
Newark Plastic Surgeon

Loss of fold.

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To answer your questions, you need to be seen by a surgeon. I will answer it with the assumption that you had breast reconstruction and the expander was removed and an implant placed. It is not uncommon to need additional surgery to optimize the results from reconstruction and I have done this very thing myself. Sometimes everything looks great initially and as your body heals, things change. It may be that there was poor communication. Although you are entitled to your feelings, it sounds like you no longer trust your surgeon. I recommend you work out the issue with her/him or find another doctor. I believe it is unlikely a qualified surgeon would see the problem in the operating room and not fix it.

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Is it Normal for the Surgery to Remove Expander is Separate from the Surgery to Repair Inframammary Fold?

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Without knowing your history and examining you in person very hard to advise. In person second opinions are the way you should go. 

Difficult question

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I think the number one question is what is the reason for removing the expander in the first place?  Also, how many surgeries were performed prior to the placement of your expander?  Was this for breast cancer reconstruction, and if so, did you receive radiation therapy?  Typically, when multiple surgeries have already been done, it is best to start from scratch to allow the tissues to heal.  This needs to be balanced by the need to keep your current breast volume, which can shrink if is not maintained by another expander or implant.  On the other hand, there are sometimes too many variables to control when trying to correct a secondary breast deformity.  Elevating the inframammary fold is one of the most difficult tasks to accomplish even as a solo procedure.  Adding the weight of another expander or implant may make inframammary fold reconstruction quite difficult and prone to failure.  I think in these situations, less is more.   

Andre Panossian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 4 reviews

More information is required

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There are various reasons why a surgeon would perform procedures in steps rather than all at once.  At times everything can be done in one surgeon, at other times breaking it up into multiple procedures helps to create a better cosmetic outcome, a more reliable outcome, or simply safer than trying to squeeze everything into a single procedure.
Without a better understanding of what was done, a simple answer to your question is: Yes, it can be done that way.
Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 519 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.