I had a skin saving mastectomy & rads in Aug 2015. I'm worried it is too high and will have a bulge near my collarbone. (photos)

He will also lift my left breast.Isn't there anyway to make the right look more droopy and natural?I would go down a size.Regarding post rad reconstruction; Can a traditional implant be successful? My surgeon said I can try but he thinks I will need a latissimus; he says my skin feels thin. I have already had a tummy tuck. I will be 6 months out of rads. Would my success rate be higher if I waited a full year? I am worried as I've started to see some new sun-spots (darker skin) on the skin.

Doctor Answers 6

Breast reconstruction

That will require reconstruction with your own tissue.  Since you have a had a tummy tuck the inner thigh tissue in the form of a TUG or PAP, SGAP from the buttock or an LD flap are all options.  Fat grafting can be added as well later.

Skin sparing mastectomy and radiation

The gold standard in these cases where you have radiotherapy change is autologous tissue using either lat dorsi plus fat grafting or a double TUG flap
implants always have issues with capsules in irradiated breasts

Nilesh Sojitra 

Nilesh Sojitra, MSc, FRCS (Plast)
London Plastic Surgeon
4.9 out of 5 stars 12 reviews

Breast reconstruction

Is that an implant or do you still have the tissue expander?  The skin color change is from the radiation.  An exam in person will help.  Often an exchange to an implant and lowering the fold a bit will allow for a better position. A lift can be done at the same time.  Fat can be injected to the skin to improve the texture at some point. An LD flap is often an option if needed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast reconstruction and radiotherapy

Radiotherapy makes the skin envelope tight and natural ptosis is difficult to achieve. Latissimus dorsi flap and contralateral breast lift is good option as you are not able to receive DIEP flap reconstruction due to previous tummy tuck. Several fat grafting sessions is also a nice alternative.

Stamatis "Stam" Sapountzis, MD
Greece Plastic Surgeon
5.0 out of 5 stars 1 review

I had a skin saving mastectomy & rads in Aug 2015. I'm worried it is too high and will have a bulge near my collarbone.

Best to seek more second opinions in person! I might suggest doing right full breast lift to see the amount of elevation symmetry attainable. Also might start lipo with fat grafting to left reconstructed breast. Than after 3 months do additional surgery to improve results.. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Post op radiation and breast implants

Thank you for your question. Implants are never very good in an irradiated field. If you have had a TT then the next best option to create a more natural look and feel in your breast would be a SGAP flap. The upper buttock lower back tissue is great and available in even the this thinnest of patients. The only issue is that only a select group of surgeons are willing to do this surgery.  Ask you surgeon about it and if need be get another opinion. It is a great flap that I frequently use in patients who have previously had a tummy tuck. Good luck, let me know if I can help. 

John Mancoll, MD
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 51 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.