POSTED UNDER Breast Reconstruction REVIEWS
Breast Reconstruction at It's Finest - New York, NY
ORIGINAL POST
For the past year, I have been a breast...
NJ_momJanuary 6, 2015
WORTH IT$2,500
For the past year, I have been a breast cancer/reconstruction patient of Dr. Keegan at Fifth Avenue Millennium Aesthetic Surgery in NYC. Dr. Keegan was the 3rd plastic surgeon I consulted with, and I selected him as my surgeon based on his compassion and kindness. Dr. Port of Mount Sinai Hospital had recommended Dr. Keegan to me, so I knew that his surgical skills were impeccable as well. I live in NJ and I had to travel 1½ hours into NYC to see Dr. Keegan, and it was worth every mile (and GW Bridge crossing!). I knew that I was in for a long reconstructive process, so I selected the surgeon who I felt would “have my back” through it all. I wanted someone I could trust, have a rapport with, and ultimately have faith in his or her surgical skill to help me through this journey of cancer and breast reconstruction. For me, Dr. Keegan was the perfect choice to help me through this stressful period of my life.
You see your doctor’s real surgical skills and emotional maturity come out when something goes wrong. My reconstruction journey was complicated by a staph infection in my left tissue expander (warning to all women undergoing breast reconstruction – BE CAREFUL SHAVING! Your underarms are not the same! Minor cuts can have major consequences.) When I noticed a bit of swelling in my left breast, Dr Keegan immediately put me on antibiotics and sent me for an ultrasound. He instructed me to have the ultrasound technician call him directly with my results, as he didn’t want to wait for the report. His instincts were right as I had a staph infection and he scheduled me for emergency surgery that evening. This was a terrifying scenario for me; however, Dr. Keegan’s reassuring words and manner helped me cope with a very frightening situation. He even held my hand during surgery until I fell asleep under anesthesia. Dr. Keegan was able to salvage my reconstruction and I continued on my journey with just a slight hiccup in timing. To look at my perfect symmetry now, you would never know I ever had an issue – again showcasing Dr. Keegan’s skill as a plastic surgeon.
All journeys come to an end and I am happy and grateful to have had Dr. Keegan as my breast reconstruction surgeon. My results are outstanding and I feel lucky to have found him. I look beautiful and feel comfortable with my new implants. While the Fifth Avenue facility has much more of a tranquil, boutique spa feel, it has a certain “Cheers” quality. It was very pleasant to go where everyone knew my name. I always felt warm and welcome by all of the staff. Of special note are Chelsea – she was always “quiet perfection” in the examination rooms, and Julie – with her personable, cheerful demeanor – she always greeted me with a warm smile of recognition when I entered their offices. While I am glad that my trips into NYC are complete, I am delighted with my results!
You see your doctor’s real surgical skills and emotional maturity come out when something goes wrong. My reconstruction journey was complicated by a staph infection in my left tissue expander (warning to all women undergoing breast reconstruction – BE CAREFUL SHAVING! Your underarms are not the same! Minor cuts can have major consequences.) When I noticed a bit of swelling in my left breast, Dr Keegan immediately put me on antibiotics and sent me for an ultrasound. He instructed me to have the ultrasound technician call him directly with my results, as he didn’t want to wait for the report. His instincts were right as I had a staph infection and he scheduled me for emergency surgery that evening. This was a terrifying scenario for me; however, Dr. Keegan’s reassuring words and manner helped me cope with a very frightening situation. He even held my hand during surgery until I fell asleep under anesthesia. Dr. Keegan was able to salvage my reconstruction and I continued on my journey with just a slight hiccup in timing. To look at my perfect symmetry now, you would never know I ever had an issue – again showcasing Dr. Keegan’s skill as a plastic surgeon.
All journeys come to an end and I am happy and grateful to have had Dr. Keegan as my breast reconstruction surgeon. My results are outstanding and I feel lucky to have found him. I look beautiful and feel comfortable with my new implants. While the Fifth Avenue facility has much more of a tranquil, boutique spa feel, it has a certain “Cheers” quality. It was very pleasant to go where everyone knew my name. I always felt warm and welcome by all of the staff. Of special note are Chelsea – she was always “quiet perfection” in the examination rooms, and Julie – with her personable, cheerful demeanor – she always greeted me with a warm smile of recognition when I entered their offices. While I am glad that my trips into NYC are complete, I am delighted with my results!
NJ_mom's provider
Replies (42)
January 9, 2015
I am in Australia and here for breast cancer re-constructions our medical insurance pays a certain amount, we pick up the balance. Do you have to pay the $65,000 you cited as the cost. I have had to have two re-constructions and neither look very authentic, apart from that I encapsulate within a year . I would never be able to meet the cost of 2 in America.
January 9, 2015
Hi Scared stiff,
My total cost was higher than usual because I had an extra emergency surgery for the staph infection, followed by a 3-day stay in the hospital. Once I hit our insurance yearly out-of-pocket maximum, my health insurance has covered all of it.
If you are looking for a plastic surgeon in Australia - there is a doctor named "Paul Quinn" who seems fantastic - he answered a couple of my posted questions on realself.com. Please feel free to read our dialogue. He impressed me with his specific and concise answers.
January 10, 2015
I think my out of pocket expenses were $2,500 for my mastectomy/reconstruction. I wrote lots of little co-pay checks to the anesthesilogists, radiologists, pathologists, surgeons and hospital until I hit my yearly max, then my health insurance picked up 100%.
January 9, 2015
What kind of implants did you get?
Sorry for all the questions.
January 9, 2015
Hi Zooey2014,
I had Allergan Naturelle model 20 - 500ccs. They are round and smooth. They are nice and soft. They flop around like real breasts when I roll over in bed at night. I can tell you that while NOBODY wants a mastectomy, there are some clothing styles that look really great with implants. I wore a Herve Leger dress recently and implants look look fantastic in compression, bandage-style clothing.
January 10, 2015
Yes - it is the internal sling which supports the implants. I can't see or feel the Alloderm under my skin. Because of the Alloderm support, I'm eternally "perky" and don't need to wear a bra (but I still do most of the time).
January 10, 2015
Now my PS doesn't use alloderm...and he said I have thin skin...should I be worried about that?
January 10, 2015
What is your PS going to use to support your implants? Just a suggestion - ask to see some photos of his/her work for surgeries similar to yours. My skin is not "thick" by any means. I'm no PS, but one of the reasons PSs use Alloderm is to hide implant ripples. Alloderm is expensive, so maybe it is a cost issue. I'd ask your PS more questions...
January 10, 2015
I think the pec muscle can support implants, but I'm not a PS. My guess (and it is only a guess), is that you will have many months of expansion (fills) ahead of you and that you will start out pretty flat. It will take a while to stretch your pec muscles enough to cover an implant. Ask your PS if it will hurt to stretch your pec muscles, and how much he/she fills at a time.
How big do you want to be at the end of your reconstruction? This is something you want to think about. My experience was that my tissue expanders were filled to 350ccs ("B" cup) during my initial surgery, and I had 3 fills of 50ccs, to a total of 500ccs. I now am a full "C" cup (Victoria Secret measured me at "DD", but I find C cup bras more comfortable). My TE fills weren't painful, just a feeling of tightness for the first day. My recon should have been finished in 3 months - I was delayed by my staph infection.
This is a great question to post on realself.com - lots of board certified PSs will chime in to answer your question: "Which is better - Alloderm or pec muscles to support implants?"
January 10, 2015
I want to be full C cup. He said 2 to 3 months of fills. He said it would hurt it " but we have medicine for that".
January 10, 2015
I did wear the TEs for an extra 2 months by choice, not because my PS required me to. My staph surgery was 4/25. I think it took 6+/- weeks to heal and get my 3 fills (I was lopsided for a while!), and I was ready for surgery in early June. Dr. Keegan's surgical schedule was booked up until late June. School was then out and I took a reconstruction vacation until Aug 4th. Dr. Keegan was OK with my decision to take a break for a while. He could probably tell that I needed some R&R away from hospitals, OR rooms and those follow-up visits.
Re: pain meds - ask your PS about driving while on pain killers. While you may feel capable of driving, you are compromised.
January 12, 2015
NJ_mom, I'm not hijacking your thread but I wanted to let Zooey2014 know that there is a site called ***3rd party link removed*** that women such as myself have been on and asked all sorts of questions reading the TE's and alloderm. Zooey may find more infomation and get support from a bunch of ladies going through the same thing she is at this current stage. It's all free and private. It helped me when I first started my journey 12/2013.
January 12, 2015
HappySpring13....I used ***3rd party link removed***extensively when going through my early days of breast cancer and reconstruction. The women are wonderful and it is a fantastic resource. I highly recommend it to all women.
January 11, 2015
Hi
Did you have any indication from the underarm area that you had infection? Could you see an obvious sign??
Thank you
January 12, 2015
Hi Ashaffer....no there was no redness, skin swelling, pus, or other indication that a staph infection was brewing. I just had pain which felt like muscle strain. I thought I had overdone it while shopping at the grocery store. After my doctor examined me and pressed on the upper left side of my pec muscle/top of my left TE, the fireworks started! The obvious staph swelling/redness set in and was impossible to miss. My left breast swelled up and a large redness developed on the underneath of my breast. During my surgery, it looked like I had 2 infection sites: upper left (near my armpit) and below my breast (see photo/surgical purple circle). The doc took 150ccs of fluid out during my surgery. My guess is the staph infection migrated (floated) down via gravity as I had no skin injury below my breast.
UPDATED FROM NJ_mom
1 year post
Reconstruction photos
NJ_momJanuary 8, 2015
Please be gentle critics of my photography! Most of these are "selfies" which I shot either in my hospital bed or in my bathroom.
I just want to point out that in my last photo - with my silicone implants - I had my mastectomy scars lasered 3 days ago (on Monday), so the scars look red and wide. In reality, the actual surgical lines are developing a lovely blurriness - and don't look like scars - especially along the center of the scar line.
I just want to point out that in my last photo - with my silicone implants - I had my mastectomy scars lasered 3 days ago (on Monday), so the scars look red and wide. In reality, the actual surgical lines are developing a lovely blurriness - and don't look like scars - especially along the center of the scar line.
Replies (12)
January 9, 2015
Hi...I'm getting TE's put in very soon. I'm really scared to start this whole process. Staph is one of the things I'm afraid that will happen. Can you tell me what to look out for with Staph? I know you said redness and swelling... Isn't that hard to detect when you have those symptoms from the surgery, alone? Did you get a fever?
January 10, 2015
Zooey2014,
I did not get a fever, but that is a symptom of Staph. My first inkling that I had a problem was a pain on the upper left side of my breast - I thought I had pulled a muscle. I went in to see Dr. Keegan and while he didn't see any swelling (it was minor at that time), he physically examined me. Luckily I was seated at the time, because my legs would have buckled when he pressed on the infection. I think it was because of my painful reaction, he put me on antibiotics and he sent me out for an ultrasound. After that appointment, my left breast swelled up - and fast! I was at least a cup size "F" by the time I got the ultrasound (see picture).
Suggestions to avoid a Staph infection - wash your hands with "Hibiclens" before you change your bandages. Take every cut seriously: wash it properly and put "Bacitracin" on the injury. You can also be colonized by Staph - your dermatologist can perform a simple nasal swab test to check if you are colonized. I can't say that my minor shaving mishap caused my staph infection, but it was a likely cause. Your underarm topography will be different after your surgery. You will be swollen post-surgery and in my case, the blade was too wide and I nicked myself. Dr. Keegan warned me to be careful shaving for the first time, but accidents happen...
January 10, 2015
Unfortunately, we are surrounded by Staph - all the time. I had the garden variety "community" version of Staph, not Mersa, which is what you hear about people contracting in hospitals.
January 9, 2015
I never heard of getting Laser treatment for your scars? What does it help?
January 10, 2015
Hi Zooey2014...
I'm having a total of 4 Fraxel Re:Pair laser treatments on my mastectomy scars. I have had 3 treatments to date. At this point, you can only really see the surgical cut marks on the last inch of my mastectomy scars. The center of the scar looks like it has healed without the scalpel incision mark. After I have finished the 4 treatments and the redness subsides, I'll post a picture for you.
January 11, 2015
I would love to see your photo's after the 4th treatment. How long after your final implants did you go for the 1st Fraxel? I've been wearing 24/7 the silicon sheets over my mastectomy scars. My scars are flat and soft, but red. My doctor never mentioned anything about laser to help fade them. Will you be going for areola tattoos? Thank you for sharing.
January 11, 2015
HappySpring...similar to you, I used silicone sheets right after my implant surgery. I used a brand called "Embrace Scar Therapy" - which use tension to keep the scar line as tight as possible. I used the Embrace strips for 6 weeks, then went for my first laser treatment. The Doc is using the stronger Re:pair laser set at a lower 15% setting. The first 2 treatments didn't look like they did anything (other than make my nice, narrow scars really red). I notice a big change in my scars now after the 3rd treatment. The scar lines are becoming less distinct. At this point, I have maybe 1/2 inch at the far end of my right scar that looks like a "scar", the entire left scar and remaining right scar look "blurry". The Doc said that he will up the laser intensity for my final laser treatment. I will be getting tattoos when I am finished (and healed) from the laser treatment. HappySpring13 - Good luck with your reconstruction!
.......If there are any doctors reading this post, please realize that we ladies HATE these scars and would appreciate any help you can give us to minimize these permanent reminders of our cancer. It shouldn't have to be so hard to find scar treatments for our mastectomy scars!
January 12, 2015
Thank you for your reply Nj_mom. Are you thinking of going to Vinnie Myers for the tattoos? My PS wants to do it, but I feel that he is a PS not a tattoo artist and a lot of women go to Vinnie. Still on the fence since I need another round of fat grafting before I do anything. By the way, your implants look amazing. Your PS did a fabulous job. I went with the Allergan 410's. They don't move around much, but I'm happy with them so far. Just wish I had more projection. I am going to look into the Embrace Scar Therapy and see if it is better than what I am using. I just wish the incision site would fade already. LOL. Thank you for sharing your story with everyone.
January 12, 2015
HappySpring...Vinnie Myers does gorgeous work. I am considering making the 3 1/2 hour trip to Finksburg, MD. His work is truly realistic! You made me giggle about "projection". My 14 yr old son keeps telling me to "put those away" while pointing at my chest. I suspect that he feels I have a bit too much projection. The grass is always greener....best of luck to you with your reconstruction!
UPDATED FROM NJ_mom
2 years post
I love my tattoos! Finally done with cancer.
NJ_momJuly 10, 2016
Hello all!
I'm finally done with my reconstruction. Since my last post, Dr Keegan surgically created my nipples and Vinnie Myers did my nipple / areola tattoos. It takes a while to heal - Vinnie waits at least 6 months after the last surgery in order to give the scars time to fully heal. I posted several tattoo pics in different sizes and angles - so you would get an idea of the beauty and complexity of the tattoos. Vinnie really does fantastic nipple/areola tattoos. Feel free to zoom in if you can - he does some shading around the base of the nipple as well as those round dots on the areola which simulates the Montgomery tubercles (I had to look that up!)
Vinnie sees a lot of breast reconstructions in his line of work - and he complimented Dr. Keegan's skill as a plastic surgeon. He said that my reconstruction is in the top 5% of the reconstructions he has seen. Vinnie said that he usually has trouble tattooing the reconstructed nipples because of the location of the scars the surgeon creates while recreating the nipple. Vinnie explained that Dr. Keegan creates nipples with the resulting tattoo in mind, so my result is a very natural looking breast. There is a wide geographical distance between the 2 men - NYC vs Finksburg, Maryland, and it surprised me when Vinnie clearly recognized Dr. Keegan's reconstructive work.
I love my tattoos and they really do complete this chapter in my life. It's nice to look in the mirror and not be constantly reminded of cancer. I hope my story and photos help you along your path towards health. Good luck to you all!
I'm finally done with my reconstruction. Since my last post, Dr Keegan surgically created my nipples and Vinnie Myers did my nipple / areola tattoos. It takes a while to heal - Vinnie waits at least 6 months after the last surgery in order to give the scars time to fully heal. I posted several tattoo pics in different sizes and angles - so you would get an idea of the beauty and complexity of the tattoos. Vinnie really does fantastic nipple/areola tattoos. Feel free to zoom in if you can - he does some shading around the base of the nipple as well as those round dots on the areola which simulates the Montgomery tubercles (I had to look that up!)
Vinnie sees a lot of breast reconstructions in his line of work - and he complimented Dr. Keegan's skill as a plastic surgeon. He said that my reconstruction is in the top 5% of the reconstructions he has seen. Vinnie said that he usually has trouble tattooing the reconstructed nipples because of the location of the scars the surgeon creates while recreating the nipple. Vinnie explained that Dr. Keegan creates nipples with the resulting tattoo in mind, so my result is a very natural looking breast. There is a wide geographical distance between the 2 men - NYC vs Finksburg, Maryland, and it surprised me when Vinnie clearly recognized Dr. Keegan's reconstructive work.
I love my tattoos and they really do complete this chapter in my life. It's nice to look in the mirror and not be constantly reminded of cancer. I hope my story and photos help you along your path towards health. Good luck to you all!
Replies (17)
July 21, 2016
Wow they look amazing! They are perfect. I will like to ask, it says the cost was $65,000. Is it 65,000 or 6,500?
November 16, 2016
Hi - I wasn't sure what number to put in the $$ field. I estimated that my insurance company paid about $65k for my mastectomy and reconstruction. I personally paid just my insurance deductible - $2,500. I just updated my review to just represent my out of pocket expenses.
November 28, 2016
Congratulations on the great outcome!! My doctor did not encourage the nipples as I was 59 and had so many complications with 7 surgeries. Think I'm going to try University of Penn as they do have a tatoo artist on staff which Jefferson did not. Thought I could live without them, but I am not happy...
March 16, 2017
Hi Sinbad1,
To be honest, the 3-D effect of nipple tattoos is pretty spectacular. Once you get your tattoos, you will be glad that you didn't risk additional surgery. And - you won't have to wait an additional 6 months to be done.
Congrats on beating cancer! Enjoy health!
To be honest, the 3-D effect of nipple tattoos is pretty spectacular. Once you get your tattoos, you will be glad that you didn't risk additional surgery. And - you won't have to wait an additional 6 months to be done.
Congrats on beating cancer! Enjoy health!
March 16, 2017
Thank you, not sure about no more surgery, lot of pain on the radiated side to touch and raising arm :(
March 17, 2017
Sinbad1,
I'm sorry to hear that you are in pain. I hope you can find some relief soon. I'm sending healing thoughts your way :)
I'm sorry to hear that you are in pain. I hope you can find some relief soon. I'm sending healing thoughts your way :)
March 17, 2017
January 9, 2017
Your breasts look amazing!! Congrats on your beautiful results, as I know this journey could be extremely difficult. I am going for a prophylactic bilateral mastectomy (brca+) at the end of this month and am anxious about my outcome. I am going to Sloane Kettering for the mastectomy and reconstruction. I am using Dr Evan Matros as my plastic surgeon. How did your ps create your nipple before you went to the tattoo artist? Thank you for sharing your journey, it is very encouraging..
March 16, 2017
Hi Catatude28,
Dr Keegan created my nipples a few months after my cutover surgery (expanders replaced with permanent implants). It was maybe a 1/2 hour surgery. Picture folding a skin napkin - while an artistic surgery, not terribly difficult. I like my new nipples - just a bit of projection, but not as big as my original ones. I look normal but not obscene! Anyway - there are scars from nipple surgery, but the tattoos cover them (they were really small anyway). I had to wait 6 months after nipple surgery to get the tattoos. The tattoo artist wants to make sure that you are well healed so that the ink stays put. I've had the tattoos 2 years and they still look great.
Good luck with your journey! You are in good hands at Sloane Kettering!
Dr Keegan created my nipples a few months after my cutover surgery (expanders replaced with permanent implants). It was maybe a 1/2 hour surgery. Picture folding a skin napkin - while an artistic surgery, not terribly difficult. I like my new nipples - just a bit of projection, but not as big as my original ones. I look normal but not obscene! Anyway - there are scars from nipple surgery, but the tattoos cover them (they were really small anyway). I had to wait 6 months after nipple surgery to get the tattoos. The tattoo artist wants to make sure that you are well healed so that the ink stays put. I've had the tattoos 2 years and they still look great.
Good luck with your journey! You are in good hands at Sloane Kettering!
January 10, 2017
Your reconstruction and tattoos look amazing!! I think these are the best results I've seen!! I have a few questions.....did you have radiation and are your implants round gel?? I'm booked for reconstruction in April and my surgeon wants me to have anatomical "gummy bear" implants and not sure I'm sold on that look.....I'm only 36 and I feel like that type of implant won't give me any upper pole fullness?? Anywho would love to hear from you. Thanks in advance
March 16, 2017
Hi kjtm,
I went with round implants. I did not have either radiation or chemo - just surgery. I had DCIS, so my cancer was caught early. I picked round implants because the gummies felt hard and I wanted to be "squishy". I'm sorry - I can't help with upper pole fullness. The downside to my squishiness is that there is some rippling depending on my posture - if I bend over, you can see ripples. The gummies don't have that problem. It was a trade-off I was willing to live with. My round implants feel real - they give when I touch them. Hope that helps! Good luck! It will all work out.
I went with round implants. I did not have either radiation or chemo - just surgery. I had DCIS, so my cancer was caught early. I picked round implants because the gummies felt hard and I wanted to be "squishy". I'm sorry - I can't help with upper pole fullness. The downside to my squishiness is that there is some rippling depending on my posture - if I bend over, you can see ripples. The gummies don't have that problem. It was a trade-off I was willing to live with. My round implants feel real - they give when I touch them. Hope that helps! Good luck! It will all work out.
March 18, 2017
Your outcome was spectacular! Do you mind if I ask who did the nipple tats? I'm at that stage in my recon and am looking for as much info as possible!
March 18, 2017
Cancel that! I just saw that it was Vinnie! I jumped the gun by posting to soon! I was reading from the bottom up, lol!
March 24, 2017
Vinnie Myers of Finksburg, MD. He travels around the country also - just call his office. Good luck! You will be thrilled by the results!
Awww, Doctor Keegan sounds wonderful, I love this "He even held my hand during surgery until I fell asleep under anesthesia." I am so happy that you found a doctor and his welcoming staff that was so kind and supportive towards you through such a difficult time in your life. What type of reconstruction did you have and are you comfortable sharing photos with the community?
Thank you for your reply and photo update, amazing results! I am terribly sorry to hear about the loss of your mother to breast cancer. I look forward to seeing your results after your areola tattoos. Thought you might find some interest in the following discussion:
NIPPLE/AREOLA TATTOOING WORTH IT??