What kind of doctor is best for BMX w/o reconstruction?

marilyn113

I finished radiation three months ago, but now want to have a BMX.  I don't want reconstruction now or later.  Locally there aren't any surgeons who do just breast surgery.  Can a general surgeon who does breasts get a good result or should I have a breast specialist do it?  Does a plastic surgeon need to be involved?

Caya

I had a uni MX, also did not want reconstruction, but I had a breast surgeon specializing in cancer patients do it.  You don't need a plastic surgeon, as far as I know, if you don't want reconstruction.

If the general surgeon has done MANY MXs with good results, you will probably be fine. I'm sure other women who have gone through this will chime in.

bayareamom

I had a surgeon who specialized in cancer but not breasts. I got excellent results. BMX delayed reconstruction.

Erica3681

If at all possible, I would try to have the surgery done by a breast surgeon. The rule of thumb with surgeons is that the more they do of a particular kind of surgery, the better they are at it. Not that general surgeons or oncological surgeons can't do a good job (I'm glad bayareamom had good results), but your best bet is to find a breast surgeon. But it's also important to tell the breast surgeon that you want the best cosmetic result possible--symmetrical incisions, no extra skin left. Some breast surgeons push for reconstruction, so are not geared toward the cosmetics of non-reconstruction.

Perhaps another option for you would be to have a general surgeon do the mastectomy, with a plastic surgeon on hand to close up and insure a good cosmetic result. This is sometimes done. That way, you would be less likely to end up with so-called dog ears, or with lumpy or uneven incisions. 

I had a breast surgeon do my bmx and made sure to ask her beforehand for the best cosmetic result she could achieve. I did wind up with very symmetrical incisions, no extra skin, no dog ears, no extra tissue left under my arms. This made my psychological recovery easier and has also made it easier to wear breast forms and bras comfortably.

otter

I had a left mastectomy w/o recon.  The surgery was done by a breast surgeon who only operated on breast cancer patients.  (She's a surgical oncologist who directs the Breast Health Center at my cancer center.) 

I was told she did approx. 300 breast cancer surgeries a year, but I imagine most of them were lumpectomies these days.  Even so, she was very familiar with all the issues involved in doing a mastectomy without recon, and she did a fantastic job.  My surgery side is completely flat and smooth, and my scar is a pale white line.

As Erica said, it's best to have breast surgery done by a breast surgeon.

otter

Sassa

I had my BMX done by a general surgeon who does a lot of mastectomies (he was doing three the day I had mine) and lumpectomies.  He is the surgeon that all doctors in the area refer their patients to for breast work.

My results were great.  When I finally decided to do reconstruction, my plastic surgeon asked who did my mastectomies after the tissue expander surgery because the mastectomy work, in his words, was "Top notch." 

otter

In deference to women like Sassa who are completely happy with the outcome from a general surgeon (hi, Sassa!), I probably should have said, "It's best to have breast surgery done by a surgeon who specializes in breast surgeries." 

Actually, the surgeon should be really experienced with the type of surgery you want, whatever that is.  A PS who mostly does "breast augmentation" probably wouldn't be a good choice for someone who wanted a mastectomy with no recon... right?

otter

dlb823

It sounds like you've previously had a lumpectomy?  Who did that surgery?  Were you happy with that experience?

As others have said, a very experienced breast (only) surgeon would be my first choice, and it looks like there are a couple of places in MI that have top-notch comprehensive cancer centers:

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers2.html

I'd be inclined to go with one of them --  or at least get an opinion at one of them -- just to be sure all your bases are covered re. thoroughness, aethetic outcome, and any possible options such as nipple sparing, if that might be of interest to you.  Good luck!  Deanna  

cbm

I had a general surgeon who was recommended by my medical oncologist for his exquisite surgical skills and his kind and caring manner.  He did/does more than fifty breast cancer surgeries a year. He was the perfect choice for me, though my doctor offered more than one referral.  I wanted the earliest possible surgery so that I could start chemo asap.  If I was going to lose all my hair, I was determined to get it back as soon as I could.  

My surgeon left a lot of tissue in the event that I might want some sort of reconstruction.  I haven't bothered to do anything, as I am afraid of infection and more LE than I have now.

Best of luck with it.  I am perfectly happy with my decisions so far.  

Cathy 

beacon800

I totally concur with Erica. 

My BMX, no recon, was done by a surgeon specializing only in breast oncology surgery at a university cancer center.  He operates 3 days a week, does multiple operations each day and has been doing so for twenty plus years now.  So, he's experienced. (and sometimes cranky!)

My results are really good, nice scars, symmetric, no extra tissue, no overly tight tissue, no pain (ever), no range of motion issues and thus far, no signs of lymphedema.  

 I really feel like I owe this guy, he did a great job.  I figure his experience made a difference. 

rozem

hi

i am in a similar situation, i had rads (i had to regardless of the type of surgery) and will be doing a bmx with TE's in about 5 months. 

Because you have done radiation the tissue in that breast has been very damaged.  I would only use a breast surgeon in our cases because they are working with radiated tissue and more difficult to achieve a good cosmetic result (even tho you are not doing any reconstruction)

hope this helps

marilyn113

Thank you all for your advice.  Beacon800 and rozem, you have convinced me I should got back U of MI for this surgery.  I had little pain with the SNB they did so agree that experience probably makes the difference.

anneflorida

I  think that a breast surgeon at a cancer center will give you the best results.  The breast surgeon has the experience to make the scar line and over all appearance the best possible.  My breast surgeon was so good that when other doctors see my scar they comment on how well it looks.

kcshreve

You can also call a plastic surgeon who does reconstruction to see if there is a surgeon they recommend who does a good job.  Sometimes the "back door" approach can give good results.

Momine

Chiming in late, but wanted to add my vote for an experienced breast surgeon. Surgery is a craft, so the more experience with a specific kind of surgery, the better. My guy only does boobs and has been doing it for decades. His work is meticulous inside and out.

cinnamonsmiles

I had a general sugeon who specializes in breast surgeries. If you are not getting reconstruction, I don't see the need for a plastic surgeon. I guess, for me, experience is a key factor. My surgeon had years and years and was very patient oriented ( as much a  surgeon who never had breast cancer could be....).

MelsMontie

I had a breast surgeon do my dbl mastectomy. He was full of knowledge, and only wanted me to do lumpectomy.... I wanted them both gone with no recon. He insisted I would want recon later. I think he left too much so sure of himself... So when YOU know what you want... Insist. I have prosthetics but only worn them once. I put them on several times, but would take them off before leaving. I am comfortable without. I wish he had taken more leaving me flat flat flat... But not going under again unless life saving.