I need 2 new boobs...can I do it sans Tes and implants????

Bippy625

I need 2 new boobs...can I do it sans Tes and implants????

Bippy625

hi all,

So, I need two new boobs. i did a PS consult, and she mentioned a flap and implants. At the time, I did not get it or comprehend.

My question is, can I avoid a flap that uses muscle, for both? I really hate the sound,of TEs and implants, and do not want to have them removed or replaced in 10 years. i realize flaps are difficult too.

I have had rads, and we were talking of doing fat grafting no matter what. Thoughts, experiences, advice is most welcomed. Thank you

barbara510

Since you live in Florida you should go see Dr. Kohori at the Miami Breast Center. I think he is the one who invented the fat transfer with BRAVA procedure. I had reconstruction using implants 4 years ago. Now one of my implants has capsular contracture, which is painful, and that means another surgery to fix it. I have never liked the feel of my implants and have decided to have them removed in April. I will either do fat transfer or go flat. I don't have a lot of extra fat so I may have to gain weight, which kind of sucks because I worked hard to lose it a few years ago. I hear the liposuction can be painful but can't be as bad as surgery. The flap procedure doesn't appeal to me because the surgery is evasive and there is a chance it will fail. I do not know of any other options. Good luck.

besa

First - when it comes to deciding about all of this and finding a skilled ps I recommend getting a copy of the latest edition of Kathy Steligo's "Breast Reconstruction Guidebook" - the best I have seen on reconstruction.

http://www.breastrecon.com/

or from Amazon.com

Also, if you haven't already seen it, read the updated section on reconstruction on this site.

Microvascular tissue reconstruction (DIEP, GAP etc surgeries) are done without taking any muscle. You need to go to a ps who specializes in this type of surgery and is experienced (cosmetic enhancement is a very different skill set. You want someone who specializes in and mainly does this type of reconstruction).

Some ps are only technically able to do microvascular reconstructions using abdominal tissue (called DIEPs) while others are more skilled and are able to use fat from hips and other sites and are even able to combine flaps for more volume if needed. The breastrecon web site above has lists of microvascular ps but this is an UNVETTED list. If you are interested in this type of surgery it is very important to research whoever you see and make sure they are skilled and doing this surgery in high volume - every week for years....

I have bilateral tissue reconstruction without any muscle being taken- one side is DIEP and the other sGAP. (The DIEP was done when I was diagnosed with bc and the contralateral prophylactic nipple sparing sGAP was done 4 years later.) I am very happy with my choice of reconstruction.

(Edited after reading debiann's post-- This warning should be added. Some ps recommend only the type of reconstruction they are able to do and don't mention or even disparage other options. There are also doctors who recommend ps they practice with or those who refer back to them instead of to the most skilled and experienced ps in the area (or in the country if you are willing to travel for surgery).Research your reconstruction options before making an appointment and then go to the most skilled ps who specializes in the type of reconstruction you are interested in.

When I was diagnosed with bc my breast surgeon referred me to a ps who had just started working in the same hospital and who was the only one to offer DIEPs there. I didn't do much research and just trusted the recommendation. I was concentrating on the bc part of my diagnosis. Turned out the ps was very will trained and but inexperienced -having done very few DIEPs on her own when not in training. That reconstruction required many revisions and I ended up switching plastic surgeons. My 2nd reconstruct, sGAP, was done by a much more experience ps who did a beautiful job.)

debiann

The first PS I was sent to did only the TRAM flap, which didn't appeal to me. I wasn't even told about the DIEP flap, which another surgeon in the same practice could perform. I learned about DIEP recon through my own research, then had to find a PS in my area who could do it. I was a little upset to learn it was a doctor in the same practice and that the first surgeon didn't disclose all my options.  In the end, all turned out well. I had a bmx with immediate DIEP recon.

Neta69

A skilled and experiencedmicrosurgeon can do DIEP (tummy), SGAP, IGAP (bum) or in some cases (NOLA Drs) a "body flap" that stacks fat from tummy and hips for bilateral reconstruction in slim patients. None of these procedures require use of muscle and they are the most common free flaps.

The BRAVA method has its downsides and is considered experimental at this stage.

Good luck finding a great PS.

Trvler

I still think finding an experienced PS who specializes in the best option FOR YOU is difficult. Especially when you call one PS's office and they won't even tell you how many DIEPS they have done unless you come in for a consult. (At which point, in my mind, they are going to push you to their specialty).

SpecialK

Just an FYI - Brava is not covered by insurance and does not have FDA approval.

Bippy625

thanks everyone, excellent info! I know I cannot get the big, real picture anywhere else. I am looking into DIEP, and luckily, haha, I have lots of fat to donate. I can probably get triple Ds if I wanted to!

Someone else recommended Moffitt, and I am unsure if any PS here does DIEPs. That is about 40 miles north, no big deal.

This is very appreciated, because the PS I went to though excellent, discussed a tram, but does not do DIEP. I am feeling so much better informed.

SpecialK

bippy - Dr. Smith at Moffitt does DIEP, but you could also see Dr. Klein at UF in Orlando.  I would avoid TRAM at all costs unless it is muscle sparing, too many post-surgical complications.

Bippy625

thank you specialk, I do want to avoid it, or using any muscle. i will add those to the list!

lbrewer

when you see a dr. Ask if they require you to grant permission to do a muscle sparring tram if they decide against diep while in surgery. Mine in orlando turned into a ms tram and I sincerely regret it.

glennie19

If you can't find anyone closer to home, Jason Rosenberg in Gainesville does a lot of DIEP surgeries. I did not have recon,, but all the women I know who used him, really love him and rave about his work.  My PCP went to med school with him and also says that he does great work. It is definitely his "calling".