Researched 'til my eyes are sore - still no idea what to do...

Anonymous

Researched 'til my eyes are sore - still no idea what to do...

Lexica

I've been reading everyone's posts, talking to my PS, reading articles, and I still have no idea what to do for reconstruction. Here is my conundrum - if anyone has experiences, words of advice, please share!

I had a skin sparing BMX and 33 rounds of radiation. RO says my skin looks 'great' but I have been having lots of back and neck discomfort that I believe stemmed from radiation. I am working with PT hoping it gets better. My PS says he recommends the lat flap because I don't have enough for two breasts if I did DIEP. Here's the thing - I don't want a lot. I was a DD+ and I want to be smaller - maybe between an A & B? I also don't want to 'mess' with the muscles in that area more than necessary, and I feel like the lat flap would be too disruptive to all the PT I've been doing.

I think tissue expanders are out bc of radiation, right? What about pre-pectoral implants? I'm high risk, so I'm afraid of not detecting a recurrence...

Can I just do fat grafting? I know it's new, any longer term success stories with this?

Anyone with 'not a lot of donor tissue' get a successful double DIEP? I'm not that small, I definitely have some tummy to take, lol.

Thank you!!

besa

there are other microvascular, muscle free options( for example combining DIEP snd T-DAP or DIEP and sGAP or bilateral sGAP alone) in addition there are ps who just seem to be able to get more tissue out of a DIEP.

I am relatively thin (about 5'5" and around 127 lbs ) and had DIEP on one side and then 5 years later had sGAP on the other.

At the I had sGAP surgery I could not find anyone in the DC, MD, northen VA area who was doing more than 15 sGAP surgeries a year (and no one who could combine or stack flaps) so I traveled to NOLA for the surgery.

If you are interested in microvascular recon you might want a consult with either Dr. Dellacroce's group in NOLA or Robeet Allen's group (I think in both in New York and NOLA) and see if they can offer you an option that you like.

Bottom line- consider arranging a consult with one of the very highly skilled , very high volume microvascular p.s. groups that are able to stack flaps and do sGAP and other micro vascular surgeries in high volume. See what they tell you and then decide.