Can a plastic surgeon perform a mastectomy?

noodlesmom

I am asking this question on behalf of a friend having surgery next week. I had both an oncologic surgeon and plastic surgeon for my DMX and reconstruction, but my friend has a plastic surgeon planning to do both. It’s not something I’m familiar with and just want to check in here to see if anyone has heard of a plastic surgeon doing both? If so, is there a specific qualification on their resume she should look for? thanks for any info you can provide.

Peregrinelady

I have had a mastectomy done by a general surgeon and a breast surgeon, but when I had DIEP reconstruction, the breast surgeon was in the operating room to perform the mastectomy before the plastic surgeon did reconstruction. I am curious to see what others say, but I was under the impression that plastic surgeons don’t perform mastectomies.

MinusTwo

I agree. My BS performed the mastectomy and my PS stepped in to place the expanders and close up.

hapa

Is the PS going to be diligent about removing as much breast tissue as possible, or will he/she remove most of it, leaving behind the fingers that reach into the subcutaneous fat in order to get a better cosmetic result? I would not trust a PS to do my mastectomy. They want a good cosmetic result so you'll tell all your friends about them and don't concern themselves with recurrence.

SimoneRC

For me, breast surgeon did mastectomies. Plastic surgeon on reconstruction. Two different types of surgeons and skills. Less time under anesthesia as they work at the same time.

Beesie

Like everyone else who's replied, I had a breast surgical oncologist (a general surgeon who only performs breast cancer surgery) do the mastectomy, and then a PS came in to do the reconstruction.

I've been on this site for 14 years and I can't recall anyone having a MX performed by a plastic surgeon.

exbrnxgrl

I suppose a plastic surgeon, with his/her general surgical skills, could physically perform the surgery but... would they be well versed enough in exactly how/how much/ which tissue to remove? I personally have never hear of the ps also performing the mastectomy. This doesn’t mean that it can’t be done or is never done but I would certainly recommend that your friend ask about this further.

BrooksideVT

I'm guessing your friend misunderstood something. Either the PS is also an oncological surgeon (not impossible, but why?), or a she will have both a breast surgeon and a plastics guy .

hapa

I think in some countries a breast surgeon does both the mastectomy and reconstruction, but I'm not 100% certain of that. Is your friend in the US?

Mavericksmom

I had a breast surgeon for my mastectomy and the plastic surgeon did the DIEP reconstruction immediately afterwards. I don’t think it is a much an issue with a PS being able to do it as much as it is the length of the surgery which seems as if it would be too much for one surgeon. Even if he/she has fellowship doctors step in for some of it, that’s a long time for one doctor to be in surgery. My surgery was over 8 1/2 hours, and that was only for a left mastectomy

SimoneRC

Think of it this way.... a plastic surgeon “could” take out your tonsils. It is not what they do on a regular basis, nor is it what their 6 additional years of training included... but he/she “could.” The 6 years one spends after medical school for their surgical specialty is very specific. A good surgical breast oncologist also has very unique skills to meticulously remove all the breast tissue, leaving thin flaps appropriate for reconstruction and not any thicker as that can increase risk of cancer. There were 2 women on these boards in the past few months who each needed to have second bilateral mastectomies as their surgeons left too much breast tissue. You want very good surgical breast oncologist!

noodlesmom

Thanks, everyone, for your input. We are all definitely on the same page, but the woman for whom I was asking (she's actually a friend of a friend) doesn't seem to want to change her plan. It concerns me, A LOT, but all I can do is share the info and hope that this surgeon is actually skilled in both. Fingers crossed for her

Tmh0921

My general surgeon (whom I've been seeing for 25 years) did my bilateral mastectomies and lymph node removal, and a plastic surgeon did/is doing my reconstruction.

I trust my general surgeon more for the “medical” aspect if that makes sense. He has performed extensive breast surgery as relates to cancer. It may be odd, but I even though my plastic surgeon is very good and very specialized, he’s not as “medical”. He’s more concerned with appearance. Having them both balances medical need with appearance.

Tracy

AliceBastable

My BS, like many others, is a general surgeon, but she only does breast surgery for medical issues. When my kidney cancer was found around the same time as the breast cancer, she shared with me her experiences as an intern on a kidney transplant team, removing donor kidneys. She put me more at ease than the urologist who performed the surgery. But it would have been inappropriate (and unethical) for her to do the actual nephrectomy. Plastic surgeons have no business dealing with removal of cancerous tissue.