Nipple Sparing Alloderm w/Implant Breast Reconstruction

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brynze
brynze Member Posts: 35
edited June 2014 in High Risk for Breast Cancer

The One Step (sometimes nipple sparing -if possible) Breast Reconstruction from Mastectomy using an Implant w/Alloderm:

There has to be doctors in the Philly area that do this procedure by now. There has to be, please-please-please please advise...

 I understand the nipple in particular in the cancer ridden breast can't always be salvaged, but please tell me someone is proficient at performing this procedure now with all the woman nation-wide raving about their mastectomy via this procedure of reconstruction.

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  • Barbara4122
    Barbara4122 Member Posts: 31
    edited May 2009

    blizzlin,

    Dr Jennifer Sabol at Lankenau will do nipple sparing if you are a good candidate.  She is doing mine on June 16th.  My PS is Dr Liza Wu from Penn, she and Dr Serletti (also from Penn) also work out of Lankenau.  I have heard recently that Dr Marcia Boraas at Penn MAY do nipple sparing when appropriate, though she is very recently on board with this. 

    I really do like Dr Sabol so I will stay with her.  Dr Wu is going to attempt a direct to implant with Alloderm for me but if she cannot put at least 500 cc without concern then I will have expanders.

    My surgery is prophylactic (BRCA1+) so I guess they are more comfortable doing nipple sparing.

    Good Luck!

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  • brynze
    brynze Member Posts: 35
    edited October 2009

    Thank you so much for getting back!!!!!!! I wish you all the best!!!! Please keep us posted so we can get you whatever support you need. Obviously I am in the area. I just met two woman who went through this at their PS post-op office visit, who were up nicely walking and talking just five days out of surgery. Other surgery's I haven't experienced seeing that. Would this be Doctor Wu's first attempt with this procedure or had she done it before? And do you know if so who she learned it from. There is  only the one doctor team that kinda pioneered it supposedly in this country called Dr. Salzberg & Dr. Ashikari that i have heard so much about so far...?

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  • Barbara4122
    Barbara4122 Member Posts: 31
    edited May 2009

    Hi bizzlin,

    I think Dr Wu has only done a handful of these.  I do trust her talent though.

    I am still deciding if I want direct to implant or expanders as direct to implant is a little more limited in size avail.  Drs Salzberg and Ashikari are very well known and many women rave about them.  I was going to go for a consult but I didn't want to be that far from home and I would most likely have had to pay several thousand out of pocket.   What PS office did you meet these women at?  Did they have direct to implant w\alloderm?

    Barbara

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  • bemurray
    bemurray Member Posts: 14
    edited May 2009

    Best of Luck  - I am doing a nipple sparing with Implants with Alloderm next Thursday in Boston.  My surgeon who has not done these yet but has asked a lead surgeon from another hospital to mentor her in the operating room. 

    Keep looking for someone or come on out to Boston......  I met with the plastic surgeon yesterday who said this is the direction mastectomies will be going in the future (for good candidates).  

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  • brynze
    brynze Member Posts: 35
    edited October 2009

    Hi there girls -

    Sorry-i had a hard time logging back in. And I should have been more clear too-was writing very fast in my last post, but I took an appointment with Dr. Salzberg. I was so upset with all going on here-heard about this doctor team (Salzberg/Aishikari) and their specific procedure-they fit me in, in one day- and off I raced to NY. It was the best day of my life since being diagnosed with breast cancer three and a half weeks ago. After spending two hours with me, him and his amazing staff, in a very busy office, without missing a beat, took such good care of me. Felt like they know how to take care of the individual, not the statistic. They then called over to Ashikari Breast Center and got me an appointment with Andrew Ashikari. I learned more and felt better from him-who also spent a goog two hours with me- than I have collectively at my breast center since the beginning. I'm sick about it now because I am hearing they may not take my insurance... This was the closest I got to saying I might be able to go through with the mastectomy that everyone is advising, and should be happening sooner than later. And I didn't know anyone raving about any doctors doing this procedure in the Philly area-as far as I knew no one was until you posted this info-my comfortability to do it at all has taken a year and a day to get to a "possibly yes". To do it with someone new scares me-just me-I guess because I am so thwarted by the thought in general. So much so that regardless of my diagnoses and medical advice-I almost wanted to risk the cancer coming back than risk mastectomy- I know - backwards :)

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  • floridian
    floridian Member Posts: 128
    edited May 2009

    My doctors have mentioned a double mast for me several times despite no cancer diagnosis yet. Still in the watch and wait phase. I feel like I need to prepare myself for this eventuality because I do not want to do 22 biopsies like my Grandmother. Does anyone know why no surgeons do the mast plus the recon? Why two surgeons? We have in the area a general surgeon turned plastic. Why would he not do both at the same time? Do you think it's insurance billing reasons?

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  • brynze
    brynze Member Posts: 35
    edited October 2009

    Hi Barbara4122

     Not that you're the one that needs the reassurance here :) but I put some feelers out today since your above post and have gotten back all positive info regarding Sabol & Wu. Just thought to mention...

    Hi floridian

    Not certain I understand, but they are two completely different specialties. The surgical oncologist deals with removing the cancer, testing it, and obviously making the call on reconstructive procedure such as nipple sparing etc... The Plastic Surgeon does the implant and puts you back together I think... I believe a General Surgeon is different than an actual Surgical Oncologist in ways relative to dealing more or solely with cancer (the SO) . I'm very new to it all so don't hold me to it!

    All the best for now!!

    :)

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  • Barbara4122
    Barbara4122 Member Posts: 31
    edited May 2009

    Hi Bizzlin,

    Yes, I still could use reassurance...I am glad you got back positive feedback.  I know Dr Wu is very interested in the latest breast recon trends...she is young and very talented.  She has a great resume so I am not afraid to trust her skills.  Salzberg was new at this once too I guess!

    I know Dr Sabol, the breast surgeon, is very skilled and I love her personality. Dr Wu is not the touchy, feely, nuruturing type but I am looking for talent and skill here!  She is certainly pleasant enough and that's good enough.

    (ps-where did you put our feelers, patients or other docs?).

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  • brynze
    brynze Member Posts: 35
    edited May 2009

    Hi Barbara -

     I'll send you a pm...

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  • dcarlson
    dcarlson Member Posts: 2
    edited June 2009

    I work in the operating room with plastic and breast surgeons and yes this a great surgery if you are a candidate and has great looking results. The alloderm helps provide more support and even if you have to go with tissue expanders at first the final results after the real implants are put in look wonderful. As far as the reason why two surgeons are needed? The oncology general surgeon does the actual removal of the breast tissue sparing the nipples in the process. The plastic surgeon puts in the Alloderm or other support substance and then places either tissue expanders or actual implants depending on the patients needs. If tissue expanders are placed, a second surgery is needed to remove the expanders and place the actual implants. In smaller breasted women tissue expanders can be used to make the breast larger and in larger breasted women, the tissue expanders enable the larger implant to be placed on the operative side to match the other side.

    The breast surgeon needs special training to learn how to dissect the tissue without harming the nipple but for the plastic surgeon there is little difference. 

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  • Deirdre1
    Deirdre1 Member Posts: 1,461
    edited June 2009

    Oh I really wish I was able to find a ps who did "nipple sparing" at the time of my surgery 2+ years ago.. I truly believe that would have helped me through the process.  Good luck ladies in finding the reconstruction you want!!! 

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  • clemmons64
    clemmons64 Member Posts: 2
    edited June 2009

    I am new to this web site and not sure where to start. I am very interested in finding someone who does the "one step, breast reconstruction with alloderm". I would at least like to speak to someone about the pros and cons, but I live in a small southern town, and there is only one way of doing things around here (and this procedure is not it). Can anyone help as to where to look for someone close by who does this procedure?

    desperate.

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  • fortunate1
    fortunate1 Member Posts: 644
    edited June 2009

    I am in Calif. on the other side of the continent from you, so I can't recommend a PS. But I wanted to rcommend the surgery. It is much easier on the body. I had one, one side only, and was feeling fine very quickly. 2 day stay in the hospital and no tissue expander/exchange process. I was not a candidate for nipple sparing. The cosmetic result is beautiful. The PS and I have some details to work out, but my only issues with my new breast are really just me getting used to the change.

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  • HeatherF
    HeatherF Member Posts: 2
    edited June 2009

    There are only a handful of doctor teams performing this very new and very unique procedure.

    I am BRCA1+ previvor (no cancer dx). I chose to have a prophylactic bilateral nipple sparing mastectomy with immediate implant reconstruction 11/07. I had this surgery with Drs Ashikari and Saltzberg in NY even though I live in Chicago. I am really pleased with the results and I thankfully had no complications. For some women even with a cancer dx this procedure may be an option. It certainly is worth investigating and I believe worth the travel if it makes sense for you personally. This isn't a great piece but it does somewhat address the procedure: http://abcnews.go.com/GMA/story?id=5624418&page=1

    I am the Chicago FORCE outreach coordinator supporting women dealing with hereditary cancer issues and learned about these great docs through FORCE www.facingourrisk.org. This is a wonderful organization with a vibrant message board as well. Interestingly enough I learned just after my surgery that there was in fact a wonderful local doctor team in Chicago offering the same procedure. Dr. DJ Winchester and Dr. Geoffry Fenner. They were featured in the Pulitzer prize winning NY Times article by Amy Harmon featuring Dr. Lindner and her journey through the same procedure. http://www.nytimes.com/2007/09/16/health/16gene.html. In the last year and half I have seen many of their patients an they are so happy. I actually took on a part-time role with Dr. Fenner doing Patient Support for his breast cancer and BRCA+ patients since he really wanted patients to have an outlet to connect with someone from start to finish in the reconstruction process. 

    In the last 6 months Dr. Fenner has had a number of patients travel from various parts of the country to work with him which is a real testament to his skill and the warmth and compassion his practice has to offer patients.

    Nothing about this journey is easy which is why it is nice to work with the best medical team you can locate. 

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  • clemmons64
    clemmons64 Member Posts: 2
    edited June 2009

    HeatherF,

    I wanted to let you know that I emailed the Lifecell Company. At first they thought I was doctor and wanted to send me to an annual conference on breast reconstruction, but after I emailed him back and let him know that I was a patient looking for someone to do this procedure, he emailed me back. He is the rep for the southeast and called personally and set me up an appointment for someone here in my hometown. So, at least I get to speak to someone who may have more information, let me know if I am a good candidate, and hopefully give me a different perspective. And if nothing else, it gave me hope today. Not only to get an appt. but that someone else did all the leg work... all I have to do is show up. And when you are in an emotional situation... sometimes that a lifesaver. I will admit, he will have a personal spokes person for his product, if this all works out. He went above and beyond "customer service."

    Thanks so much for you help and encouragement. I'll let you know if I coming to Chicago!

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