Ask plastic surgeon Scott Sullivan, M.D., your recon questions!

I had a double mastectomy in November 2015. Based on earlier testing my surgeon was pretty certain I would need radiation. I immediately had reconstructive surgery and had begun the fillings. A month into the fillings the pathology report came back as needing radiation based on the size of tumor, 8.5. Soooo, having said that, the plastic surgeon had to deflate my breast. So now I am having radiation with expanders in. My question is whether this is common or uncommon?

I was dumbfounded to learn that my plastic surgeon did not use Alloderm for my direct implant. I can't find this procedure anywhere...I didn't even think it was possible without alloderm. Apparently he put it under the serratus muscle as well as the pectoral muscle, but there is a place near the sternum where there is nothing between the skin and the implant. Can I expect problems with this procedure? Why don't I hear about it being done

I just had a bilateral, nipple and skin sparing mastectomy with free tram flap recon on Dec 30th. I had opted for this surgery with hopes not to have implants. However, my new breasts (a cup- was a smaller b cup prior) are not quite right and my surgeon has suggested getting implants under this tram procedure in my revision surgery later this year. I'm not having any luck finding others or any articles anywhere where this mix of reconstruction is done. Any advise on the commonality of this practice or where I might get more information? Additionally, one of my nipples now looks like an inny belly button- is this common too? Any help or others out there that are going through or been through this I would greatly appreciate hearing from you!

I had my exchange surgery 10 days ago. Today my drains came out and I saw my new breasts. I'm pretty devastated. I had the Naturelle 410's put in at 740cc. They look flat and wide. I was a full DD before dx. I was actually ok with the TE's. These have no projection! Does this change over time? I was dx at 33 years old. It's been 2 long years all leading up to this. My PS said I'm healing nicely and everything looks good. Do these drop?

I would avoid the tram flap. It comes with a 40% hernia risk. Just scoot over to the thread abdominal bulge after tram flap. Plenty of info there on women that have had to have hernias repaired after tram flaps. I'm one of them. I developed 3 hernias after the tram flap. If I had a chance to do a do over, I would have chosen flat or implants. As DIEP was not an option for me by that former PS who I fired.

Question:

Having reconstruction with implant on one breast and lift with implant on other done at same time. How much pain is associated with reconstruction with implants?

Question 2:

What differences are there between saline implants and those made with silicone

why do a lat flap and not just implants? Can radiated skin/area not 'hold up' the implants? I'm going with a C cup so I'm really confused. I have lots more questions to as my PS. Just thought I'd try another opinion. I was now told she wants to do the lat flap on my right and implant on my left. Not happy about going thru that surgery if I don't have to. Thank you

Can implants be replaced years after the initial reconstructionwith diep flaps under the spared skin? Can nipple reconstruction be preserved in this case?

hi there. I have a strange question to ask. My double masc and reconstruction took place 7 yrs ago. I was going through those airport security machines and twice I've had to have a female TSA agent feel up upper right chest wall because I've set off the machine somehow. I do have a strange and kind of hard ridge in the area they press on. I'm trying to figure out if it's related to my implant (but why only one side and not both?) or what it might be. I wondered if anyone else has had this happen??? Should I get back to my plastic surgeon or my nreast oncology surgeon for an exam or ultrasound? I'm worried about what it might be, if I'm honest.

Su

I have had 16 rounds of chemo,3 chemo medications and 35 rads of radiation. Im triple negative BRCA positive. Bilateral mastectomy removed 2 metaplasic sarcoma tumors with good margins & no spreading to lymph system. Ive had a complete hysterectomy post tx to prevent recurrence.

I have had 3 fat graphs with not so great results on my affected side (radiation). I do not want any flap surgery. Im only interested in fat graphs. I asked my surgeon if a very small implant could be done. I have been advised by my plastic surgeon i cannot have implants after 35 rads of radiation without a flap surgery (skin cooked and too thin)...is there any option for women like me orher than the extreme flap surgery? Evs

I tried to get a fill on my left side, but I had a shooting pain going down my side and arm. It was pressure and like something was on fire. Has anyone had this problem and is there anything you can do to prepare for the next fill? Thanks for your help.

Hi Dr Scott

I am desperately seeking answers. I had a double mastectomy and tram flap reconstruction in March 2016 and I am still having issues with recouping. First, if I had known how awful I was going to look, I would have never even done the recon but only the mastectomy surgery. I apparently have severe lymphedema. My arm seems to be under control but my stomach is not! It has been 9 months and my stomach starts out flat and through out the day distends anywhere from 4 to 6 inches. It is like being pregnant with my twins. My stomach is so stretched out it feels like it's going to pop. I have compression sleeve for my arm and compression vest for my abdomen trunk area every day. People constantly say to me "you're lucky you're alive", but honestly its becoming very hard to stay positive. I have been to 8 different doctors, I've had three endoscopies, a colonoscopy, mris and tests up the wazoo...please advise. thanks MQY

MQY, I sent you a private message

I have lymphedema on my left arm, hand, trunk, all around my mastectomy scar and swelling in my back. I have not had reconstruction yet. Have not spoken to a surgeon, but am doubtful skin stretchers will work because of how immovable this scar is, and they'll have to do a flap surgery. Will this make my lymphedema worse?