Best in the country for pre-pectoral reconstruction?

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millee_moo
millee_moo Member Posts: 7
edited November 2018 in Breast Reconstruction

I am having a prophylactic bilateral mastectomy hopefully later this year and am very set on pre-pectoral reconstruction for a lot of reasons. I am fairly thin (about a 20 BMI) and tend to put on weight in my lower half. I was told by my plastic surgeon of choice that I would probably not be a candidate for over the muscle implants because there probably wouldn't be a lot of tissue cover. While his pre-pectoral cases looked incredible, it's clearly not his preferred method. I'm in the pacific northwest, but am willing to travel anywhere in the country. I'm looking for a surgeon who is just great with these and does a lot of them. I'm fine doing multiple surgeries and having expanders first so direct to implant isn't a concern. I have already looked at the list of everyone who does them and read the entire pre-pectoral thread on here, but it's hard to tell who does them versus who is an expert at them. Does anyone have any recommendations? Especially people who have had it done who are on the thin side/didn't have a lot of natural tissue/fat cover. Thanks in advance!

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  • VegGal
    VegGal Member Posts: 507
    edited October 2018

    My PS does a lot of them. My BMI was 19.5 and I had plenty of coverage and did 2 rounds of fat grafting.  She is in Ft Worth TX, though. Kind of a road trip!

    Are you a younger person?  If so, I would not rule out some kind of flap procedure.  It's permanent and no need for revisions and maintenance.  You might want to check out NOLA just to make sure. 

    Good luck!

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  • millee_moo
    millee_moo Member Posts: 7
    edited October 2018

    Thanks for the response, it's very helpful to hear it is possible. I definitely expect to need some fat grafting. Did you do DTI or need expanders?

    I am pretty young and have considered a flap but I would have to go a LOT smaller and I'm already pretty flat, so I don't think I want to do that. I've always wanted to go a bit bigger anyways so I figure lemons to lemonade here haha.

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  • VegGal
    VegGal Member Posts: 507
    edited October 2018

    Hi, 

    I had expanders, sub-pecs and finally pre-pecs. I am older, had nursed a baby for a LONG time and mine were pretty droopy.  

    It sounds like you may be a pretty good candidate for DTI. That would certainly make things easier, although you really need to have a good surgeon lined up beforehand. 

    I'm sure others will chime in soon. 


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  • LisaK12
    LisaK12 Member Posts: 107
    edited October 2018

    I strongly recommend Dr. Joanne Lenert at GWU in DC. She does these regularly. I was able to a avoid tissue expanders and had immediate, one-step reconstruction with pre-pectoral implants using alloderm. I'm very pleased with the results and most importantly had very little pain and was able to raise my arms above my head immediately following the surgery.

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  • Lula73
    Lula73 Member Posts: 1,824
    edited October 2018

    Just an FYI on the flap recon - you don’t have to be overweight to do it. NOLA is able to do it on any shape/size lady - even ones where other docs say it can’t be done-NOLA gets it done. Let them be the judge of how much tissue you have and how big they can make them. I worried I wouldn’t have enough-turns out I had way more than enough. NOLA offers consults via phone with pics via email at no charge. Check out their website results photos and you’ll see thin women too. It’s worth checking into.

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  • crossh
    crossh Member Posts: 44
    edited October 2018

    Hi Milee,

    Just wondering if you had your surgery yet? I am scheduled for a PBM on November 9th, with tissue expanders until the size is right for an implant. Having pre-pectoral, also don't have enough fat to take from stomach. Wondering about recovery time.

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  • mountainmama406
    mountainmama406 Member Posts: 99
    edited October 2018

    Dr Stephen Hardy // Northwest Plastic Surgery Associates in Missoula MT ... he has been a dream.

    I did BMX DTI to Feb and have followed up with fat grafting. Super happy with both him and the hospital here. From my initial consult with him I have never felt pressured to do reconstruction beyond what I wanted. He and the breast surgeon here (Dr Brad Pickhardt) that did the bmx are awesome. I know advocating for your health and medical decisions is a big deal in all this but I never worried once having them be my team - they were my biggest blessings in all this to just turn it all over to them and know I was in the right hands.

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  • Fryda
    Fryda Member Posts: 11
    edited November 2018

    I'm 5'4, 173 lbs, and my prepectoral dermal matrix 250ccs tissue expanders look great. Dr. Elizabeth Kim, Cedars Sinai, Los Angeles.

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