Plastic Surgeon on the East Coast

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Anonymous
Anonymous Member Posts: 1,376
edited February 2021 in Breast Reconstruction
Plastic Surgeon on the East Coast
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  • Nikkyb09
    Nikkyb09 Member Posts: 13
    edited January 2021

    I wanted to ask if anyone has a good recommendation for a PS on the east coast. I'm from Salem MA but willing to travel within reason (probably under 5 hrs of driving).

    A little backstory, but I'm 29 years old and have IDC, grade 2, HER 2 -, ER/PR +, with DCIS. I just finished neoadjuvant chemo on Jan. 11th. (AC+T). From MRI results, I had full resolution of the cancer in my breast, and suspicious lymph nodes! (yay)

    But next step is surgery, and due to having the CHEK2 gene mutation I'm leaning towards a BMX. Ideally I'd like to have the BMX, get expanders placed, have radiation, then go for the switcharoo to prepectoral silicone implants. It'd be nice if I could go at least up a cup size (currently 34A). I figured if I'm going through all of this I might as well get SOMETHING out of it. But I understand if it seriously cannot be done. I know radiation messes with the integrity of the skin, but I'd rather not go through flap surgery with my own tissue if possible. I don't want to mess with muscles (I'm a physical therapist assistant) or have scars all over.

    I have met with a breast surgeon, and she gave me the names of two PS. I picked the one who had more experience. But upon reading reviews I came across 2 pretty bad ones.. not due to poor bedside manner, which I could overlook. SO, I am trying to do my own research and find other plastic surgeons to get second opinions with in case I end up really not liking the one I picked. It is a lot of work researching, and I'm overwhelmed. So I'd love to get some recommendations from people who have went through BC, to find someone who is actually specialized in breast reconstruction/dealing with BC patients.

    Any help would be super appreciated!
    Thanks!

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  • SimoneRC
    SimoneRC Member Posts: 419
    edited January 2021

    Dr. David Song at Georgetown University Hospital. Dr. Justin Sacks at Washington University St. Louis , previously Johns Hopkins. Two of the best in the country. Would be more than 5 hours from you.... But both nationally known and recognized.

    Good luck with everything!

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  • Redkitty815
    Redkitty815 Member Posts: 44
    edited January 2021

    I went to Amy Colwell at MGH and she did a fabulous job. I had a different kind of surgery than you (BMX direct to implant because I wanted a reduction) and I will likely need some small adjustments, but I found her to be knowledgeable and compassionate and her work was great.

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  • MikaMika
    MikaMika Member Posts: 342
    edited January 2021

    Hello,

    I can not recommend a PS since I live in a different area, just my 2 cents...As I found, some surgeons can keep your nerves (in the breast area) to preserve sensitivity. Otherwise your breasts will be numb after mastectomy.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited January 2021

    Usually with a mastectomy and expanders there are two surgeons working in tandem. The breast surgeon does the mastectomy. The plastic surgeon comes in and places the expanders and closes. It was important to me to have docs that worked well together.

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  • Nikkyb09
    Nikkyb09 Member Posts: 13
    edited January 2021

    SimoneRC -Thank you for the suggestions! Probably too far for me unfortunately. Trying to avoid flying.

    Redkitty815 - Dr. Colwell is the one I'm set up with! It's reassuring to hear that you had good results. Since I don't know anyone who has gone through BC personally, reviews are really all I have to go off of. And although she had good reviews too, there were 2 that stuck out to me that made me scared to go along with her. I know you have to take some reviews with a grain of salt, but its tough to ignore after you read them. Did you also have Dr. Gadd as your breast surgeon? And did you end up having radiation after surgery? Over the muscle/under the muscle implants? Sorry, I may attack you with questions :)

    MinusTwo - I completely agree! My thinking was that if I ended up finding another PS that I wanted to consult with and ended up liking them, that they probably would have a breast surgeon that they could recommend that they typically work with. I'd be open to switching if I felt more comfortable with that pairing. But I know not the way most people go, kinda working backwards.

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  • LillyIsHere
    LillyIsHere Member Posts: 830
    edited January 2021

    Nikkyb09, my BS was Dr. Dominici from Brigham and Women/Dana-Farber.

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  • Redkitty815
    Redkitty815 Member Posts: 44
    edited January 2021

    Nikky-Attack away!! That’s why we’re all here for each other. Feel free to message me. I did have Dr. Gadd as a surgeon. She seems to be excellent as a surgeon, but her bedside manner was not a fit for me. I saw Dr. Domenici (referenced by Lilly) for second opinion and found her to be more comprehensive in her explanations and was strongly considering going to her. But I love my MO at MGH and thought she worked more closely with Dr. Gadd so they would be a more seamless team. I think I saw the same reviews on Dr. Colwell that you did but both searched these boards and found more favorable reviews and then met with her and she was super competent and clearly explained everything to me.

    I had radiation after my surgery and because of that had implants over the muscle (I guess going under is not great with radiation after). I also could not have nipple sparing surgery because I asked to take 3 cup sizes off-I used to be an F cup-and Dr. Colwell said my nipples would not be straight after such a large reduction. After all of it, the scars have faded a lot and the new boobs actually feel like mine. My cancer side sits a little higher than the other so I prob need a lift on the non cancer side and I want nipple tattoos. One note: Dr. Colwell is pretty strict about restricting activity for several weeks after surgery...I was annoyed at the time because I wanted to do PT to get ready for rads (which got pushed back for another round of chemo anyway), but now I am grateful for her caution given how well they have healed.

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  • Nikkyb09
    Nikkyb09 Member Posts: 13
    edited January 2021

    LillyIsHere - Thank you for the BS recommendation. Who was your PS? and are you happy with your results?

    Redkitty815 -Thanks! I think I felt the same way you did with Dr. Gadd the first time I met her, she asked me if me and my husband were planning on having kids.... I do not have a husband lol. I was a little thrown off. But the second time meeting her went much better, she was pleasant. I don't need someone to be super friendly as long as they know what they're doing! :) Who is your MO? Was the reason why your cancer side sitting higher just because of radiation after? Dr. Gadd had mentioned that can occur, little worried that'll happen.. stinks we go through the process of trying to have a good aesthetic outcome only to have radiation take its toll next.

    I've heard certain things can help with radiation after surgery, like getting fat grafted to the area beforehand, use of hyperbaric oxygen therapy, etc.. going to ask Amy if there is anything I can do to improve my likelihood of a good outcome. It's good that her being strict about movement seemed to work in your favor. Being a physical therapist assistant, I know the importance of moving your limbs/joints very soon after surgery to increase range of motion, but I definitely wont push it too far. Did she give any specific reason for holding on PT? I have seen rotator cuff repair patients and we usually start doing passive range of motion pretty soon after surgery.

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  • LillyIsHere
    LillyIsHere Member Posts: 830
    edited January 2021

    Nikkyb0, I am happy with my PS. I will send you a message with his name. I had nipple spearing DMX and he decided to put the implants under the muscle, rightfully considering the skin gets thinner from letrozole. He couldn't get any fat from my stomach and legs for fat grafting even though he tried but I am still happy with the results. No need to wear bras, I don't like my nipples anymore because during the summer with a light shirt they poke through the shirt LOL!

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  • muska
    muska Member Posts: 1,195
    edited January 2021

    Nikky, I had your team at MGH over seven years ago. Dr. Gadd is a very experienced breast surgeon and she often works wit Dr.Colwell. Dr.Colwell did a very good job on me and her follow-up was excellent and pro-active. I wouldn't be looking any further if I had to go through it again.

    The only word of caution is about radiation. If it's in your treatment plan impact on reconstructed breast is unavoidable. Discuss that beforehand.

    Best

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  • Nikkyb09
    Nikkyb09 Member Posts: 13
    edited February 2021

    Lillyishere - Thank you! And interesting, I hadn't heard that the skin gets thinner with letrozole. I'm hoping that if all goes well I'll be able to do some fat grafting. Fingers crossed.

    Muska - Thank you for the response! It's very reassuring to hear that you had a good experience and felt as though you were in good hands. I'm happy to have heard some good comments through this board, its putting me more at ease. My consultation is tomorrow, hopefully the snow storm coming doesn't effect it. I'm coming up with a list of questions, will definitely talk about radiation. As of right now I've been told by Dr. Gadd that she has talked with my MO and Radiology and they all feel as though I will need radiation no matter what. How was your experience after radiation? How much did it affect your reconstruction? I've read different results, some saying they had pretty much no poor effects with radiation, and others w/ significant changes. Dr. Gadd said they usually have a better experience w/ prepectoral implants vs. below the muscle. I think that she believes I'll do better w/ direct to implant w/ prepectoral implants then radiation. But I've read a lot of posts where people have gone to expanders, and just switched to implants after radiation. It pushes out the time line, but I'd rather do that and get the slightly bigger size I want if possible. Plus I figure if there are any changes after rads that she could have a chance to help things out when she switched me to implants. Idk if thats possible, but will definitely ask.

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  • muska
    muska Member Posts: 1,195
    edited February 2021

    Nikky, my implants were sub-pectoral. I had expanders placed first and inflated in parallel with chemo, then exchange surgery, then radiation on one side. Each case is unique, so when you discuss the reconstruction type - prepectoral vs subpectoral - I recommend you ask about pros and cons of both and most importantly, what would allow for better/easier cancer monitoring going forward.

    I chose to radiate w permanent implants in to avoid the risk of poor healing after radiation and much longer process. The end result 7 years later:

    - have not had any additional surgery since the exchange

    - the non- radiated side feels and looks great

    - the radiated side became perkier and there’s moderate capsular contraction without pain

    - esthetically, none of the imperfections are seen when dressed

    Ask they show you before and after pictures to get your expectations right

    Good luck

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  • mtmunroe
    mtmunroe Member Posts: 2
    edited February 2021

    I am meeting with her on February 28th to discuss my prophylactic double masectomy on March 18th. I am glad to see her name because I am so lost as what to expect or even ask.

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  • dtad
    dtad Member Posts: 2,323
    edited February 2021

    Hi. I had a great experience with Dr Christine Rohde from Columbia Presbyterian. I had direct to implant reconstruction 6 years ago when not a lot of PS were doing them. She isn't oozing bedside manners but very brilliant surgeon which is all I cared about! Good luck.

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  • Cpeachymom
    Cpeachymom Member Posts: 518
    edited February 2021

    Nicky- Southern Mass here. I have prepectoral, delayed recon, after rads. Dr Russell Babbitt in Fall River. He’s a good doctor; I would recommend him, even if it’s just for another opinion. Hope this helps!

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  • mtmunroe
    mtmunroe Member Posts: 2
    edited February 2021

    I am new to all of this so no idea what much of the abbreviations mean. I am also have a prophylactic masectomy so I am sure much of the abbreviations do not apply to me. I am happy to hear positive reviews about Dr Colwell though. I have been so nervous and the few bad reviews had me worried.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2021

    mtmunroe: Here is a link for new members. Topic # 7 or 8 is all the abbreviations. Glad to hear you apparently don't have breast cancer at this time.

    https://community.breastcancer.org/forum/131


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