reconstruction

Questions to ask a Reconstructive surgeon
I had a right mastectomy and had a tissue expander put in by the plastic/reconstructive surgeon at the time of the mastectomy.I have plenty of extra skin so no saline injections will be required before the exchange surgery. Here are some questions you might want to ask the reconstructive surgeon. Not all will necessarily apply to you, but it is a place to start. Hope these ideas help. Good luck.

* Are you board-certified?

* Do you specialize in breast reconstructive surgery?

* About how many of these procedures have you performed? How many do you perform each year? Where do you usually perform these procedures?

* Am I a good candidate for breast reconstruction? Why or why not?

* What is the cost of breast reconstruction surgery? Is the procedure covered by my insurance? Are you a preferred provider by my ins. carrier?

* What type of breast reconstruction do you recommend?

* What are the benefits and limitations associated with this procedure?

* What are tissue expanders? Will they be used? Why or why not?

* Do you recommend saline or silicone implants? Why do you recommend this type?

* What size implants do you recommend?

* Will tissue from another part of my body be used in my breast reconstruction?

* Will nipple reconstruction be performed?

* How should I prepare for breast reconstructive surgery?
How long will the procedure take?

* What type of anesthesia will be used during reconstructive surgery?

* Might I require a blood transfusion during the procedure?

* What types of complications can occur during breast reconstructive surgery?

* Will I be admitted to the hospital after surgery? If so, how long will I be in the hospital?

* What can I expect immediately following the procedure? How will my pain be managed?

* Will I need to have a surgical drain? How do I care for this drain and when will it be removed?

* How will my breasts look and feel after reconstructive surgery?

* What type of results can I expect? What will my scar look like?

* When can I resume normal daily activities following reconstructive surgery?

* Might I require more than 1 surgical procedure?

* If getting implants, what changes can I expect in the implants over time?

betsymorgan said:

I answered on the other post
Hi, Betsy--
I answered on the other post for reconstruction. I'll repeat my offer here for anyone who hasn't read that other one...I had a reconstruction with a tram-flap (where you use your own tissue from your abdomen and get a tummy tuck in the process). I took pictures in case I ran into other women who wanted to see what before and after looked like.

Ask your doctor (who *will* have a plastic surgeon he/she likes) if he/she has pictures, or the PS to show you pictures not just of before and after but of the drains in situ, 2-week after, 4-week after, etc. I asked my PS just yesterday (when I was getting my nipple!) if he had pictures and he said he only pulls them out when patients ask. It didn't occur to me to ask about drain pictures!

I also should have asked about numbness resulting from the surgery. Your new breast will have no feeling. None. And it will not have a nipple for awhile. I wasn't ready for that...

Betsy

did you have a large scar
did you have a large scar left on your abdomen after your reconstruction? the plastic surgeon told me it is not a regular tummy tuck, that there would be a large horizontal scar going across the belly.
ive since opted no reconstruction right away, but i was just wondering.

scar and stuff
I *do* have a scar, from one hip bone to the other. But I have the nice flat belly of an 18-year-old! Not kidding! I was told at the time that I had enough fat from having kids for one B cup, but not two...(I'm small-breasted, and thought I might as well go up a size!). So the option was to have either 2 implants or one tram-flap with the A to look like the remaining breast.

From what my ps told me and from my research, I understand there are only 2 places you can get tissue transplants from: your belly or your back (I don't remember now if it's called a tram-flap or not...). It might be possible to get it from your butt, but the possibility of the tissue dying (since it doesn't have it's own blood supply) is higher and not recommended (I think). The one from the back takes some of the muscle and fat from the area where (if you have extra fat) it sort of puffs out around your bra back and shoulder strap. That is "disconnected" from a place in your back and swung around under your arm to the breast area. It remains attached under your arm. That way it has its own blood supply.

You may not need an entire reconstruction. I've re-read your post, and the ps may have other options for you. The nice thing is, you've got time to think about all your options. One thing I really like about my ps: he has made me look at whatever he'd done right away. It might not seem like a big deal, but I did NOT want to see my new breast (I was afraid); I did NOT want to see that there was no nipple; I did NOT want to see the drain...and when I did look, I realized that it looked pretty good and wasn't nearly as scary as what I had imagined.

Your oncologist would have good recommendations for ps's in your area, if you need a place to start. Good luck!

betsy