Atrophied muscle above implant

[Jodee]

Hello,

     Thank you so very much for making this available to those who are suffering and in need of good advice. I am a young woman, who led a very active life before I was diagnosed with breast cancer. I sell Real estate and I am also a musician, therefore like "most" woman, my body and looks are very important to me. I had a radical masectomy of my right breast, went through six months of chemo I choose not to do radiation. I have a tissue expander in until my surgery is completed. The problem is, the muscle above the impant has atrophied. My surgeon has explained two options: back flap or taking fat from my lower abdomen and insert that above the implant. I opt for the fat "thing." She said that complicatons can arise from this, such as infections and lumpiness. Please help me!! Is there any other options for this problem? To look at me with clothes on, you would never guess I "was" sick, however, I want to wear tank tops and low cut gowns again. I am a very positive person and this is not holding me back, however, if there is an option to help me look "normal"again??  I am more than gratful for any advice you can give. "Thank you again!"

Surviving "In Style" on L.I.
Jodee

[Jodee]

Thank you so much fo taking the time to write me. I have a tissue expander in, that will be taken out and replaced with an implant. The problem is the "dip" in my chest. The atropied muscle. My surgeon is not taking a muscle from my stomach, however, just some "fat" to put in the "dip" in my chest. Is this atrophied muscle a common thing after a masectomy? Is there any other alternatives? Thank you again for your time and have a nice day.  Jodee..

[CCF-RN,MSN-rf]

Dear Jodee:  You need to have a discussion with a very good plastic surgeon - one who does breast reconstruction regularly.  If the one option is to do a TRAM flap, using tissue from the abdomen, this is a method of reconstruction that is often done without the expander.  Depending on the surgical technique, there may still be some scarring.  Also, depending upon the amount of tissue that is removed from your abdomen, you may or may not be able to carry a child if that is something you are considering.  A "back flap" can also be considered reconstruction and can be done without an expander.  From what you are saying, I cannot tell if the procedure is designed to correct a minor flaw or to replace the expander with a real tissue reconstruction.  In any case, the pros and cons, as they apply specifically to your situation, need to be discussed with the plastic surgeon.  Specifically, you need to address your desire to wear low cut gowns so that the surgeon can discuss the expected outcome and whether it will meet with your expectations.