Implants after Tran Flap

[Tklein9495]

Due to DCIS, I had a mastectomy of my right breast and a tram flap last May.  No chemo, no radioation.  The tram flap did not take and I ended up with huge wounds on my abdomen and breast.  I am now healed and my plastic surgeon says I can have now an implant placed in my breast area.  He suggested I start with an expander, have scar revision done on my tummy, and in about 8 weeks (after the skin has stretched) have implants placed.  Multiple people in my support group have told me I should go with another doctor since my tram failed, but I really like this doctor.  What should I do?

[Archibald S Miller III, MD,FACS]

I think that tissue expansion is a good option. It is also well recognized that the loss of a tram flap is a complication that can occur with that surgery. The loss leaves a defect that is undesirable, but unavoidable. It can happen to any surgeon.and patient. If you trust your surgeon, and he has good credentials and a successful history with other patients, then you are not foolish in working with him or her. Just make sure the dr. is experienced in the type of reconstruction you are contemplating.

                                     arch s miller ms md facs

[JHAE]

I am 50 and recently had a bilateral mastectomy with immediate reconstruction with an expander and then saline implants.  If I had it to do over again I would not do the reconstruction.  I have not been comfortable in my own skin since the mastectomy 7 months ago.  There has been a lot of pain involved with the expander and also with the implants interacting with my pectoralis muscles.  The implants don't look or feel like breasts and they get in the way of my arms.  I am planning on having the implants removed soon.  I think the stats say that about 1 out of 3 reconstruction patients have their implants removed within 3 years.  From my experience, I am surprised it isn't more.  Good wishes for whatever path you choose.

[Archibald S Miller III, MD,FACS]

The majority of patients have a more pleasant experience with reconstruction. But you are right, not everyone really does well.

                               arch s miller ms md facs