Q: Breast Reconstruction Options?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:45

I have been diagnosed with intermediate DCSI. My surgeon has performed a lumpectomy and the margins are not clear. Currently, it is considered 3.5 centimeters and was told I would need the 6-week radiation treatment rather than the 1-week because of the size. I would rather not do another lumpectomy at this time and do a mastectomy to be safe. I'm a heavy woman and am currently a DD. What is the best reconstruction option?

A: Mastectomy with sparing of skin and immediate reconstruction

Mastectomy with sparing of skin and immediate reconstruction is a good option as it avoids radiation and recurrence. Whether to spare the nipple, use your own tissue, or implant has much to do with your body habitus and aesthetic desires. DD sized breasts rarely have the nipple in a normal position and likely will require reduction in your breast skin envelope to yield an aesthetic breast reconstruction. It would be best to meet with an experience breast plastic surgeon to review the options, risks, and photos of the various surgeries.

Q: Had Full TT 3 Months Ago. Tummy Bulging W/hard Blood, How Do I Liquify This?

Submitted by Q-A from clee on Wed, 06/15/2011 - 09:46

A: Might require imaging

To have an abdomen bulging with blood 3 months after abdominoplasty is most unusual. Radiographic imaging by way of ultrasound or CT scan may clarify the underlying problem. Best to see your surgeon for a reassessment.

Q: Alternative Approach to Correcting Male Gynecomastia Deformities?

Submitted by Q-A from clee on Wed, 06/15/2011 - 07:06

I would really appreciate any advice anybody could offer. Last year I received gynecomastia surgery. The results are not sightly and I'm looking into corrective surgery. One of my nipples is very inverted (the nipple itself), while the other side seems to have experienced an aerola contour deformity (looks weird as I move around). Many MDs on this site recommend fat grafting, but another doctor I spoke to swears by a one time, fat flap sculpture, dynamic technique to permanently resolve.

A: Revision must be judged from risk/benefit standpoint

Revision must be judged from risk/benefit standpoint. You provide a good photo but an examination is necessary to determine maturity and mobility of the tissue planes deep to your areolae before a surgical plan of correction can be proposed. Visit a reputable experienced board certified plastic surgeon for another opinion.

Q: Age 22. Best Breast Lift Technique w/ Minimal Scars?

Submitted by Q-A from clee on Tue, 06/14/2011 - 19:52

nipples are above 1 1.5 cm above the crease breast nadir(the lowest part of breast) is 1.5 cm below the creast rib cage size 85 cm and the measurement around the nipple 102 cm sternal notch to nipple 21,5 and 22,5 and one breast is samller than other anh they are apart from each other

A: Your photos suggest a mild form of tubular breasts

Your photos suggest a mild form of tubular breasts. As such there is mild contraction of the breast base, ptosis, enlarged areolae. My best results have been with areolar reduction, augmentation mammoplasty with submammary silicone implants with base expansion with mammary tissue radial incisions.

Q: 18 with Sagging.

Submitted by Q-A from clee on Sun, 06/12/2011 - 21:56

I am 18 years old and i am looking for advice in what would be the best procedure for a "Breast Lift". im not looking to get implants i am happy with the size and firmness of my breast i just need a lift to enhance what i already have and im looking for an opinion of what would be the best procedure for my type of sagging.

A: Vertical mastopexy is a good choice

Based on the provided photo it looks as though you would be a great candidate for a vertical breast lift. This surgery would improve the shape of your breasts and the size of your areolae. Additionally, this surgery will likely not interfere with your sensation and your ability to lactate. For best results contact a board certified surgeon.

Q: Breast Explantation Due to Intracapsular Rupture with Fluid Build

Submitted by Q-A from clee on Sat, 05/14/2011 - 09:07

fluid build up in my right breast, ultrasound showed there is a thick film of capsular around my implant. Look swollen but no pain. I went to 2 surgeons, one said to remove implant without removing any capsules nor stitch up the implant pocket. While the other one will remove all capsules, stitch up pocket.

My implants are under the skin and they're saline. I have them for 7 yrs. Which one should i go with? Will the fluid goes away so i can leave them in since I have no pain? Please advise.Thx

A: Not really understanding some points...your clarification necessary

You mentioned that you have saline implants for 7 years, yet they are ruptured with fluid and swelling. Saline ruptures lead to deflation and their treatment is by replacement usually with assistance of the manufacturer provided the parameter of the warranty are followed.

Silicone is a different matter. 7 years ago there was a moratorium on their placement. Ruptures silicones should probably be removed.

If you are having exchange of implant, then either a pocket exchange or capsulectomy would be wise since the capsules are thick according to your imaging studies.

Q: Breast Augmentation Recommendations for Appropriate Size & Profile

Submitted by Q-A from clee on Fri, 05/13/2011 - 12:57

Scheduled for a BA - April 28,2011. My PS recommends a Mentor,smooth,300cc HP or 275 cc Mod+. I feel this is smaller for my body type than I was expecting(from my research in what I have seen from other ladies of my stature averaging 350-375cc's).

I am 5'8 1/2" tall, 130lbs, 30" ribcage, 34 AA, 16 cm sternum to aerola, 18cm sternum to nipple, 5cm nipple to breast crease, BWD - 11.7cm. Looking for opinions on an appropriate size as hoping for a bit bigger (~375cc max). Is this possible for me?

A: Breast width dimension is a good guide

Your BWD of 11.7cm has you as a suitable candidate for multiple sizes and projections from base width to 11.5 to 12.5. I would suggest your review with your surgeon the various size and projection options with those base widths to come to an implant with your goals in mind.

Q: Best Procedure to Fix Ptosis and Tubular Breasts?

Submitted by Q-A from clee on Fri, 05/13/2011 - 11:55

My breasts were always very tubular and oddly shaped. I dealt with weight gain and loss throughout high school (Bs to DDs). I want pre-consultation insight from a few doctors or patients that are familiar with the different types of surgeries available, mainly the ones best suited.

How hard is it to fix my ptosis, skin sagging, over large nipples and tubular breasts? $ is not an option when it comes to my body. What ways can I combat scarring being that I'm bi-racial? I am 5'10 145 lbs 20y/o

A: You have a mild form of tubular breasts

You a mild tubular breast form with what appears on your photo to be a good tissue envelope. Lowering your inframammary fold through a periareolar approach with circumareolar mastopexy and areolar reduction is a good plan.

Furthermore, placement of a submammary cohesive gel implant will likely yeild better shape with less chance of the waterfall or late double bubble look from descent of the breast. You should use silicone scar sheeting on the surface of your healing incisions to lower the risk of a poor scar outcome.