Are You Comparing Apples to Apples When Weighing Your Breast Reconstruction Options?

We at The Center for Natural Breast Reconstruction know that the Internet is a great place to read and share information, but it is also a great place to become misinformed. Before making any decisions about your breast health, please make sure to contact a surgeon to discuss all your options and make the most informed decision you can. Keeping with the spirit of the Internet as a research tool, today’s Ask The Doctor Question comes from a discussion forum we participated in on WebMD.com. The answer highlighted below in pink comes from our team and showcases the importance of making sure you really are comparing apples to apples when weighing your breast reconstruction options.

Q: Has anyone had a hard time with breast reconstruction after bilateral mastectomy? I had two infections in my right expander, 2 and 3 months after my surgery. The first we conquered with antibiotics; the 2nd we did not, and I had to have it removed 4 months later. I spent the last 5 months healing from that, and just last week had the expander replaced. Hoping for the best this time! But there is significant skin loss on my right side, and my surgeon wonders if there will be enough stretch to accommodate saline fills to match my other side. And of course we all wonder if THIS expander will behave itself and not get infected. Has anyone had this experience, or one similar? Thanks.

A: Why don’t you go with the DIEP Flap procedure – they use the fat and skin from your abdomen area – I have had no problems from this procedure and I have heard of a couple of people who have had issues with infection with the expanders. Find yourself a Plastic Surgeon who does the DIEP Flap procedure

A: I also had a bilateral mastectomy but had to wait 2 years before reconstruction. I also had the expanders but had no problems, maybe it was too soon after your surgery. I would not recommend a tram flap ,it just sounds like an awful surgery.

A: There is a difference between and DIEP Flap and a trans flap.
The DIEP Flap they only take the fat and skin from your abdomen nothing else – they find a good blood supply at the reconstruction site. The Trans Flap is they take your stomach muscle and pull it up through to the breast cavity and also bring the fat and skin from the abdomen area. I for sure was glad that I did not do the Trans Flap.

A: (The Center For Natural Breast Reconstruction’s Answer) The free TRAM flap sacrifices a portion of the transrectus abdominus muscle (hence the acronym TRAM) but doesn’t tunnel it up through the abdomen. The DIEP flap does not use any of that muscle to transfer the blood supply to the reconstruction site. A skilled micro-surgeon with fellowship training in muscle sparing free flap reconstruction provides a permanent reconstruction option with a successful DIEP without sacrificing needed abdominal musculature. There is A LOT of great information on the web about this and what questions you should ask to make sure you are choosing a microsurgical team who has the experience and at least a 98% success rate. Talk to ladies who have had DIEP, GAP, HIP, SIEA flaps ( but not TRAM, it’s not the same) and see what kind of downtime they have had, you’ll probably find it similar to the amount you have had with the repeated implant/expander problems. Best wishes on your research and recovery.

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