Chronic Pain After DIEP Flap Surgery–Can You Help?

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: After a double mastectomy in April 2010, my left expander was replaced in June 2010 due to leakage and became infected.

I was hospitalized and given vancomycin and oral antibiotics for almost 3 weeks. Infection spread to right breast and both expanders were removed the same month.

I had DIEP flap surgery in December 2010, but I have had severe pain and shocking sensations in chest, ribs and stomach. My surgeon says he does not know what is causing this pain. Is it the result of nerve damage? And is there any way to fix this?

A: So sorry to hear about your experience! Out of 1,011 flaps to date, we have very few patients with chronic pain, but unfortunately it does sometimes occur. We usually examine the areas in question with a CT and/or MRI, but usually this does not show any abnormalities other than normal post-surgical changes.

In this scenario, we then refer the patients to our pain therapists, who almost always are able to provide significant relief. Please let us know if we can provide additional information.

Dr. Richard M. Kline, Jr.

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Removing Expanders and Getting Implants: How Severe is This Surgery?

This week, Dr. Richard M. Kline of The Center for Natural Breast Reconstruction answers your questions.

Q:  I am interested in having tissue expanders removed and putting in permanent implants. How severe is this surgery?

A. Thank you for your question!

We don’t do implant surgery very often, but removing the expander and placing the permanent implants is, generally speaking, pretty straightforward.

 The second stage of expander implant reconstruction involves the removal of the tissue expander, followed by placement of the implant, and creation of the final breast shape. This is an outpatient procedure, performed by opening the mastectomy scar (no new incisions are made) and removing the expander. Before placing the final implant, changes that need to be made to the implant pocket are addressed. These can include repositioning the implant on the chest wall, improving the inframammary fold, using Alloderm or  Strattice to address areas of thin skin, and revising or removing the capsule as needed. The final implant is then placed in the pocket, and the incision is closed. Drains are usually not needed. Placement of the implant will result in a softer, more natural breast as compared to the tissue expander.  According to which of the above procedures are to be performed, you can expect to spend 2 to 4 hours in the operating room.

Feel free to forward any other questions you may have…..We’re always happy to help!

Richard M. Kline, MD

Center For Natural Breast Reconstruction

 

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!