Posted by Dr. D on October 5, 2009, 9:03 pm, in reply to "Implant to Autogenous"
98.163.254.196
Dear Sisterstruggle,
I like to wait for a few weeks after chemo whenever possible but we also do mastectomy and flap immediately after induction/adjuvant chemo to avoid another operation down the line. So, in essence, these women are in your same situation but instead of placing an implant we go straight to flap and those patients do fine. In other words, you could have the flap at the same time as mastectomy if you choose.
If you choose implant first, it is as I wrote before. Have a full skin sparing mastectomy (if you are a candidate for it, which induction chemo often does for you even if you are a marginal candidate before the chemo again assuming the chemo has shrunk the tumor) that preserves all of the skin of the breast leaving no need for expansion. I prefer to do the "one step" or alloderm assisted implant reconstructions in those scenarios. The full size implant is put in right away with no need for expansion. If your surgeon's take enough skin away to need expansion then the likelihood of you needing a skin patch is higher especially of you are small breasted.
Hope not too confusing,
Yours,
Dr. D
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