Tissue Expanders in Breast Reconstruction: Not Just for Implants!
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- เผยแพร่เมื่อ 14 ก.ค. 2020
- The Foundation interviews Dr. Minas Chrysopoulo of PRMA in San Antonio discussing the function of tissue expanders in breast reconstruction. Tissue exanders can be used for implant-based reconstruction and autologous (using your own tissue) breast reconstruction.
Dr. C talks about the staged approach using expanders for implant-based reconstruction, placement of the expander, pros and cons of tissue expanders as it relates to surgery, complications that can develop, and also the benefits for those having delayed reconstruction in the setting of radiation if they are using their own tissue as in a DIEP flap breast reconstruction.
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Yeah I’m dumb I just said ok I didn’t know my options never check it out. Just whatever the doctor said now I have expanders and one is infected. Very painful. Finally getting it out. I wish I would’ve check my options. First I was just scared and nervous and said yes to everything thinking the doctor knew best they don’t thank you for your program, I’m still scared and nervous but I will start doing things better and it’s been a long journey. I just want it over.
I'm sure you do Katrina. I hope some of the videos on this channel will help prepare you with questions as you move forward.
Excellent video, I just had last minute expanders added to my mastectomy surgery due to my diep flap being delayed for COVID reasons. I did not have time to research and ask all my questions prior to surgery but this video provided the answers. Thank you.
Music to my ears and exactly why we make these videos at the Foundation Diane. I wish you well as you plan your upcoming surgery. Stay safe and be well.
Thank you so much for discussing this important topic. I am really hoping to avoid radiation but it is good to know there are some ways to lessen the impact of radiation on your reconstruction options, one of which would be to use expanders during that phase of treatment.
Absolutely Cynthia. Be sure to speak with your oncology and breast surgery team to learn about recurrence risk, with or without radiation. All of the information they give you will be part of your shared decision-making conversation and ultimately what decision you find best for you based on this conversation. Wishing you all the best!
If the animation deformity is present with the expanders in place, why would one proceed with the final implant placement under the muscle? Fat grafting doesnt cover the animation, although it is suggested it may. It would save a surgery, to revise the pocket to above the muscle as the second surgery, Even with supra pectoral drawbacks (fat grafting does help the rippling) this placement is superior to ending up with oddly wrinkled breasts d/t known animation. I'm confused, but very satisfied with the suprapectoral implant replacement and fat grafting result.
I am glad to hear you are pleased Donna. Prepectoral seems to be the new trend in implant placement to avoid the animation deformity you speak of. Each surgeon is different and it is important to be well informed about all surgical options, risks, and benefits and having this conversation at your consult.
Hi, thanks for all of this wonderful information. And you’re right… tissue expanders are not just for implants. I have tissue expanders in that will be replaced with my autologous thigh tissue in a month. (Vertical PAP) My right expander appears to be encapsulated. It is hard, and the nipple has risen up about 3 inches. It’s a little uncomfortable. My physical therapist showed me some ways to loosen it by pulling on my armpit. But my plastic surgeon said that won’t work because the tissue expanders are sewn to my chest. I didn’t want to question that or him, because I have so many questions I try to piece them out carefully so as not to irritate him. Since then I’ve looked everywhere for why or how tissue expanders are sewn to the chest…but I see nothing written about that. Is it true that they would be stitched in? What did he mean by that?
All of us at the Foundation wish you well. 🌸
As far as the expanders being sewn to the chest, I can’t say for sure since I didn’t have them but can certainly find out.
Hey @Diep C Foundation, do you have any video on skin and nipple sparing mastectomy and replacing breast tissue with either autologous tissue or breast implant? Thank you.
Hi Aim2B. Thank you for the suggestion on nipple sparing. I will add that to the list. Here is one that may answer your other question that is quite comprehensive with a well-respected surgeon in the U.S. th-cam.com/video/xHdn956wsjw/w-d-xo.html
Hi there, I am back to watching these videos. Two years of covid and i am still waiting for breast recon :(. I am not sure if you are able to provide some insight to this question. If a patient has had mastectomy as well as radiation done, is it really impossible to use implant? What if the radiation was just three weeks and healed very well? My question is how does one assess if the radiated mastectomy site will be fine for implant (rather than DIEP Flap)- is this assessed by physical examination/appearance of the skin , or can this only be assessed by re-opening the scar site? Do you have any idea? Thank you.
Great question. Radiation can have long term affects on the skin but my sage advice, talk to your plastic surgeon to get a fair assessment of your particular case. I don't believe "re-opening the scar site" is something that is necessary but again, speak to your plastic surgeon. I am going to direct you to this video. After watching, let me know if you have further questions. th-cam.com/video/ovnieFHmkG4/w-d-xo.html
@@DiepCFoundation Not sure how i missed your reply, so sorry about it. I sought a third opinion and this surgeon recommends that I still use autologous tissue for the radiated side. Since I do not have a lot of spare tissue, we agreed double stack would be best. And I am so thankful for your videos because your channel was the one where I first learnt about double stack! It is appalling how the first plastic surgeon whom was recommended to me and I saw her twice, did not even suggest double stack to me. She is a very experienced surgeon. She caused me a lot of self doubt and condemnation and grief these last three years while waiting for a possible reconstruction just because I was on the public queue to get recon done. In short she has a very narrow unmaganimous heart. That is why I was experiencing so much self doubt to stay with her and in the end sought more opinions all at my own cost! Finally I think I have more or less decided to go with this third one privately. At least we can firm up on a date. So sad that I have to start saving for these surgeries which the government could have paid for but I just cannot see the light at the end of the tunnel on the public queue which is already long and COVID made is doubly worse. I just want to get on with my life!
@14:00 Dr talks about pre-pec (I think) expanders where they are re placed over the muscles. What is the point of grafting fats there when the expander is just a temporary thing for about 3 months? Also for pre pec expanders, when they are finally removed, do the final implants also placed above the muscles? If so, what is the risk of the implant not staying in place? Will it ever ‘drop’ or shift eg during exercise? 🤔 Hope my questions are clear. Thanks for this video. Its wonderful. 😘
Hello and thanks for your inquiry. I believe he is referring to fat grafting after final implant placement and the expander is removed to smooth out any contours or ripples from the implant placement. The risk of implants not staying in place when placed over the muscle and dropping during exercise...the hope is that it will be very minimal. I think this is somewhat based on surgical techniques, skill and experience of the surgeon, but also anatomical body structure in the patient. Over time, any type of breast reconstruction, whether autologous, using your own tissue, or implant-based reconstruction will see changes as the body matures and changes. I hope this helps a bit. Thanks for your question.
@@DiepCFoundation Thank you. Yeah that’s one of my worries. I am trying to decide between Diep flap and implant after a unilateral mastectomy. I am thin and hardly have fats enough for diep flap but still doable. But since I am undergoing such a huge surgery I would like to increase at a cup to a B. Implants is the best bet. But I don’t want to need to harvest muscle from behind and have a other huge scar. I hope to just use tissue expander and implant over the current muscle. Pre pec seems good idea. Plus I have had radiation for three weeks years ago but surgeon tells me my skin doesn’t look like it has gone through radiation, looks very good healed very well. But still it is a littler concern. 🙏
@@Dandelion_flight At the Foundation, we wish you the very best!
@7:13 what is this ADM he is talking about? Is that taken from dead people? 😬 Thanks.
Great question. It is derived from both animal and human components. This article explains it. Look for the first paragraph in the Introduction to answer your question. Hope this helps. www.ncbi.nlm.nih.gov/pmc/articles/PMC6378261/