MSK Plastic Surgeons
Hi! Newly diagnosed with DCIS in my right breast. It is in my entire breast and my breast cancer surgeon who is at MSK said i need a mastectomy. She has recommended plastic surgeons within the hospital but none of them have any before and after photos I can find. Also, i can't make more then 1 apportionment at a time to meet them and see their work to see if that is who i would want. I am able to get immediate reconstruction, but now i may consider a private plastic surgeon.
Has anyone used a plastic surgeon they would recommend at MSK? And has anyone decided to get a tissue expander and go to a private surgeon instead? In that route, do i need it filled slowly or can it be prefilled to have immediate surgery after the initial mastectomy?
Apologies i have so many questions.
Comments
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Hello @mcarr617 and welcome here. I’m sorry about your new diagnosis and all the sudden decisions you are now needing to make. It can be so overwhelming. All of your questions are good! I know there are several very helpful threads on this forum about reconstruction options. I’m not able to give you any names because I’m in a different state but I wanted to at least say hi 😊
A plastic surgeon will evaluate your body and explain which options would be best for you. I was given two choices - DIEP flap or implant - but for various reasons both would require a tissue expander at first so I’m going the route of implant and currently have the tissue expander. It gets filled gradually. My first fill was at 4 weeks after my mastectomy and I’ll get them every other week until it’s at the size the surgeon is aiming for then I’ll need to wait a couple of months I believe before he exchanges the tissue expander for the implant. So it’s a process! I’ve been speaking to another woman who just had her mastectomy and her surgeon was able to do the implant immediately after her mastectomy. When I met with my plastic surgeon I asked him his honest opinion about which type of reconstruction did he think was best for me and he gave me good information to think about, pros and cons of each, but it was really half and half, no one stood out as absolutely the better choice.
This probably doesn’t help you much but I’m sure others will comment soon. I wish you all the best in your decision-making!
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Hi there, @mcarr617, and welcome to our community! We're sorry you find yourself here, and echoing @needs.a.nap, in the position to have to make so many difficult decisions so soon. But we hope this community can be a source of support for you! This is a great place to ask your questions, and find out what other questions you should be asking/considering as you make your decision.
You can absolutely go with a private plastic surgeon, and we (and many of our members) recommend and encourage meeting with multiple surgeons to find the one you're most comfortable with. Obviously technique and results are incredibly important, but equally important is their bedside manner and level of care. Many surgeons won't publish (on their website, for example) before and after photos of these types of procedures due to patient privacy laws, but the majority should be happy to show their work during your consultation. The scheduling issue sounds frustrating, it can be difficult to schedule with multiple providers within the same specialty within a practice or center, but perhaps you can schedule consultations with one of the MSK surgeons and a private surgeon concurrently to start to narrow it down?
We have a very helpful thread on tissue expanders as well, that may help answer some of your more specific questions about that process.
Please do keep us posted as you navigate this journey - we know it's a lot to process, but you are not alone!
The Mods
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Hi -
As the moderators said, even though they don't publish before/after photos online, plastic surgeons at MSK will generally show you photos in the office.
It's great that your surgeon says you can have immediate reconstruction. And as needs.a.sap points out, tissue expanders take weeks to fill and require another operation down the line.
You don't say whether you're considering DIEP or implant? DIEP is a much more complicated operation than implant, but MSK does indeed have surgeons highly skilled in the procedure, who can give you good technical and aesthetic results. If you are thinking of going that route, have your breast surgeon narrow PS recommendations to only those top doctors, and don't waste your time there with surgeons who do mostly implants.
And, as the mods say, you should feel free to consult with an outside PS. If nothing else, it may give you more info and ideas you can take back to MSK. And, as they also wisely said, in the end you need to choose someone you are comfortable with, wherever they may practice.
You sound as though you're already putting a lot of thought into it all, which is great. Hope you find the perfect match!
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