Breast Reconstruction Questions

Replacement of Implants, Original Cancer and Radiation in 1985? (photo)

posted by ajimerson

Q:  I had lumpectomy & radiation in 1985. I got UM silicone implants in June 2011. Left radiated side 400cc, right 325cc. Easy recovery; no problems – left breast is nice but firmer & smaller and right is softer & lower. Not really noticeable in bra. Can I increase the left side rather than reduce the right w new implant? Can I lift the right w/o moving nipple? Will I always be asymmetrical regardless of what I do? I am 61 and really don’t want a big major surgery. Options? Opinions? THX!

A:  Thank you for your question.  I generally don’t perform fat transfer to the breast after lumpectomy.  There appears to be some capsular contracture on the smaller side.  This could be corrected in conjunction with placement of a larger implant on that side.  Lifting the larger side (mastopexy) would involve moving the nipple.

Why Do So Few Surgeons Work in an Actual Hospital As Opposed to Their Private Surgery Centers?

posted by ajimerson

Q:  Am I wrong in wanting to be operated on in a hospital, even though these surgery centers are accredited? It just seems safter.

A:  Almost every board-certified plastic surgeon you will meet operates in at least one hospital.  Having hospital privileges is a requirement for most accrediting organizations.  There are several reasons why so many of us and our patients prefer surgery centers.  First and foremost is patient safety.  I run my own AAAASF-accredited surgery center which allows me to hand-pick the best nurses, anesthetists and other staff to help me take great care of you.  I have no control over who is working in the hospital.  Most surgery centers also have MUCH lower infection rates than hospitals.  The second benefit is cost.  Hospitals are expensive to run and that cost is passed on to you.  I have no influence on the anesthesia and facility fees that they will charge my patients.  I am much better able to control costs in my own center and I pass that savings on to you.  Additionally, I am able to offer better service in my own operating room than I am at a hospital.  I offer a variety of surgical dates and times and my staff is particularly attuned to your needs.  It’s equivalent to the service difference you would notice when comparing a fast food chain to a sit down meal at a family owned restaurant.

Are Unequal Breasts Normal? (photo)

posted by ajimerson

Q:  i am 21 yrs old and have unequal breasts.the left one is bigger with the nipple pointing upwards while the right is smaller and sagging .i am quite skinny and wonder if it has anything to do with my weight.please suggest a suitable treatment as it is causing me distress.

A:  Breast asymmetry (unequal breasts) are EXTREMELY common – in fact, most women have some asymmetry.  Your photo is a bit tough to view, but it looks like you may have more than asymmetry.  Your right breast is considerably smaller than the left.  The base of the right breast is constricted.  You may have what is called a tuberous breast deformity.  If it distresses you, surgical correction is available.  I would suggest scheduling a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery to discuss your options.