Breast Reconstruction

[Marian299]

Hi - I have tried to get an answer before but with no results so I am trying again.

Last year I had bi-lateral mastectomy, reconstruction with silicone implants and nipple and areola reconstruction.  Now the doc was going to close with a "purse string" closure around the grafted areola and pull in all of the breast tissue so that the only scar would be around the areola.  After I awoke he had changed the plan and placed the graft over the scar so there is now a scar at each side of the areola as well as a scar under the breasts to place the implant (he intended to place the implants through the areola opening earlier).  So my question is - can this be redone so that a purse string is placed and the scars gathered into the areola grafted area?  Can this be redone so that at least the scars around the areola are hidden?  I would really appreciate an answer from a plastic surgeon before I go globe trotting to find a doc who can do this only to be disappointed.  Thanks in advance!

[Archibald S Miller III, MD,FACS]

I can tell you that what you are asking is possible if your skin is very soft and pliable. If the area is tight, then it will be difficult to pull the scars into the areola. The longer the scar, the more difficult it will be. I may recommend you thinking about enlarging your areola by pigmenting it. That may solve your problem without surgery. I hope this helps, respectfully,

                            arch s miller ms md facs

[Marian299]

(I'm sorry I forgot to mention this above)  The scars are each approx. 3 inches - still doable?

[Marian299]

I just wanted to thank you for your straight forward answer.. I have been trying to get such an answer now since the implant/areola reconstruction.  The skin is pliable and perhaps after the adjustment I would "touch it up" with tattooing.  This was all done for DCIS Stage 0 without any radiation or chemo (my father died of bc)   This renews my hope - I wouldn't have had this done at all here if I hadn't been told (after three other plastic surgeons consults!) that is could work - a "snap" was what I was told!!   My intent was to go to San Franscisco and maybe even hold on to my nipple/areola.

Now the trick will be to try to find someone who will do this - my heart was broken after all of my research and removing one of my breasts prophylactically to insure the easiest and best results from my plastic surgeon - only to awake to a completely different situation!  He did apologize but that didn't take away the heartbreak - he said that he didn't have "any medical reason" for doing it this way - he just "forgot"!  So I thank you for renewing my trust/faith in plastic surgery!  Thank you!

Thank you!