VicWytch

Breast reconstruction after WLS

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Hi Dr. Gupta,

I am about 1 year out from gastric bypass, and have reached my goal weight for the past 4 months. Unfortunately I was also just recently diagnosed with breast cancer, stage 1 (invasive ductal carcinoma) in my left breast. Because of the WLS, the size of my breast is barely a B cup with lots of loose skin. The breast surgeon has said that the area to be taken out (2 inches) would severely impact the look of my breast if I went with a lumpectomy, and so she recommends I investigate a double mastectomy (for symetrical reasons). 

I meet with a plastic surgeon in about a week, but my question is about whether I would have enough loose skin/fat on my tummy or butt to do any of the reconstruction without implants. I know I have the skin, but I believe the fat is crucial as well, and I'm not sure I have enough of that left. 

Have you ever encountered this situation before with WLS patients and breast reconstruction after mastectomy?

Thanks in advance for your advice.

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Hello VicWytch,

Thanks for your question.

Yes I have encountered your situation before.  I agree with your breast surgeon's recommendation.

You are correct that enough fat is crucial for a good result with autologous (tissue flap) reconstruction and that available fat is significantly diminished after massive weight loss, which usually means implant reconstruction is a better option.  But your plastic surgeon will be the best person to make that determination after he/she has a chance to consult with you and examine your tissues.

Good luck with your surgeries.

Sincerely,

Abhay Gupta MD, FACS

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Thank you for the prompt response. Appreciate it!

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