SECOND OPININION PLASTIC SURGERY APPOINTMENT

Wednesday Nov 26, 2008, met with Dr S. in Morton Grove. MUCH better experience. Felt she was given fully informed choices of the three types of procedures he performs with the pro's and con's of each. After examining Judy, he feels that she is a candidate for the TRAM procedure which uses the tissue from the abdomen to reconstruct a new breast. Because she has limited tissue and fat in her abdomen, the end result would be a size 34 B or 34 A instead of the 34 C which she is currently. She could then have a reduction on the remaining breast in the future. She had been previously told that with a saline implant she would need a lift procedure to the remaining breast. So, it appears that with either an implant or her own tissue, she will require a procedure on her other breast for "symmetry". From a plastic surgeon's perspective, her choices are: 1) Immediate reconstruction with tissue expanders to be followed by saline implants - or - 2) Delayed reconstruction using her own tissue with tissue from either her abdomen or her back. The abdominal procedure leaves a large abdominal scar. This surgeon uses a microsurgical muscle sparing technique which uses very little if any of the abdominal muscle. The procedure itself is an eight hour procedure. The back procedure leaves a smaller scar on the back, takes three to four hours, but still requires an implant. The shortest, less invasive of all of the procedures is the implant procedure. The implants look less like and feel less like a breast, they also are not considered to be lifelong, but last 10-15 years. These are decisions to be made in the next couple of days.

Our next meeting is with the Radiation Oncology physician on Monday Dec 1st to see if he has an opinion as to whether she should have immediate or delayed reconstruction since she may need radiation therapy. He may recommend that she wait for reconstruction until after radiation therapy is completed to assure the maximum benefit from the treatment. After her meeting with him on Monday, she should have all of the information she needs to make her decision and then surgery will be scheduled for sometime that week.