Who’s not a candidate for muscle sparing autologous reconstruction?

For women, breast reconstruction is important to how they look and feel after a mastectomy. Muscle sparing autologous reconstruction is a fancy way to say that the new breast is rebuilt using your own (natural fatty) tissue from your belly, buttocks or upper thighs. Your important muscles are preserved and never sacrificed in order to reconstruct your breasts. We also transfer sensory nerves that can help the new breast   feel more like your old breast. In addition, this type of reconstruction doesn’t use synthetic implants which can break and will also need to be replaced down the line. Breasts made with muscle sparing autologous reconstruction will last a lifetime. Unfortunately, some patients have been told that they are not suitable candidates for this breast reconstruction procedure. If you are one of these people make sure you ask a surgeon who specializes in natural tissue reconstruction without sacrificing your muscles.  If you have been told you don’t have enough fatty tissue give us a call.  Chances are you do have enough fatty tissue and we can help. Every surgery comes with risks, however most women who are healthy enough to have a mastectomy surgery can safely have breast reconstruction.  Some health conditions may put a patient at higher risk for complications following surgery. Some specific conditions we see that may need to be corrected before surgery or that may require a specialized approach include:

• Congestive heart failure or another heart problem which might prevent the patient from being anesthetized for a lengthy period of time.
• Uncontrolled diabetes: Patients with uncontrolled diabetes are at risk for such problems as postoperative infection and poor wound healing.
• Uncontrolled hypertension: Anesthesia can increase your blood pressure and if your blood pressure is already too high you may be at risk for problems after surgery.
• Smoking: It’s not a health condition, but smoking leads to a variety of health problems, so if you’re a smoker, you are going to be given a hard no for this procedure. That is, unless you quit. When you smoke, your heart and lungs don’t work as well as they should, which can lead to breathing problems, a greater risk of developing pneumonia, slower healing and a higher risk of infection.
• Severe bleeding or coagulation disorder: Surgery causes blood loss and if you have a bleeding disorder it can cause additional bleeding. Blood clots can be very dangerous and if you have a blood clotting disorder or previous blood clots you could have a higher risk for blood clots after any surgery.
• Body mass index: BMI is a consideration when evaluating surgical risk. Some women with a higher BMI may actually have a fat distribution that is favorable for the procedure.
• Past surgeries: With a muscle sparing autologous reconstruction, donor tissue from different areas of the body can be used. Past surgeries might render one tissue donor site unavailable. These include buttock implants, a tummy tuck and multiple open abdominal surgeries, etc. In almost every case if one area is not available because of previous surgery we can use another area that has not had previous surgery.

What now? If you’ve been told that you are not a candidate for muscle sparing autologous breast reconstruction, get a second opinion. It’s important to talk to a plastic surgeon who is experienced in performing these types of procedures on a routine basis. Dr. Craigie and Dr. Kline will evaluate your health history, discuss all of your options and answer any questions and concerns that you may have about all of our procedures.