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Plastic Surgeon
Plastic Surgeon, Plastic Surgeon (MD)
Category: Plastic Surgery
Satisfied Customers: 920
Experience:  30 years experience; Board Certified in Plastic Surgery; Member American College of Surgeons;
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I had a mastectomy for lobular breast cancer (November 2015)

Customer Question

Hi - I had a mastectomy for lobular breast cancer (November 2015) and am due for a preventative skin-sparing mastectomy on my right side. I am 52yrs old, weigh 69kg's, am 1.72meters tall and my normal cup size is a D. I have seen a plastic surgeon who has said that he could create size B breasts with the tram flap procedure. Consequently he has recommended the latissimus dorsi flap procedure combined with implants for me.
I do not participate in competitive sports, but swim almost daily - a life long habit -(breaststroke, crawl, backstroke) and kayak and play tennis socially and only occasionally.
I am concerned about the long-term impact of the latissimus dorsi flap procedure on my general physical health- and my ability to swim in particular.
My questions are:
- Can the tram flap procedure be combined with implants-
- can the tram flap procedure be combined with fat grafting-
- does fat grafting last long term if body weight is stable -
- and in your experience, which procedure in general usually gives the best results?
Thank-you so much!
Submitted: 1 year ago.
Category: Plastic Surgery
Expert:  Dr. Phil, MD replied 1 year ago.

any other medical issues?

Expert:  Plastic Surgeon replied 1 year ago.
Thank you for your question. Breast implants can be used with the Tram flap. The best results have been with the Tram flap but good results are also achieved with the latissimus flap. You would lose some function in sports with bilateral latissimus flaps. Fat grafting is really not good for breast reconstruction. The fat will eventually be reabsorbed by the body. I am available if you have more questions.