I had a mastectomy and am deciding whether I should have immediate or delayed breast reconstruction surgery. What are the pros and cons?

There are several considerations to look at in deciding on immediate/delayed breast reconstruction surgery.  Among these is vascularity, or how well blood or lymph travels through the remaining tissue of the breast mound after the mastectomy.  Post a mastectomy, radiation therapy can be prescribed – in this case, it would be best to wait as the implant would not take well in an irradiated tissue bed.  With reduced blood supply, there is an increased change for scar tissue formation.  The reverse is true – for patients not requiring radiation, immediate breast reconstruction may be better.  Also there is the highly possible negative psychological impact of waking up from the mastectomy without a breast – immediate breast reconstruction would then be well timed. A more practical consideration for immediate reconstruction is that more of the natural breast skin is preserved after a mastectomy, making for a more realistic and satisfying reconstruction.  But then again, there are some that may feel overwhelmed with having to make such  decisions regarding their cancer treatment, believing in the adage of “one step at a time.”  They will come back to their surgeons later on when they’re good and ready to do something.

What is the difference between liposculpture and liposuction? Chanel

Hi Chanel, thanks for your question. Liposculpture is a derivative of liposuction. These terms are often used synonymously. Liposuction strictly refers to the removal of fat cells from a certain area, sort of like “debulking” the area of fat. It uses a cannula which is a metal rod with holes at the end that is attached to a vacuum suction in order to suction fat from the deep fat areas of the body. On the other hand, liposculpture removes fat in areas to sculpt the body. A good example of liposculpture is the procedure where the surgeon carves out and defines the existing rectus abdominis muscle to reveal the “6 pack” or “washboard abs”.  It entails a combination of procedures, including removal of skin and fat from different parts of the body, such as a tummy tuck, breast lift, and/or breast reduction.  You should have a consult with a board certified surgeon to determine which procedure is best for your targeted areas for improvement.

I have small bladders or sacs containing liquid on my mid cheek grove. I want to get rid of them, what’s the best procedure for this

Hi, thanks for your question.  Some doctors treat this condition through surgical removal, oral diuretics and steroid injections, but these may yield minimal and often temporary results. Instead, a specialized laser resurfacing process will treat the condition and manage the critical wound healing protocol following the procedure.  Laser skin resurfacing creates a wound in the area of the sacs and coaxing the skin to heal this area with better quality skin.  By purposefully damaging the skin with just the right amount of injury, the skin can heal without any problems with scarring and, in fact, with better quality skin.  In contrast, invasive surgical procedures are more time intensive and provide results which are often less than optimal. Treating just parts of the face through laser skin resurfacing takes about 30 to 45 minutes. A full-face treatment takes up to two hours.  Following the laser procedure, the treated areas will be bandaged. After 24 hours, you will need to clean the treated areas four to five times a day and then apply an ointment such as petroleum jelly to prevent scabs from forming.  Swelling after laser skin resurfacing is normal. Your doctor may prescribe steroids to manage swelling.

 

I had nose surgery but after 7 weeks, the tip is still very swollen. Is this normal? Sab

Hello Sab, thanks for your question.  Swelling after nose surgery is not uncommon. It takes about 12 weeks for your nose to be “camera ready,” so while you are understandably concerned and anxious, your experience is fairly common.  Wound healing is a complex biological process, a large number of cell types are involved in the process.  Multiple factors can impair wound healing by affecting one of more phases of the process.  Some factors that influence healing are oxygenation, infections, age, presence of sex hormones, stress, diabetes, medications, obesity, alcohol consumption, smoking, and nutrition.   Four weeks post op, most patients are healed, except for swelling in the tip of their noses.  You should expect to notice subtle changes in your noses for up to a year.  I would suggest that you give yourself a little more time to see the results of your surgery as people heal at a different pace.

I play a lot of basketball and my nose got hit badly but I’m not sure if it was fractured. There was some swelling right after the injury. But now, about 5 months after, I can’t breathe easily and my face is painful and I get congested a lot.

Hi thanks for your question.  A ball hit to the upper face can fracture the delicate bones around the sinuses, eye sockets, and bridge of the nose or cheek bones. It can be difficult to determine if you’ve fractured your nose after the injury described.    The adrenaline rush you feel during a hard game of basketball can make it hard to be sensitive to your body’s cues.  The symptoms you shared (the swelling, breathing problems, congestion and the pain) can point to a possible nose fracture requiring nose surgery.  Of all these symptoms, you should be concerned about congestion which could come from persistent drainage from one or both nostrils.  This could be cerebrospinal fluid draining from the brain to the nose, which can happen after an injury to the head.  It is best to have an x-ray taken of the nose after a thorough physical exam; if there are other suspected fractures, a CT scan is in order.