Expert: Claes-Gustaf Nordquist, M.D. - 9/11/2006

Question
I had a prophylactic bilateral mastectomy on June 19th 2006.  I am brca 1 positive that is the reason for the mastectomy.  I had tissue expanders put in at the time of the mastectomy.  My plastic surgeon said the tissue expander failed on my left side.  They put 445cc's of saline in it and it just kinda squishes around and hangs there.  The plastic surgeon said instead of replacing it he is just going to do a breast augmentation and not bother with the muscle.  If he covers the muscle don't I run the risk of hiding a developing cancer?  He also pulled my drains when I was still putting out close to 100cc's a day.  I ended up with a 513cc seroma and my skin has ugly stretch marks all over the side with the expander that is working and the breast is nasty looking.  I asked him about that and he said oh well.  Will he be able to clear that up or will it always look that way?  Thank you in advance for answering my questions.  

Answer
First of all, I'm NOT a plastic surgeon, so your question includes technical elements I just can not answer! However, you have removed - if I understand you correctly - all ordinary breast tissue on both sides. If that has been done correctly and completely then your breast cancer risk should be more or less completely eliminated, as I'm sure was the reason for this maybe somewhat drastic surgery. So I do not think any developing cancer there will be probable. For the rest of the question I must ask you to direct it to an expert on plastic surgery as it is completely outside my field of expertise. Though I do understand your concern and I agree, I find the desciption of the whole thing strange myself.