hi suekay, I too am concerned about who will operate on me. I believe an oncoplastic surgeon is the best.
Have been trying to get info via the internet, but so far not much to report.
All the best anyway.
A plastic surgeon is really what you need for reconstruction. As your breast surgeon made a muck up of your op I would ask to be referred to a plastic surgeon who specialises in reconstructions. www.opstionsforreconstruction.com will give you the different centres and what operations they can perform. There is no rush now so take your time and make sure it's done right.
A breast surgeon can do some simple reconstructions but if a skin graft is necessary, as is the case with a free flap (like DIEP or TRAM), it has to be done by a plastic surgeon as it is far more complex surgery. It means blood vessels have to be isolated, removed with the flap of donor tissue, and reconnected, carefully monitored to make sure the tissue stays alive and the blood supply 'takes', which is not necessary if an implant is used. I am delighted to have had a successful immediate DIEP recon after mastectomy and axillary clearance 6 weeks ago, both surgeons in theatre together, and straight into a specially heated side room off the plastic surgery ward. The plastic surgeon has the much more lengthy job. My op was about 11 hours - I was assured the whole team, including the anaesthetist, have a very early night before these! Lyn x
I had a masectomy and DIEP recon 2 weeks ago.I had a Breast surgeon for the mascetomy and a plastic surgeon for the recon.Like its already been said my BS would do tissue expanders but thats about all.The plastic surgeon seemed to concerntrate more on the cosmetic side really.I t made the surgery longer though.A simple masectomy is a couple of hours where as a DIEP was about 8hours!
I t can be frustrating if they don't work closely together though. When I was considering my options both surgeons could not get together to meet me and perhaps if I had discussed things I may have chosen another type of recon!!! But who knows???
At my hospital, the breast surgeons and plastic surgeons work closely together. I don't think any of the breast surgeons perform reconstructions, and the plastic surgeons don't perform breast surgery, although I think I have heard of some breast surgeons elsewhere who do the simpler reconstruction using tissue expanders. The plastic surgeon who did my LD reconstruction specialises in and is very experienced in reconstructive breast surgery. She talked about which reconstruction I would like (prior to this appointment I had been lent a video the hospital had put together about the different types of reconstruction), and then examined me to see if the LD was feasible (it was, with a small implant). Maybe your surgeon is now refering you to a plastic surgeon which is why he said, 'that's for a plastic surgeon'?
I don't know but would hazard a guess that a plastic (cosmetic) surgeon's area of expertise is to make the patient look as good as possible whereas a surgeon surgeon's primary concern is performing an operation that will save or prolong the patient's life and the aesthetics aren't his top priority.
I was fortunate, the consultant surgeon who cared for me was mindful that I would not want to be too disfigured and spent time showing me where he intended to cut and explained how he would reconstruct what he removed but I only had a wide local excision, I am sure if I had had to have a masectomy I would have been referred to a cosmetic surgon afterwards.
Since my diagnosis I have found it invaluable to make a note of questions I want answering, There is so much to take in, on top of the emotional side of things there is so much information and you can't possibly expect to remember it all (and I am sure the chemo does not help I am getting really scatterbrained)
Sorry, I don't seem to have been very clear
I only have the one surgeon - breast - who did the mastectomy and reconstruction
I don't understand why some people have two - breast and plastic
i.e. what does the plastic surgeon do that a breast surgeon doesn't do
I too have to have 2 surgeons for my mastectomy next week one to take it off and the plastic surgeon to put in imlant and reduce the good breast. I have to assume that they each specialise in their own type of surgery.
The reason I ask is that a breast surgeon did my mastectomies and immediate reconstruction (skin saving - which went wrong so now he is going to do an ld)
When I asked him something at my last appointment
He replied "thats for a plastic surgeon"
but of course I can't remember what I asked him -
(possibly would he be taking 'stuff' from my tum if there wasn't enough on my back)