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Underwent mastectomy with impant. Had chemotherapy and herceptin. Lyme disease. Will the breast removal heal fast?

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Cosmetic & Plastic Surgeon
Practicing since : 1993
Answered : 65 Questions
4 years ago I had a mastectomy with an implant for reconstruction. I had 4 rounds of chemo and 3 months of herceptin before the surgery. I also contracted lyme disease right before the surgery. The incision would not heal over the implant. Surgeon had to cut away dead tissue and restitch the incision 4 times before it finally closed. After that I had 30 radiation treatments without the boosts at the end to the incision.

I'm thinking about having the implant taken out and having my breast removed on the other side so that I'm just flatchested. Do you think I'll have an easier time healing since I'm healthy now?

Is there any kind of supplement that I can take to increase the chances that the incisions will heal
Posted Sat, 7 Jul 2012 in Beauty & Cosmetics
Answered by Dr. Surindher 1 hour later

Thank you for using XXXXXXX for your health related query.

I went through your mail regarding your problem.

1. Wound healing is always delayed in irradiated areas because of the poor blood supply. But, since it is 4 years since you had the procedure and radiation, the tissues would be far less reactive and your wound healing would be much better.

2. Elective mastectomy on the other side should not be a problem as the surgery would be through normal tissues unaffected by the disease process and hence wound healing should not be an issue.

3. As far as supplements go, if you have a normal healthy diet that should be enough. As long as your blood hemoglobin, serum proteins (especially albumin) are fine and if you are not a diabetic or smoker, healing should be fine.

But, considering all that you have already gone through on the diseased side and since it has settled down well since the last few years, I would urge you to reconsider having the implant removed (unless you have pressing reasons for the same). You could get an elective mastectomy and an implant on the other side too.

Please talk to some support groups where you could find people with similar problems and hence they could also help you with the decision making.

If you are not comfortable with implants, another option is to have it reconstructed using your own tissues ( muscle flaps) which would be bring in fresh normal tissue there and hence help with healing of the wounds too.

But, I would suggest that the final decision needs to be taken after a physical examination and after seeing the local site. Your surgeon could help you decide after examining you. In fact you could ask him for other reconstructive options too, like the muscle flaps.

We wish you all the best and hope we could be of assistance in helping you decide. Please keep us posted of your progress.

Thank you for your query.

Aesthetic Plastic & Reconstructive Surgeon
Above answer was peer-reviewed by
Follow-up: Underwent mastectomy with impant. Had chemotherapy and herceptin. Lyme disease. Will the breast removal heal fast? 19 hours later
Thank you for your informative answer. I have one more question.

Do you think there is any point in asking the surgeon to use surgical glue AND stitches to close the incisions? Would that help at all?

After the mastectomy and implant surgery, the doctor used glue twice to close. The other times he used sutures. I'm thinking about asking him to use both.
Answered by Dr. Surindher 13 hours later

Thank you for your follow up to my reply.

Sutures are used inside the wound and for the skin closure we can either use sutures inside which do not have to be removed or can use glue on the outside. It doesn't make too much of a difference in a fresh wound.

The surgeon must have used glue later on because the skin edges would be too swollen to hold sutures properly. Hence you can leave the decision to him

Sutures or glue doesn't make a difference, as long as your wound healing is good, both will work just fine. And even when using glue, the inner layers are sutured together.

All the best for your procedure. Keep us informed as to how it went.

Best Regards
Aesthetic Plastic & Reconstructive Surgeon
Above answer was peer-reviewed by
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