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This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.Question: I had both breasts removed with stage 4 cancer. The left breast with the silicone wouldn't stay closed, so the plastic surgeon did a tram flap with muscle from my abdomen. So now one breast has silicon and the other has muscle from my adomen. I didn't get nipples on my breast. Is there anything else I can do to improve this mess.Answer: Thank you for your question. After losing an implant on the radiated side, the best next step is to reconstruct that breast with natural tissue. Which you did. As you are aware complications with implants increase when radiation is needed. Since you already have an implant on the other side. it will tend to be different from the tram side. Options include adjusting the shape of both breasts vs. replacing the other implant with natural tissue from another area of your body. We recommend doing this without using any of your muscles, only skin and fat either from the thigh area or buttock area. If you are happy with the implant breast reconstruction and don’t want to start over and go through another extensive reconstruction using natural tissue then it may be possible to adjust the TRAM reconstruction in a way that helps. You can always have nipple reconstruction if you desire, and that can be done as a minor procedure alone or possibly combined with revision of the reconstruction. I could give you more specific information about your options if you would like to give me a few more specific details. Thanks again for the question, let me know if I you would like more information.