implantsThe below question is answered by Dr. Richard M. Kline, Jr. ofThe Center for Natural Breast Reconstruction.I had a 4.6 cm lobular carcinoma treated with neoadjuvant chemo (ac+t). Five treatments to go scheduled to end on 1/17/12. Tumor had been reduced to 2.7cm thus far. Scheduled for bi-lat mast in early Feb. I am slim, 5'4" and 112 lbs now. Normally about 120 lbs. surgeon here in nj is recommending expander and fills followed by radiation and several months later, an exchange. He says I may have enough abdominal fat for a tram flap for one breast. Could I come to you six months after radiation for a diep flap or some other procedure if I just have mast and do nothing else for six months following rads? Thank you Hi, Sorry to hear about your situation, but we would absolutely be happy to see you. If you have decided for sure you want to be reconstructed with your own tissue, I would strongly recommend that you stick to your guns and not have expanders placed, for the following reason. The expanders will create a "divet' in your bony chest wall, which will not go away, and some of your flap volume will be required to fill the "divet," and thus not be visible in the breast mound. If you were more "fuller-figured" this would not be an issue, but it is a huge issue for slender patients. We have encountered very few patients who cannot be reconstructed due to inadequate donor sites, although it's not too uncommon for slim patients to not end up quite as large as they'd wished. If you'd like to send photos of front and back we could give you a preliminary assessment of your donor sites, although of course the absolute assessment is best done in person. Good luck, and please feel free to call or email with any other questions. Richard Kline Center for Natural Breast Reconstruction

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