What are your opinions on partial breast reconstruction with silicone implants after lumpectomy & radiation? My breast and plastic surgeons indicate I would be unhappy with the outcome and I should just do bilateral mastectomy given the relatively large area of microcalcifications that need to be removed from my small breast. I am concerned about implants without breast tissue feeling hard.
There are a number of options for partial breast reconstruction that do not require a total mastectomy., including oncoplastic reduction, perforator flaps, and partial latissimus flaps. You should seek a second opinion from a plastic surgeon with experience in partial breast reconstruction. And if after the second opinion you do pursue a full mastectomy with reconstruction, there are a number of options there as well. Good luck.
There are many options after a partial breast reconstruction . It largely depends on the size of your natural breasts, your desired size after reconstruction as well as the extent of the tumor that is being removed. If you are in a situation where the are of microcalifications is so large that a significant area needs to be removed, your breast and plastic surgeons may be correct that a mastectomy is the only option to get clearance of all the suspicious areas as well get an aesthetic reconstruction. Without seeing pictures as well as your radiology results it’s not possible to render an opinion here. I would encourage you to get a second opinion though
There are many ways to reconstruct a abreast. Not infrequently a lumpectomy with radiation leaves a defect that is very difficult or impossible to reconstruct and make symmetrical with the other side. Having the same operation on both sides makes it a lot easier to reconstruct with a better result. Especially if you do not have to have radiation. Your surgeons know best about your case and will tell you what is best in their experiences. I am sure they already told you about the pros and cons but if you do not understand you need to keep asking questions until you understand. If you do not understand you need to get a second opinion. Sometimes we continue to get other opinions until we hear what we want, have it that way and end up worse.