Mastectomy and Reconstruction

Hi Summer,

I have just posted that I am due to have my PBM in the next couple of wks. I chose to have recon with expanders and implants. I mainly chose this because I wanted the shorter recover time. And less scarring. I've also read that if the expander/implant route does not succeed that some sort of flap procedure could be tried subsequently.

There are several types of flap recon available now. The most common is probably the TRAM where tissue (or tissue and muscle) are taken from your tummy and tunnelled up to the breast area.

There is also a FREE TRAM which (not too sure about htis one) is similar to the TRAM but I think the tissue is not tunnelled up, instead it is reconnected to the existing blood supply and nerves in the breast area.

There is the DIEP (Deep Inferior Epigastric Perforator) flap. Again similar to the TRAM but its also a 'free flap'.

Then there is the LD, which you've heard of. The SGap, the LGap? where the tissue is taken from the buttocks or thighs and I'm sure there are others too.

There is a good book called the Breast Reconstruction Guidebook by Kathy Steligo that has been recommended to me. It goes thorugh many options in fairly normal, non medical language. http://www.amazon.com/Breast-Reconstruc ... 0966979966

There are also some good websites - try www.facingourrisk.org
or http://www.macmillan.org.uk/Cancerinfor ... ction.aspx

And if you ever want to talk to another 'mutant' please get in touch.
REgards,

Flo.

Thanks Flo.

I can't get tissue expanders with implants because the Plastic Surgeon says that they could fail because the skin needs to be stretched and this really can't be done very well after radiotherapy.

I've just ordered the book you recommend so hopefully I'll get to look at that before my next appointment.

If anyone has any information on the Latissmus Dorsi, I'd be very interested to hear.

Also, are we allowed ask about a particular Plastic Surgeon on this site? Not sure if we're allowed name them?

Thank you.

Hi Summer73
Great to hear that you are at the reconstruction stage.
I had an LD done two months ago and I am very pleased with it.
If you PM me I can speak to you on the phone because it is
a big decision and I found it great to talk with people before I
made my mind up.
But... for the benefit of any non posters at the same stage as Summer I will give a little insight.............

I had the option of any type of recon as I did not have radiotherapy - my surgeon told me it was totally my own choice so I did get in contact with people who had gone through the various options (though word of mouth and my BC nurse) and eventually decided on the LD for the following reasons

1. Flap Reconstruction gives a very natural ''feel''
2. I am small chested so LD was perfect as I could do so without implants.
3.In the recovery spectrum, LD is middle between.
4. I liked the fact that no implants needed to be used - I know that implants are safe now and all of that but I felt that because the ld muscle was brought over still attached to its own blood supply there would be less risk of infection, rejection etc.....
5. The length of time on the ''table'' was another factor - I was about 5hours - a tram flap would have been about 7-9 hours.
The length of time on the table has an effect on the recovery time.

Once I had my decision made:
I had been in a muddle for ages trying to make my mind up but once I decided on the LD Flap I didn't think or worry about it anymore.
I started to think positive and looked far beyond the operation - admiring swim suits and dresses that I would be able to wear etc. - this positivity took away all nerves of going into hospital.
I was SO looking forward to having my body back to its former glory again that the operation became just something I ''had to do'' to achieve this.
Day of Operation
I had built up such a positive ''picture'' that I was gunning to get to the theatre - it was going to be the only icky step to closing the BC book and getting closure to the previous two years.
- Woke up after operation with no pain whatsoever - after a few hours a nurse helped me to the loo and eventhough the first time getting out of the bed was ''uncomfortable'' it was probably the best thing I did...... because it got easier each time after that.
Day 2.
I sat out of bed and had plenty pain killers - the most akward things were the drains.....Did a little walking in the coridoor.
Day 3.
I did longer walks from this day onwards which I think really helped to get the recovery process going.

I was in hospital for 9 days because my drains were slow and eventhough the medics had said that the LD operation would be a far more severe operation than the Mastectomy was...... I felt it much easier to recover from..... I guess my head was in the right place and I wasn't worried about the journey ahead like I was for the mastectomy - I ate really really well for the few months before the operation and did alot of walking - another plus.

Eight weeks on - I am DELIGHTED - I am wearing tops that I had to forget about and I don't have to put my hand on my chest every time I bend down to pick up something in public or at work.
The scars are healing away nicely - the bio oil is blending the scars which eventually will be just hairline and every now and again I just look down inside my t-shirt and say ''YES !!!!!''

I only now realise how much I missed my boob - when I learned that i had to have a mastectomy I just wanted the ''bad boob'' gone - didn't give a hoot about having it off...... the day I missed my boob was the day I went for the silicone prostesis - I felt I was wearing a harness and hated having to put it on even if I just wanted a pyjama morning (I hated the ''blank'' spot through my pyjamas...)

If anyone has any specific questions please keep this forum going - I would be delighted to pm or meet up with anyone who is on the decision route - its a big decision and an important one too.

take care and hugs to all.
r

Thank you so much for your reply. That is so much help. I'll pm you about it too.

Just to add, I'm actually going for a bilateral mastectomy and reconstruction at the same time so its a big step for me.

Just found this video from Ch4 Embarassing Bodies - it shows the final stage of reconstruction - attaining symmetry, creating nipple & tattoo.
http://www.channel4embarrassingillnesse ... struction/

Hope you find this helpful.