Mastectomy and Reconstruction

Hi there spudburf,

It's quite daunting making decisions, and sometimes even when you give it careful consideration you may still be unsure. Its good to have this forum and seek others stories first as it may help you make your choice, but at the end of the day only you can decide what is important to you.

I gave a lot of thought to my reconstruction prior to my mastectomy. I was afraid of complications I read about with immediate reconstruction so I opted for delayed reconstruction. I didn't want a permanent implant but I had a saline expander put in to preserve the breast skin.

I spent 2 1/2 years mis-matched (natural boob FF cup, expander approximately B cup) with considerable discomfort round the expander. I was originally told I could have my reconstruction a year after radiotherapy but because of delays in referral and long waiting lists I waited almost 2 years!

I opted for a prophylactic mastectomy with immediate reconstruction on my left breast at the same time as I had the expander removed and the delayed reconstruction on the right. I am currently recovering from my double TUG (thigh) flap reconstruction (Feb 25th). My legs are sore, but it is manageable and I am improving each day. The immediate reconstruction on the left is great. The delayed reconstruction on the right is not so good and will require further work to improve size and shape, this is because of the scar tissue from the expander and damage caused by radiotherapy

If I were to start again I would have immediate autologous (own body tissue) reconstruction. I think there would have been fewer problems and I would have been sorted out much sooner.

Sorry for the long post, hope it helps!

Karen

Thank you Karen for the information.
I wasn't expecting to have reconstruction with the mastectomy so I'm a bit thrown. Part of me is saying do I really need reconstruction and should I try and live for a while without a left breast? Then the other part of me is saying I'm only 50yrs old will I regret it? Also I had such a long and awful time in chemo (lots of complications) that the thought of getting well and then being thrown back into dealing with drains/operations etc is terrifying me!

I'm meeting with the plastic surgeon in the next couple of weeks so I'll have a list of questions for him.

And yes you're right Karen, I'm hoping to get lots of different stories so I can weigh them all up. Thanks for your honesty. Lots for me to think about now.

Hi all,

I am due to have surgery after chemo, not sure how mush until I get scans done to determine whether lympectomy or mastectomy.
With only one breast affected does anyone know if the ok breast is given a lift to match new one, or will new one be shaped to match ok side?
Never thought to ask oncology doc, keep forgetting to ask lots of things when I see them.
Thanks, hoe all are keeping well.

Georgie

Hello Spudburf and Georgie123
Hope you are both doing ok?
I'm here to give my tuppenceworth on surgery. I had a mastectomy with immediate reconstruction (skin sparing, nipple sparing) using a small implant and a Latissimus Dorsi flap, followed by chemotherapy, radiotherapy and Herceptin. I had encapsulation so ended up going back for revisional surgery where they cleared scar tissue that had built up and put in a slightly larger implant but nothing that you would really notice.
I had no complications from either of these surgeries; the first one was 7.5 hours long and the second one was 6 hours long.
I think the most important thing for me is keeping up my physio exercises. If I don't do them I am extremely tight and stiff in my chest area and under my arm. As a result of the mastectomy, I have no feeling at
I haven't had any corrective surgery done to the non-surgical side; I have been told it's available to me but the only time the difference in the size of my breasts is noticeable is if I'm wearing a tight top; (one side is 36DD, the surgical side is 36B) but I have been give a fantastic little mini-prosthesis that works the same way as the chicken-fillets so I slip that into my bra if I feel I need to even things out.... I forget I even have it in sometimes.
I hope this is of some help; but if there is something specific you want to know please don't hesitate to contact me. Or maybe have a look at some of my posts.... My surgery was 29th March 2011 (and as I type I just realised that it was 3 years ago this week!!!!), so I have a few posts on how I got on since then.

Take care & hope it's health and happiness for you both xx

Hi all
I haven't posted in ages but I've checked in periodically to see how you are all doing. Hi to all the new ladies and sorry you've had to join us.

I'm also facing recon now (2 yrs post surgery) and I'm in a dilemma.
Spudburf, I can understand how you feel about being out of action again. I had a hysterectomy etc 6 months ago and I felt so miserable being back in patient mode, it reminded me too much of the bad chemo days. So that's my first dilemma, whether I'm ready to face surgery again. Had gynae surg 2011, mastectomy (+chemo, rads) 2012, hysterectomy 2013 and now facing recon 2014!
The next dilemma is which type of surgery. The surgeon recommended LD flap which involves moving the LD muscle from my back around to the front and then putting in an implant. The second choice is DIEP flap which he called the "tummy tuck" version. He says I don't really have enough belly flesh for that but he could try it and then maybe find some fat somewhere else. He said DIEP is a huge operation and is about 92% successful and LD flap with implant is easier op and is about 97% successful. So I asked him why, if LD and implant is so good why doesn't everyone have that and he said lots of women go for the free tummy tuck! Odd answer! So I'm supposed to make up my mind which type I want to go for. I'd appreciate any thoughts from those who have been there, done that, so to speak. A few questions bother me..Why is there a reluctance re implant? Will the implant sit there all perky forever while the other one droops? If you have DIEP, does that mean that the reconstructed breast would increase or decrease along with your body as time goes by, weight gain/loss etc?
And a general post recon question, do you end up more sore, tight, needing physio, worse lymphoedema if you have any type of recon? I'm doing ok at the moment and am quite scared of messing with the area again.
Sorry for the long post. Thanks, Josephine x

Hi Josephine,

Here are my answers. I had the TUG recon(from the thighs) because I did not have enough tummy tissue (Buttocks are another source of tissue if your tummy is thin). You will need more physio afterwards but you risk of Lymphodema is the same as it is already as they don't touch the lymph nodes again. My breast area is not as sore or tight as my first mastectomy, but my legs were very sore and tight. They are improving daily.

Although I am only a month out I have been told that over time my new boobs will soften a bit more (they already feel more natural than the saline expander implant I had for 2 years). Because my own body tissue is used they will droop a bit and gain or lose weight like the rest of my body. I have 2 more small revision procedures to go to improve the shape and add a bit more fat to my new boobs ( a bit off the hips ) but these are normally day procedures.

For me I did not want a permanent implant as it felt like a foreign body inside me, but it is a personal choice, I know several women who are very happy with their implants.

Hope this is useful.

Karen

Thanks all for your replies. I've decided to have the mastectomy without immediate reconstruction. I will only be 8 weeks out of 9 months of chemo and I don't feel strong enough to have a 6-8hr operation. Also my plastic surgeon was extremely honest which I appreciate and I'm so sick of being sick that I'm going to wait and have the reconstruction later on in the year and by then I should be certain which type I want!!! .

Gosh you've had lot of surgery Josephine so the best of luck with your decision. The only think I know about implants if its any help is that they they need to be changed every 10 or 15yrs and my surgeon told me if I took this option then they would have to lift my good breast to match it!

Good luck again and let me know what you decide.