Mastectomy, now what?

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terriw
terriw Member Posts: 4
edited March 2014 in Breast Cancer #1
I'm new to the forum. I had a bilateral mastectomy in November for lobular and ductal carcinoma-in-situ. I'm going to have reconstruction done, but would like input on pros and cons of different procedures, i.e., TRAM flap, implants, etc. I'm 38.

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  • jane38
    jane38 Member Posts: 123
    #2
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    Hi Terri. I'm 62 and am still in the throes of reconstruction. I had a modified radical mastectomy for my cancer in March 1999. In February 2000 I had a mastectomy on the unaffected side and a bilateral free TRAM flap reconstruction. On Halloween I had revision of the right breast and nipple-areola reconstruction on the left. I still have nipple-areola reconstruction on the right to go and this will be done in either February or March 2001.

    A free TRAM flap is a very hard operation. My surgery took 11-1/2 hours. I was in the hospital for seven days, on very heavy duty pain meds for four of those days. Would I do it again? In a heartbeat.

    The nipple-areola reconstruction is not bad at all except for the incision that is made in the upper inner thigh where the skin becomes darker than the rest of the leg. That is rather uncomfortable but only until the stitches come out.

    I know of one lady who had implants done. At the time of her bilateral mastectomy she had tissue expanders inserted. Later, after chemo was completed she had the implants and then nipple-areola reconstruction. She was not happy with her reconstruction. It looks fine but she thought the process was too long and too many times under anesthesia.

    Look up all the research you can about the various forms of reconstruction. Talk to your breast surgeon and to your plastic surgeon. Together, the three of you will come up with the right type of reconstruction for you. You can have it done at any time after you complete chemo, so there is no rush. There are breast prosthesis that look and feel like the real thing and help to keep you from being unbalanced during your treatment. There are special mastectomy bras with pockets for the prosthesis. You might want to go that route. Just research, ask lots of questions, demand answers and refuse to be brushed off. Make sure that what you do is right for you.

    Keep in contact.

    Jane
  • tekgal
    tekgal Member Posts: 35
    #3
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    Hi Terri ~ Hope my situation can be of help. I was diagnosed last January w/2 tumors in my right breast (intraductal carcinoma) so had a mastectomy. Then, in June I began the process of reconstruction with a tissue expander for an implant. They opened my scar and placed what amounted to a deflated balloon in my chest. It was pretty uncomfortable for about 3 days. Three weeks after that, I began saline injections. I am a size 36 B, so my plastic surgeon injected a total of 440 CCs of saline over a period of 10 injections. He had to "overexpand" me to get extra tissue. In October, I had my expander replaced with an implant and am VERY pleased. The second surgery was a walk in the park, pain-wise. All in all, the actual expander placement was the worst ... but worth it! Good luck.
  • vjfmseattle
    vjfmseattle Member Posts: 1
    #4
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    Terri, This is my first time on this website. I was diagnosed with ductal carcinoma in November. A lumpectomy revealed extensive DCIS so I'm having a mastectomy on the right breast next week.

    I definately want to have reconstruction but am struggling with the decision about which type. Although the long term results with the free TRAM flap sound best, I'm just not sure I want to sign up for such an invasive procedure. I'm leaning towards an expander with a saline impant. My plastic surgeon tells me he no longer does reconstructions in tandem with the mastectomy --- he prefers to wait 1-2 weeks to give the breast area time to reestablish blood supply and to confirm pathology results (make sure immediate chemo or radiation isn't indicated). He claims to get much better results by waiting this short amount of time.

    I saw a reference in another message about a website with information on reconstructions: www.diepflap.com. I haven't checked it out yet, but thought I would share the website info with you.

    I'd be interested in hearing what you learn and decide to do.

    Victoria
  • terriw
    terriw Member Posts: 4
    #5
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    tekgal said:

    Hi Terri ~ Hope my situation can be of help. I was diagnosed last January w/2 tumors in my right breast (intraductal carcinoma) so had a mastectomy. Then, in June I began the process of reconstruction with a tissue expander for an implant. They opened my scar and placed what amounted to a deflated balloon in my chest. It was pretty uncomfortable for about 3 days. Three weeks after that, I began saline injections. I am a size 36 B, so my plastic surgeon injected a total of 440 CCs of saline over a period of 10 injections. He had to "overexpand" me to get extra tissue. In October, I had my expander replaced with an implant and am VERY pleased. The second surgery was a walk in the park, pain-wise. All in all, the actual expander placement was the worst ... but worth it! Good luck.

    This is the route that I'm thinking of taking, howwever, there are a few things that I need to ask the plastic surgeon. For one thing, the plastic surgeon's office is about 90 miles from our home. I work for a doctor's office and I want to see if they'll let my doctor do the injections. If not, I might have to go the TRAM flap route, although I didn't really want to go through that invasive of a surgery.
  • terriw
    terriw Member Posts: 4
    #6
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    vjfmseattle said:

    Terri, This is my first time on this website. I was diagnosed with ductal carcinoma in November. A lumpectomy revealed extensive DCIS so I'm having a mastectomy on the right breast next week.

    I definately want to have reconstruction but am struggling with the decision about which type. Although the long term results with the free TRAM flap sound best, I'm just not sure I want to sign up for such an invasive procedure. I'm leaning towards an expander with a saline impant. My plastic surgeon tells me he no longer does reconstructions in tandem with the mastectomy --- he prefers to wait 1-2 weeks to give the breast area time to reestablish blood supply and to confirm pathology results (make sure immediate chemo or radiation isn't indicated). He claims to get much better results by waiting this short amount of time.

    I saw a reference in another message about a website with information on reconstructions: www.diepflap.com. I haven't checked it out yet, but thought I would share the website info with you.

    I'd be interested in hearing what you learn and decide to do.

    Victoria

    Hi Victoria,

    I leaning towards the implants also, however, my plastic surgeon is 90 miles away from my home. I have an appointment with him in Feb. and I want to see if my regular doctors would be able to do the injections of saline. If not, I might be going the TRAM flap route.
  • terriw
    terriw Member Posts: 4
    #7
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    jane38 said:

    Hi Terri. I'm 62 and am still in the throes of reconstruction. I had a modified radical mastectomy for my cancer in March 1999. In February 2000 I had a mastectomy on the unaffected side and a bilateral free TRAM flap reconstruction. On Halloween I had revision of the right breast and nipple-areola reconstruction on the left. I still have nipple-areola reconstruction on the right to go and this will be done in either February or March 2001.

    A free TRAM flap is a very hard operation. My surgery took 11-1/2 hours. I was in the hospital for seven days, on very heavy duty pain meds for four of those days. Would I do it again? In a heartbeat.

    The nipple-areola reconstruction is not bad at all except for the incision that is made in the upper inner thigh where the skin becomes darker than the rest of the leg. That is rather uncomfortable but only until the stitches come out.

    I know of one lady who had implants done. At the time of her bilateral mastectomy she had tissue expanders inserted. Later, after chemo was completed she had the implants and then nipple-areola reconstruction. She was not happy with her reconstruction. It looks fine but she thought the process was too long and too many times under anesthesia.

    Look up all the research you can about the various forms of reconstruction. Talk to your breast surgeon and to your plastic surgeon. Together, the three of you will come up with the right type of reconstruction for you. You can have it done at any time after you complete chemo, so there is no rush. There are breast prosthesis that look and feel like the real thing and help to keep you from being unbalanced during your treatment. There are special mastectomy bras with pockets for the prosthesis. You might want to go that route. Just research, ask lots of questions, demand answers and refuse to be brushed off. Make sure that what you do is right for you.

    Keep in contact.

    Jane

    Hi Jane,

    Thanks for all of the great information. I'm thinking of going with implants, but there are some questions that I have to have answered by the plastic surgeon first. Otherwise, I might be going the TRAM flap route. I have had abdominal surgeries before and I'm not even sure that a TRAM flap is an option for me. I have an appointment with the plastic surgeon at the end of February.
  • travelbound
    travelbound Member Posts: 2
    #8
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    tekgal said:

    Hi Terri ~ Hope my situation can be of help. I was diagnosed last January w/2 tumors in my right breast (intraductal carcinoma) so had a mastectomy. Then, in June I began the process of reconstruction with a tissue expander for an implant. They opened my scar and placed what amounted to a deflated balloon in my chest. It was pretty uncomfortable for about 3 days. Three weeks after that, I began saline injections. I am a size 36 B, so my plastic surgeon injected a total of 440 CCs of saline over a period of 10 injections. He had to "overexpand" me to get extra tissue. In October, I had my expander replaced with an implant and am VERY pleased. The second surgery was a walk in the park, pain-wise. All in all, the actual expander placement was the worst ... but worth it! Good luck.

    Need to make a decision. I am having my right breast reconstructed on Feb 2 after a mastectomy and tissue expander and need to decide whether or not to uplift my left breast to make them even. With a bra Im fine and really dont want more scars to my natural breast. Can anyone help me?
  • wandy
    wandy Member Posts: 1
    #9
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    I am undecided about getting reconstruction. I had a right mastectomy 5 years ago and finally have an appoint. with PS but now am apprehensive about doing any type of surgery. I don't heal all that well and I am afraid of pain. I don't mind the prothesis that much only problem is when I want to wear a low cut top or bathing suit. I am not in a relationship and don't plan to be in one. I am 62 years old. Any suggestions on how I can decide.
  • butterflylvr
    butterflylvr Member Posts: 944
    #10
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    wandy said:

    I am undecided about getting reconstruction. I had a right mastectomy 5 years ago and finally have an appoint. with PS but now am apprehensive about doing any type of surgery. I don't heal all that well and I am afraid of pain. I don't mind the prothesis that much only problem is when I want to wear a low cut top or bathing suit. I am not in a relationship and don't plan to be in one. I am 62 years old. Any suggestions on how I can decide.

    HI,
    I went with the tissue expander route. I currently have my expanders fully inflated and I am half way through with radiation. My implant exchange surgery will be down the road. My Plastic surgeon gave me a book on the implant process. Here is a website for the type of implants I will eventually have. The link I am providing will hopefully shed some light on some of your breast reconstruction questions.

    http://www.natrelle.com/breast_reconstruction.aspx#/1/

    Hugs,
    Lorrie
  • csr771
    csr771 Member Posts: 117
    #11
    Options
    wandy said:

    I am undecided about getting reconstruction. I had a right mastectomy 5 years ago and finally have an appoint. with PS but now am apprehensive about doing any type of surgery. I don't heal all that well and I am afraid of pain. I don't mind the prothesis that much only problem is when I want to wear a low cut top or bathing suit. I am not in a relationship and don't plan to be in one. I am 62 years old. Any suggestions on how I can decide.

    DIEP Flap Reconstruction - January
    I had a skin sparring mastectomy of the left breast in January. I decided on the deep inferior epigastric perforator (DIEP) procedure. Now that it has been five months and the healing is well underway, I can honestly say that I am glad that I went with this procedure. I think that reconstruction is a very personal choice. The PS I am with now was my second opinion. I did not care for the first doctor. His recommendation was implants. Since the breast mound is my own skin, I have cleavage and when I wear a bra it does not look too bad. I will more than likely have a nipple put on next year. Right now, I am trying to heal and deal with the fact that I am a BC survivor and have had my breast removed. I am not as far along emotionally as some of the ladies here. I still look in the mirror and see that I am scarred up. It was better for me to wake up from the mastectomy and have something there. I did a lot of research and pretty much knew what I wanted to do. It was the right decision for me.

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