waiting for reconstruction??

pamelaa · May 2003

Help! I'm having a bilateral masectomy in a few weeks for lobular carcinoma in situ. I lost my younger sister 1.5yr ago at age 40 to infiltrating ductal so have opted for surgery with tamoxifen. My surgeon is upset that I don't want reconstruction at the time of first surgery. My plastics say wait and there will be less chances of complications and a better end result. Always been an A so not too upset! Gonna be at least a B when I'm done!!!hahah anyway, I'm 45 yo tomorrow and with a very suportive husband. I'd like some input from those who have been there! Pam

raku · May 2003

Hi Pamelaa,
I had LCIS too, plus DCIS. Like you, I opted for the bilateral masectomy. I wanted immediate reconstruction (implants) but had to wait because I had a terrible infection that they originally thought might have been breast inflammatory cancer(ruled out later via biopsy). From what I understand (consulted plastic surgeons and oncology surgeon) there is more skin to work with if you have reconstruction done at the time of surgery. I waited six months before starting reconstruction. After my masectomy I was glad because I hurt like the dickens and couldn't imagine tolerating expanders when trying to recover. My chest was really tight from the scar tissue and the plastic surgeon had a really hard time getting the expanders in.

Of course, there are advantages and disadvantages to both...immediate reconstruction versus delayed. If you have it done all at once then it is one less surgery. I've had three operatons in one year and sometimes I look at people I known for a while and say to myself "Hey, I should know that person's name but can't remember".

Some women like to wait in case there are complications from the masectomy. Also, there is so much to think about when deciding what to do about the cancer that having to think about reconstruction is overwhelming. Decidng what type of reconstruction is a very big deal. One advantage to waiting was that it gave me more time to find a plastic surgeon I was comfortable with. I read somewhere that we spend more time checking out tires for our cars than we do plastic surgeons. That had a big effect on me and I searched and searched to find one that 1) took the time to listen to my concerns 2) made me feel she could get a good result 3)was able to explain in language that I could understand the pros and cons of each type of reconstruction for my body type. So for me waiting turned out to be the best thing although at the time I was disappointed I couldn't have reconstruction right away.
Happy Birthday tomorrow! Glad to hear you have a supportive hubby :-) Take Care.

minnie112256 · May 2003

Hi Pam,
I went through the same desision last nov. My oncoligist wanted me to wait and my plastic surgeon wanted me to do it right away. I had a tissue expander put in at the time of my mastetomy. I am glad I did. I started having it filled about 3 weeks later and now my implant is in and I am done. It was a hard desicion especially when I was still dealing with the cancer but in the long run I think it was the right thing. My implant looks great and I am happy with it. You have to decide what is best for you but my feelings were the sooner I did everything the sooner I could get back to normal(whatever normal is LOL). Good luck and God bless you.

5656 · May 2003

HI, MY NAME IS BARBARA I AM 35 AND I HAD A DOUBLE MASECTOMY AND RECONSTRUCTION AT THE SAME TIME. I HAD CANCER WHEN I WAS 18 YEARS OLD AND DO TO THE TREATMENT I HAD I GOT BREAST CANCER.
I DO NOT NO IF I SHOULD OF WAITED BUT I HAVE HAD 2 EXTRA SURGERYS SO FAR. I HAVE HAD ALOT OF PAIN AND I REALLY DONT NO HOW I SHOULD BE FEELING AND IF IT IS RIGHT. MY DR. IS STILL FILLING UP THE INPLAINTS AND
I HOPE THAT EVERYTHING GOES GOOD FOR YOU. BARBARA

DeeNY711 · May 2003

Hi, Pam! I had bilateral mastectomy 2/20/03 and opted not to have reconstruction at the time of surgery. I wanted the healing to be as quick and uncomplicated as possible before beginning chemotherapy. Second reason had to do with the surgery itself being enough without additional hours on the operating room table under anesthesia for the reconstruction part. My primary goal was to attain the best possible outcome as far as the cancer went, and the choice I made was best for me. The radiologist who will be doing radiation therapy after the chemo explained that the remaining skin (which is quite tight now) may be leathery and inflexible following radiation treatment, likely to limit reconstruction options and outcomes. I can live with that. By the way, I had bilateral mastectomy on a Thursday and went home the next day, happy with how I managed to get around and navigate activities of daily living far better than I would have thought possible. Since you are the one who has to live with the consequences, make the decision that seems best to you. Hugs, Denise

iris48 · May 2003

Hi Pam,
I chose skin saving bilateral mastectomy with expanders place in at the same time the mastectomy was done. The process allows for the expanders to be filled slowly to your bodies tolerance since you are stretching your skin to permit the final implants. The expanders are then removed and the saline implants are slipped in and filled. Depending on your body frame, skin tissue available and how well it stretches will help determine which cup size you wind up with. The process is uncomfortable and takes determination to go through with. However, my final results are symmetrical, cup B and natural looking, used my own skin from center of reconstructed breast mounds to make nipples and they were tatooed which looks very real. I have a lot of feeling in new breasts which was surprising to me. I call the new breasts, "my girls." They are different from my original ones but look very normal and makes dressing easier. Today, I swam for the first time in a long time and was thrilled everything was working - no pain anywhere. Happy Birthday and good luck to you whatever you decision.
Hugs, iris

blossomtime · May 2003

I had a left mastectomy in june 2002 with tissue expanders at time of surgery. I finished chemo in jan 2003 and radiation in march. I have seen my plastics surgeon since completing treatment and looks like my skin tolerated radiation well. I am scheduled june 11 for my saline implant and a lift on the right side. For me it was the right decision for immediate reconstruction. I feel it helped my self image immensely. One of the major reasons I chose tissue expanders was the extended anesthesia time needed to do tram flap. I have never regretted that decision. Good luck to you. Will be keeping you in my prayers.

FresnoD · May 2003

Pam,
I am 44 years old and had a bilateral mastectomy on April 16 with reconstruction using tissue expanders. Surgery only took 2 1/2 hours and I would have gone home the next day if I didn't have problems with nausea. Every 2 weeks the doctor has been filling the expanders. It is quite painful because it is so tight but I am really pleased with how everything looks. It is an amazing process and I am really glad I did it at the same time I had the mastectomy. As it is there are several surgeries involved so it is 1 last surgery if you do it at the same time. Everyone is different but I have no regrets about doing it at the same time. Good luck.
Diane

Unknown · May 2003

So glad you are all sharing. I made my first consultation apptmt in a month. Thinking about a saline implant. How long on average are you living with expanders? And what do you do while they are in with bra - etc. Live lopsided if you have one breast? I don't think my prosthesis fake boob would be useable then would it? Thanks!

raku · May 2003

unknown said:
So glad you are all sharing. I made my first consultation apptmt in a month. Thinking about a saline implant. How long on average are you living with expanders? And what do you do while they are in with bra - etc. Live lopsided if you have one breast? I don't think my prosthesis fake boob would be useable then would it? Thanks!

Hi Getupandgo, I had surgery to put expanders in last December. My plastic surgeon is taking it really slow. I get expanded approxiamately every 6 weeks. Right now I am on hold because I have a lung infection and she told me that if we did an expansion (add fluid) while I had an infection that we might encounter an infection to the expander site and then would have to take them out and start all over. That made me sit up and take notice. So I'm in a holdong pattern right now.
Some women are able to get quite a bit of fluid put in the expander at the time of surgery and just need a few follow-up visits to get the total expansion. Must be nice:-)
My surgeon had a good way of explaining it to me. She said some women need a longer time to let the skin stretch...like a pregnant woman needing 9 months to stretch for the baby. So I carry that image in my head. Giving my chest lots of time to stretch out.
As far as bras go I had to get new ones. Old ones were totally useless in my case. I wore my Reach to Recovery bra alot because what ever size I was it fit. I also got two others that fit around the torso but not the cup so I would have room "to grow" (hah!) I had prosthesis too and was unable to use them once the expanders were put in. At first, right after surgery they would have fit but I was too sore to use them. By the time I could have used them I was too expanded out. I had a bilateral so I would continue padding my Reach to Recovery bra until I was able to get by without the extra filling.
Bye for now.

waiting for reconstruction??

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