prosthesis versus implants

It's an individual choice. I had an immediate implant (no expanders) during my unilateral mastectomy. The only problem was that I had radiation afterwards. The implant shrunk and my 1st plastic surgeon's answer to that was to replace it with another implant and then later inject fat to round it out. She had already done the nipple reconstruction. (don't get that done until you're absolutely sure you're done with reconstruction). The replacement implant pushed the new nipple up too far. She lifted my other side (twice to try to achieve symmetry). What I found out after going to a new plastic surgeon and reading more on the subject is that implants after radiation don't always give the best results. The skin can become so tight, it will only stretch so far. My new PS relifted my other side a 3rd time and I had much better results. Because I was so pleased with his work, next week I will be having a lattissmus dorsi flap. He will cut out the reconstructed nipple and I will have healthier skin, muscle and tissue across my breast which should give me better results and shaping. I may have to have an expander put in if my plastic surgeon doesn't like the results with an implant at the time of surgery. I really trust this doctor. He spends so much time with me talking about all of my options and listens to me. My first PS wasn't like that at all.

Having said all of that, I will end up having at least 2 more surgeries than I should have had. However, reconstruction is not necessarily a one shot surgery. Expect revisions. I didn't know this going in and wish I had. I don't expect to have perfectly matched breasts- it won't happen. However, I shouldn't have a nipple on the top side of my breast either! I'm getting close to 3 years from diagnosis and will be glad to get my reconstruction done! 

This is just my experience. I'm sure you'll hear many more! 

Hope this help!

Clementine_P said:

Implants for me

Hi Crissy,

So sorry you are going through this.  Just keep in mind that there is a light at the end of the tunnel and you will be okay.  I had expanders and then after I finished chemo I got implants.  For me, the surgeries were easy as was recovery.  Since I was 40 at the time, I felt that I wanted to get the implants and the nipple surgery and tattoos as well.  I wanted to feel as put together as I could.  I don't regret any of it.  I will say that when I was in the period with only the expanders I could completely see going with a prosthesis instead of going through another surgery but in the end I am really happy I went the route I did.  It worked for me.

Feel free to ask any questions here.  Nothing is off limits.

Best of luck,

Clementine

did you have Radiation? I have a left side implant and need to begin my radiation - doctors had said it was safe to have the surgery before but now i'm hearing horror stories about the radiation thining out the skin so that it no longer holds the implant - causing you to need more surgery.

having the expander in for 6 mos, for me, was difficult, but now think that was because of the lymphnode surgery. And it is pretty amazing that there can be a "breast" again.

good luck! it certainly is a journey!

Sue K 

Crissy K said:

prosthesis vs implant - with radiation

I will have radiation.  So far, if during surgery they confirm lymph nodes aren't affected, I won't need chemo. 

Implant survivors, did you have silicone, saline, or body tissue for implants?  I read that temporary implants expand the chest muscles, then a permanent one is put in (at least for saline and silicone).  Silicone doesn't sound good if it leaks.  Saline can go flat if it leaks and then it has to be replaced.  I see the plastic surgeon tomorrow so I'll find out if I do radiation before permanent implant.  He seems very recommended around here so I think I am in good hands.

My other breast will have to be reduced (or prophilactic mastectomy and implant) at least since I am large-breasted.  So I'm wondering if it's easier to have a prosthesis, or if I will get frustrated in dealing with it the rest of my life.

Hi Crissy,

I had silicone.  I was told that silicone is best for people like us - without any breast tissue.  That it doesn't ripple and is softer to the touch.  I am not and was not large breasted so I can't answer that part of your question.  I had temporary implants (a/k/a tissue expanders) put in during my mastectomies surgery and then after chemo had those swapped out for my silicone implants.  The expanders get filled periodically with saline to stretch the chest muscles to make room for the implants.  Then when you are filled and ready for the swap, you have another surgery.

I hope this helps.

Clementine

I decided not to do anything more than the double mastectomy.  I did not want extra surgery or recovery.  I also was aware that sometimes there are problems that arise.  My husband was in agreement with my decision.  I did not want to be taking more time away from my "regular" life than I had to.  As it was, surgery/recovery, chemo, and rads took about nine months of my life.

I have fakes.  For the moment, I have good insurance which paid for what I needed.  I think I can replace the set (and two bras) once a year.  One of my DRs writes the script.  I went to a fitter my Cancer Navigator recommended.

No, I don't always wear them.  I have figured out how to dress so it is not obvious when I have left my "bosom buddies" home.  ( I am an educator.)   I can see the humor of my situation.  My husband, as well as friends and family, have some good laughs sometimes.

My journey began two years ago.  I am getting more and more used to my new look.  Although I know I can change my mind, I won't.  It just isn't worth it to me.  

It will be 20 years in September that I have used prosthesis.  For me it was the right choice.

The only problem is that on a very hot day, they can be tiresome.  I live in the Northeast and truly we might have a week of very hot weather.  During that time, if I am home, I don't wear them.

Best to you as you make your choice,

Doris