Breast reconstruction-To Do and How?
Comments
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I am scheduled to get a TRAM later this month so have just gone through some of this decision process. Have you seen a plastic surgeon yet? That may help with your decision.
Make sure you are comfortable with the surgeon. The first one I saw left my husband and me with the feeling that there was no good reconstruction option for me. My radiation oncologist encouraged me to get a second opinion. We're glad we did, the surgeon I'm working with now took the time to explain the different procedures and why I was not a good candidate for some.
Bottom line. Due to what the radiation did to my skin, he did not recommend an implant. Said there could be a risk of extrusion (the implant popping out through the skin). He walked us through the types of flaps available and why a TRAM would be his recommendation.
See what type of pre screening the surgeon may want you to have. Mine wanted me to have a cardiac consult due to the chemo and a PET scan. The scan led to a breast MRI that identified multiple microcalcifications in the remaining breast. They can't say the calcifications are benign and there are so many that even if they biopsy a few and they are negative can't guarantee all are negative. So I'm now considering having a simple mastectomy done at the same time of reconstruction (if it's possible - still working that). Just found out about the MRI results 3 days.
Why am I'm telling you all this? Make sure you are comfortable with the plastic surgeon. If he isn't willing to take time during an office visit how do you know he'll take the time in the surgical suite needed to give optimal results. If he doesn't offer, ask if he has before and after pictures of previous patients. Our second surgeon took over an hour talking with us volunteered to show us pictures.
This is a big decision, make sure all your questions are answered. It is your body, do what is right for you.
Hope this gave you some food for thought.0 -
I had a right side mastectomy 2 years ago. So far I have chosen not to reconstruct. I've done alot of research and my personal opinion is the negatives (complications, recovery time, ect.) outweigh the positives. The only type of reconstruction I would consider would be DIEP, which is similar to a TRAM without having to take the muscle from the abdomen. Unfortunately I don't think it's available in my state. Whatever you decide to do, research it. I think alot of doctors have the attitude that it is not a big deal. Also if you belong to a support group you could ask about the experience of other's in the group. good luck!
shelly0 -
Hi travanelli. You've got to go with your gut feelings. I knew from the beginning that I would have reconstruction. My situation was similar to yours. I had a mastectomy, chemo & radiation as well. It was a little over a year when I was reconstructed with a TRAM flap. Right afterwards I was almost sorry I had done it. It hurt like heck!!! It's like having a baby though, you forget a lot. I think any good plastic surgeon will tell you that having an implant under radiated skin is not your best option. Stretching that damaged skin is a risk. Get a couple of opinions, make a pro and con list and do what feels right to you. Good luck.
Susan0 -
This advice is to prevent recurrence and surgery again. There is a promising new drug therapy called Herceptin developed by Genentech. Your physician should order a lab test to determine eligibility for Herceptin treatment. The test kit is called "Her-2/neu antibody test kit". They take a very tiny sample of tissue and run the above test. If you have questions please feel free to call me at 925-963-6983.0
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I had a bilateral tram immed after my mastectomy. I opted for both for symmetry and because I had a cancer that was likely to recurr, and had already had a lumpectomy in the other one. Also, I am est/prgten neg.
I would have done the diep if it had been available in my area to save my ab muscles, but, I do not regret have reconstruction.
Do be sure that you like and trust your plastic surg. good luck making your decision. Jan0 -
The Center for Reconstruction in New Orleans is SO helpful! You owe it to yourself to at least visit their website and look at what they are doing. I just hate the thought of muscle getting cut out of your body if you don't have to go that way. The Center for Reconstruction helps make travel plans, offers a place right in the hospital for patient' families to stay and even meets you at the airport to bring you to the facility- also returns you to the airport after surgery. It may be a hassel to travel- but I live in Pennsylvania and I stumbled on them through my own quest to find a reconstruction that didn't seem more destructive than beneficial... and I am traveling to New Orleans this July to have my breasts rebuilt. ( I am 37 and had surgery this December to have my breast removed....) They are very helpful and accomadating... you could just check them out. Miashelly65 said:I had a right side mastectomy 2 years ago. So far I have chosen not to reconstruct. I've done alot of research and my personal opinion is the negatives (complications, recovery time, ect.) outweigh the positives. The only type of reconstruction I would consider would be DIEP, which is similar to a TRAM without having to take the muscle from the abdomen. Unfortunately I don't think it's available in my state. Whatever you decide to do, research it. I think alot of doctors have the attitude that it is not a big deal. Also if you belong to a support group you could ask about the experience of other's in the group. good luck!
shelly0 -
Dear Trav -
I want to also encourage you to check out ALL your options before making a decision. There are some great websites that explain the various tissue transfer surgeries -- if you have trouble finding them, feel free to email me and I will drag some of the websites to my reply to get you going. I also encourage you to go to the DiepSisters website -- there they maintain a list of recommended (by happy patients) drs all over the country who successfully do the tissue transfer surgeries. Perhaps you will find other drs who will tell you that you can have a DIEP or GAP (both of which are less invasive, have less complications and are easier to recover from) instead of a TRAM.
Remember that it is generally best to take your time, research out everything you can and ask every question (there is no dumb question when you are considering surgery).
Regards,
Linda0
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