prostheses or implants?

Kathh

Hi. I'll be having a bilateral mastectomy and am wondering how any of you who have used prostheses have found it to live with them. A friend of mine says that hers causes her to sweat often and itch constantly. Is this typical? I'd never heard of this before. Hopefully some readers will be willing to share their experiences, for which I'll be most grateful.

I've had radiation on one side. I was initially thinking I'd get implants, but the surgeon explained that the radiated skin could heal differently than the nonradiated skin and cause asymmetry; he also mentioned the possibility of further surgery to correct problems arising from poor healing of the irradiated skin and also a possible eventual replacement should the implant leak. In my opinion, avoiding future surgeries sounds like the best option since I'm just recovering from shoulder surgery. But if anyone has thoughts or experience with having implants after radiation, I'd love to hear about that, too.

Thanks, all! This is a wonderful site - so glad I discovered all these helpful voices.

mmontero38

Hi Kathh.
Because I had no time to look for a reconstructive surgeon right away I elected to do my reconstruction after my mastectomy and all the related treatments were over. Luckily, I did not have to have radiation but I went through 6 rounds of CAF. I am currently wearing a prosthesis and to tell you the truth they are not that great. They are not necessarily comfortable, unless you have pockets sewn into your bra or buy special mastectomy bras, they are always shifting. It just seems to me as if you are forced to wear mastectomy undergarments for the rest of your life which are not necessarily inexpensive even if your insurance covers part of it. You still have to meet your deductible etc. In reading through a lot of the survivors comments it seems that there are more possibility of problems on the radiated side. Did you ask your doctor about doing the tram flap? I am currently interviewing plastic surgeons to do my reconstruction. I am more inclined to go with the tram flap then I am to insert implants. Check again with your surgeon and see what he says. Also, google breast reconstruction and it will give you some of the resources we have available before making any decision. Keep us posted. Lili

cabbott

mmontero38 said:

Hi Kathh.
Because I had no time to look for a reconstructive surgeon right away I elected to do my reconstruction after my mastectomy and all the related treatments were over. Luckily, I did not have to have radiation but I went through 6 rounds of CAF. I am currently wearing a prosthesis and to tell you the truth they are not that great. They are not necessarily comfortable, unless you have pockets sewn into your bra or buy special mastectomy bras, they are always shifting. It just seems to me as if you are forced to wear mastectomy undergarments for the rest of your life which are not necessarily inexpensive even if your insurance covers part of it. You still have to meet your deductible etc. In reading through a lot of the survivors comments it seems that there are more possibility of problems on the radiated side. Did you ask your doctor about doing the tram flap? I am currently interviewing plastic surgeons to do my reconstruction. I am more inclined to go with the tram flap then I am to insert implants. Check again with your surgeon and see what he says. Also, google breast reconstruction and it will give you some of the resources we have available before making any decision. Keep us posted. Lili

Hi Kathh,

I do not have a bilateral, but I do have a right mastectomy. I am built fairly small: 34 almost B. Wearing a prosthesis for me is no big deal. I was given 2 lounge bras with pockets from the hospital. For the first month or so I had to use polyester batting. Then I graduated to a real silicone prosthesis and mastectomy bras. I was in my mid-forties then and really didn't have a problem with the new bras. They run more expensive: 30 to 40 dollars each. But my insurance picks up most of the cost of a new prosthesis every two years and the bras come under my mediflex program. That's a big discount. I don't get bothered by sweat or weight, but I think that is because I am not large. I have heard from folks with a D cup that life is different for them. (Shucks, when I was walking back from post-op neither the nurse or I could tell if they removed the right breast without peeking under my robe! Fortunately they did!) I have to be careful about not wearing really low cut necklines and the selection of swimwear is limited. But I always find plenty to wear and it never stops me from going to the beach. I'm okay with how I look, but I know it's not for everyone. For me less surgery was important. But you might look into the tram-flap or tram-free flap. That kind of reconstruction might compensate for the skin and circulation problems that can occur after radiation in certain areas. You would have to talk to a really good plastic surgeon to determine what other choices are out there and which are best for you. You can wait as long as you need to before doing reconstruction, though some hospitals are set up to do it when you first have surgery. One of my friends was unpleasantly surprised to find out she had to wait because she had to have radiation afterward and the plastic surgeon didn't want his operation to possibly fail. She could still have reconstruction, but a different kind and at a different time. I consulted the Susan Love website to read about all the choices. It is worth a look-see just to give you an idea of what reconstruction choices are out there. I'm sure you will make the right choice for you.

seof

I had double mastectomy Dec. 21 and had spacers installed by the reconstruction surgeon with the expectation that I will be doing reconstruction surgery after radiation. The spacers are like temporary implants which prevent the skin from shrinking, making reconstruction more difficult because it will have to be stretched back out again. I considered prosthesis or implants before my surgery, and here is my personal opinion as it applies to me: Prosthesis: pro = the surgery for the mastectomy is simpler and quicker to recover from without the spacers being added. Con: forever after I would have to look at myself without breasts and I would have the trouble of being sure the prosthesis fit and stayed in place. Implants: You've got the more difficult recovery with the spacers (unless the surgeon can go ahead and put them in, which she can't for me because of the radiation), but you dont have the cons with prosthesis. Con = all I've read and all Drs. agree that implants must be replaced at some point (5 years, 3 years, 10years...depends on who you talk to). Reconstruction using my own tissue: con = an extra surgery which means extra recovery time. pro = almost no chance that my body will reject it, and I have not heard of it having to be redone. It is a long process, especially if radiation or more chemo is involved, but it is not a bad trade-off...several months of treatment/recovery for several years of good health and long life!

Do your research and make the decision you feel best about. seof

Unknown

Hi Kath.
I lost one breast in '86 and the other in '88.
No way was I going for more surgery, so I have worn prosthesis ever since.
I have tried different kinds (silicone, which mock the weight of a normal breast, and foam, which are virtually weightless). I have settled on the foam because the weighted ones caused pain in my neck and shoulders. Apparently my muscle structure is not what it once was in that area.
At any rate, I believe the BRA is as important as the prosthesis itself. Be sure you get one with COTTON pockets. This helps with the sweating and itching. Also, look for wide adjustable straps. And be careful to get the right size... you may need to try on several...don't assume that your original size still works.
Well, it's been all these years now and I hardly notice that I am not 'attached' to my boobs any longer. It is an adjustment but we do what we have to...we are WOMAN! God bless.

cabbott

unknown said:

Hi Kath.
I lost one breast in '86 and the other in '88.
No way was I going for more surgery, so I have worn prosthesis ever since.
I have tried different kinds (silicone, which mock the weight of a normal breast, and foam, which are virtually weightless). I have settled on the foam because the weighted ones caused pain in my neck and shoulders. Apparently my muscle structure is not what it once was in that area.
At any rate, I believe the BRA is as important as the prosthesis itself. Be sure you get one with COTTON pockets. This helps with the sweating and itching. Also, look for wide adjustable straps. And be careful to get the right size... you may need to try on several...don't assume that your original size still works.
Well, it's been all these years now and I hardly notice that I am not 'attached' to my boobs any longer. It is an adjustment but we do what we have to...we are WOMAN! God bless.

Cotton pockets are good, but I have also found ones with cool max pockets (like what athletes wear while running to stay cool). Cool max are good too!

24242

My fight over 10 years ago and eventually had second breast removed after a year of more lumps.
I had always thought I would have reconstruction or implants but 10 years later still without. Due to complications that I had during surgery which does come with its own set of risks I finally accepted my body and life without breasts and am finally comfortable in my own skin. I couldn't see taking any more risks than necessary with the surgery thing and found I was comfortable once the loneley old breast was removed. I have found dark colours hides the flat chest well and am very glad for the coarse of action I have taken. Just my experience to add to the others.
Being good to yourself first is most important and doing what you need to do to feel good about yourself.
Tara

3cbrca

I had a bilateral and was supposed to have expanders, but my plastic surgeon called in sick (lost his vision) that day so we went ahead without them. I have been wearing the prothesis and they are like strapping bowling balls around your neck! and they hurt my lymphedema. I have had one plastic consult and she won't do straight implants because of the RT. I have an appt Tuesday with another Plastics and I have a feeling that I will get the same recommendation - latisimus dorsi flap which is a big, big surgery and I'm not sure I'm up for it. I've allready ruled out the "tummy tuck" DIEP because of the risk to the loss of abdominal muscle and back support...
she

Skybuf

Hi there. I will be having my bilateral mastectomy Jan 28th....I have been living with a heavy DD prosthesis and like others it's too heavy to wear. Like 3cbra said, it's like having bowling balls around your neck. I too developed lymphedema in my L arm and a heavy prosthesis dosen't help. I am looking forward to having this thing off, no more mammos and less chances or reocurrance they say. The biggest problem for me is the weight, no sweating or itch here. I am looking forward to wearing nicer bras with two 'light' prosthesis that stick on.
I'll be posting after my surgery....only a few weeks away! yikes