which reconstruction

ohilly
ohilly Member Posts: 441
edited March 2014 in Breast Cancer #1
Hello, group. It's ohilly. After much going back and forth, I have now decided to definitely get a mastectomy (I was leaning toward this anyway). So now I am going to focus my questions on the different types of reconstruction, which I understand are tram flap and implants. Can someone tell me their experiences with both of these? What was the recovery time? How did the reconstruction look? Were there any complications. Your answers would be appreciated because I have to decide soon. Thanks. Ohilly

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  • seof
    seof Member Posts: 819 Member
    #2
    Each step of this process has new fears and new decisions, doesn't it? I have had a bilateral mastectomy. My plastic surgeon put in expanders to keep the skin from shrinking to a flat chest because I knew I wanted some kind of reconstruction. I will have to wait to finish chemo and radiation, then wait till the tissues heal up and "settle" after radiation, so my reconstruction may not be for another year. I have plenty of time to research my options. What I know so far is:

    Implants: faster, easier surgery and shorter recovery, usually have to be redone after a number of years (it varies by individual, I've read between 5-10 years). My plastic surgeon says think of it like tires on a car, they all wear out and have to be replaced, or they leak, or something. Routine exams with implants are ultrasound, no mammograms.

    Using your own tissue: surgery is harder and recovery is longer because you have 2 sites that have to heal (breast and donor site...bilateral doubles the trouble) but rarely have to be redone. Can continue to have mammograms for routine checkups.

    TRAM flap procedure: Uses muscle and fat from abdomen, stays attached at upper side, tissue is pulled up under the skin to create new breast. This is one of the oldest "tried and true" methods, so more Drs and facilities offer it. It uses more muscle tissue than other methods. Thin women may not be good candidates, or women with lower back pain. Because the flap is attached at the top, it is quicker because the surgeon does not have to attach as many blood vessels. Recovery from this is usually longer because more tissue is moved from the donor site.

    DIEP flap (and some variations of it with other names): A thinner layer is removed from abdomen, completely detached. Takes longer because Doc. has to attach blood vessels, but recovery is easier because less tissue is removed from donor site. Newer method, not as many Drs. or facilies have experience with it.

    LAT flap: Like TRAM, but flap comes from back of shoulder blade area.

    Again, Talk to your plastic surgeon, look on MD Anderson, ACS, or other reputable websites. I ordered the book, "The Breast Reconstruction Guidebook" by Kathy Steligo. The website in the book is www.breastrecon.com. I have found it to be very informative and easy to read.

    You will make the best decision for you. seof

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