Reconstruction confusion

seof
seof Member Posts: 819 Member
edited March 2014 in Breast Cancer #1
OK, those who have "been there, done that" I would like to hear the voice of experience. I will be having a mastectomy in December. Doctors are saying there are no factors indicating that a double mastectomy should be done, but I am concerned about the 10% chance of recurrence I still have and how easy it will be to match the other side when the reconstruction is done. I would also like to hear advice/experience about implants versus Tram or Lat flap. The limited research I have done seems to indicate that a bilateral mastectomy would make it easier to make a more symmetrical appearance. Of course, I have yet to check with or insurance to see if the bilateral would be covered, since Drs. are not saying it's necessary.

Thanks in advance for sharing
seof

Comments

  • newboobs
    newboobs Member Posts: 121
    ok seof you asked-- this may be WAY tmi, but here goes. I had a mastect. on the right side with saline implant. That breast area, most of my underarm, back of my arm and a bit of my shoulderblade area are numb- it's not a big deal in everyday life, but it does bother me as a "woman." I had a reduction and lift on the other side at same time as mastect-- that side is great -- about 95% sensitivity. Mine slightly don't match, but I wear a bra with slight padding and I'm good to go :-).

    Hope this helps....hugs to you and prayers for the best decision for you!
  • Future
    Future Member Posts: 133 Member
    Seof,
    I had a right mod radical mastectomy in 2003; in 2005 when getting tests prior to reconstruction tests results on left breast were questionable so opted for simple mastectomy on the left with saline implant. Doctor's didn't say I should or should not go with the simple mastectomy when I was deciding, but after the surgery they did say they thought I made the right decision. Right side was dorsi lat flap with implant but due to infection implant was removed. So......if you are considering a lat flap realize that if saline implant has to be removed you will probably have a small(er) breast just because limited amount of bulk available. I had radiation on the right side and think the problems I have on that side are really related to the radiation. I did light weights and push ups prior to the surgeries and how much I can do now is pretty close to what it was in 2003.

    Hope this helps
  • Skybuf
    Skybuf Member Posts: 143
    seof, here is my take and experience. I had a radical mastectomy Dec 2005, chemo and radiation, 19 lymph nodes removed, 17 malignant so I had no choice but to have the mastectomy. I am a DD cup and the prostethis I wear is very heavy and bulky and does not match, Swimming is another story with the larges size (C) cup form for mastectomy bathing suits. I looked into reconstruction, and have another appointment November to see the Plastic Surgeon, they wanted to do the flap thing but due to radiation and dead skin cells they said it would most likely not take, I seen pics of others and didn't like the results, so for ME I am opting to have another mastectomy on the R side and getting two forms after "smaller ones" not so heavy. It's a personal dicision but one I can live with. If I was 30 again I probably would go for reconstruction but I am 59.
    God bless you and help you make your dicision.
  • anet
    anet Member Posts: 12
    Hi seof,
    I had DCIS on one breast with no node involved. I first had lumpectomy, but the margins kept coming back positive, so on the third try, I had mastectomy and decided to remove my other breast because it would give me more peace of mind and also because they said I would not need tamoxifen or any other drugs (if I removed both).
    I just had my expanders replaced with saline implants in July. I am doing fine. I do not feel much but it is still a little uncomfortable at night but I can live with that. I did not want any other reconstruction option because I was concern about recovery and muscle strength. I was an A originally and now a B cup...not heavy at all.
    I think I had to go through the lumpectomies first...I was not ready for mastectomy at first...
    Wish you the best of luck!!!
  • cabbott
    cabbott Member Posts: 1,039 Member
    I had multifocal ductal carcinoma on the right, no node involvement, and had a right mastectomy without reconstruction. I debated having the DIEP flap reconstruction, but after feeling a prosthesis and seeing how okay it felt, I opted for the prosthesis and no reconstruction. I was an almost A cup to begin with so the prosthesis was light and easy to wear. I thought it would preserve more nerve function to have less surgery and that I would recover faster. It is a bit of a bother selecting the right swimsuits (Landsend helps in that department) and there are a few other fashions I can't consider wearing, but for the most part I don't have any problems or concerns. I was able to reach above my head within 30 hours of surgery and I was back to work in less than 2 weeks. I have plenty of nerves left though the strip that was stitched is numb and some of the other nerves react differently than they used to. I worry about the other side when I have mammograms, but it has been 5 years and nothing has happened over on the left yet. They are keeping a close eye on things as I am at high risk, but meanwhile I have the pleasure of one breast with normal nerve functioning. You will have to decide if you can sleep at night if you keep your breast. Also look into DIEP and SIEP flaps if you are near a large city with breast reconstruction experts. Only about 10 to 20 centers offer these options, so I am told, but they offer faster recovery and less body insult than the Tram flap. If all goes well, they do not need to be replaced like the implants might. The Susan Love site has information on reconstruction decision making I found useful. Good luck!
  • newboobs
    newboobs Member Posts: 121
    anet said:

    Hi seof,
    I had DCIS on one breast with no node involved. I first had lumpectomy, but the margins kept coming back positive, so on the third try, I had mastectomy and decided to remove my other breast because it would give me more peace of mind and also because they said I would not need tamoxifen or any other drugs (if I removed both).
    I just had my expanders replaced with saline implants in July. I am doing fine. I do not feel much but it is still a little uncomfortable at night but I can live with that. I did not want any other reconstruction option because I was concern about recovery and muscle strength. I was an A originally and now a B cup...not heavy at all.
    I think I had to go through the lumpectomies first...I was not ready for mastectomy at first...
    Wish you the best of luck!!!

    Anet- for sleeping, get one of those long body length pillows- it works great!
  • pmillr2000
    pmillr2000 Member Posts: 26
    I had DCIS, left breast. As the right side was not involved, I had only the left breast removed. The first plastic surgeon botched the reconstruction in a major way, and I've just had it redone. 1st time around I got a saline imlant on the left side, reduction & lift on the right. I found the saline implant to be HORRIBLE (could have a lot to do with the surgeon) and he got carried away with the reduction so my right breast was about half the size. The new surgeon replaced the saline implant with silicone and put in a small silincone implant on the right to bring it up to size. They don't match exactly, but they're much better and I think I'll be very pleased with the results when everything is all healed. I have wondered MANY times if I shouldn't have gone ahead and done bi-lateral, both for the peace of mind, and for better reconstruction results. I'm glad you're at least looking into it before making your decision. I didn't. I don't know if I would have decided any differently, but I'll always wonder.