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Reconstruction doubts

23 REPLIES 23
Member

Re: Reconstruction doubts

Hello Alyson,

After waiting a year after surgery and radiotherapy I had decided on an implant but then my surgeon told me I couldn't have one as there is now no skin in which to put it, if you see what I mean. He said the radiotherapy meant that it was not possible to stretch the skin to accommodate an implant. So the only choice would be a diep flap, which I'm 'happy' to go ahead with. So I don't know if you can have a skin graft or something but it wasn't an option offered to me. Good luck with it whatever you decide on!

Member

Re: Reconstruction doubts

Hi Delly

I have just read your post and wanted to say thanks. I had a single mastectomy in October last year, and I have just seen my surgeon about recon, at first I thought diep flap but I’m not sure I can put myself and my family through that. So I am now thinking of breast implant and reduction to my normal boob as it’s a 30JJ! You spoke very wisely and it was good to hear from someone going through it. I have to wait 12 months after my last radiotherapy so surgery will be in the new year! 

Take Care

Alyson xx

Member

Typical Me - I was just surprised, but pleased your appoi...

Typical Me - I was just surprised, but pleased your appointment came up so much more quickly than you expected.

I'm all with Evie on the age thing. I'm now 60. Was 55 when finally embarked on bi-lateral delayed implant recon, following masts at 47 and 48, so yeh, many years delayed, just due to other unexpected life's brown stuff, that can come along. And hence why I'd have been faaar happier having immediate recon same time as masts. Would have all been done and finished long ago. And why I would always advise anyone to have immediate if poss, obviously dependent on whether radiotherapy was required, and its effects on the skin, as with yourself, as to whether it be possible.

Again, I don't have any issues about or with infection. Have had none throughout both masts or expander installation (sounds like a boiler!! Smiley Very Happy). Of course there are risks of infection with ANY op. They have to warn us. But, I have to say, Typical Me, I'm a little surprised at your BCN almost "dwelling" on infection, from what you're saying, rather than being supportive to you for recon. Would that be something to do with you being Celiac perhaps??

Mystery Mouse mentions a lady in her 70's awaiting "self tissue" recon - Very brave, self tissue at her age, because, both you're healing and infection fighting abilities tend to reduce with age. But, Wow, good for her, I say. Blummin Brill in fact.

Also Evie's attitude "I don't think ANY age should be a barrier to having reconstruction" and "you can be grateful to be here and STILL have recon". How succinct is that. At the end of the day, TM, it's whats going to make you feel happiest and the most comfortable with your body, after such an awful, and what is frankly a "maiming" physical experience with a mastectomy (I certainly felt "maimed" after my 2nd mast), as well as the mental trauma of course, for what you have left of your life. And yes, of course, there are plenty of women, for whom it isn't such an issue to be without and "choose" to remain flat. Are okay with it, as have posted on here. That's great also. 

Is it vanity? Well what if it IS? So what!  Many years ago, we wouldn't have had the option of reconstruction, would we?  But . . . Why has it been more and more developed? It's gone from delayed "basic" stuck on implants, to tear drop shaped, to "immediate" implants same time as mastectomy, to give an immediate replacement of what was lost. Then to all the different areas of the body to have "self tissue" recon from - tummy, back, buttocks, inner thighs. Then Strattice slings developed for implants, for a more natural look/finish when moving ones arm. Why?? I can only presume because so many women would rather have an integrated bodily replacement, than just a prothesis, otherwise such methods wouldn't have been developed, would they??   

If the option's there, and it's possible with what other treatment effects have had on your skin, why the heck not, I say. 50 is NO age these days, neither is 60 any more. You may live on to 70, 80, 90+, who the flip knows. But surely better, with what makes you feel happiest.

And T.M., as I said before, I was massively impressed with what your oncologist said to you about implants, he was actually wanting and wishing to set your mind at rest. Sounds a good 'un to me. Please do keep us informed, will you. I'm very keen to hear.

Evie - That's great you've made an appointment to check out your possibilities - No harm hey, just a bit of time to give up, but that could possibly give and bring you happier results. I hope it IS simple to rectify for you, and if so, you go for it, darlin girl. Again, I'm so interested to hear.

 

Loads of love to everyone, Dellypoos, xxxxxxxxx

 

 

 

Member

Re: Reconstruction doubts

Hi TypicalMe and Delly

Sorry I missed your earlier message TypicalMe to say you have your pre-op booked on Tuesday. Delly always gives great and reassuring advice, so I’ll see if I can add anything extra.

It’s very normal to question whether you need or want further surgery, especially in the run up to it. As you will have seen, I had decided not to have further surgery to change my implant for a smaller one - but having listened to Delly’s points I’m going to rethink that (and have just booked an appointment). I had surgery when I was 49, so same as you. It is a very personal decision, I don’t think any age should be a barrier to having reconstruction, it’s how you feel about it, there is no right or wrong answer. I get what you are saying but you can be grateful for being here and still have a recon. There’s no need to apologise for offloading, that’s what this forum is for - offloading, sharing advice and supporting. We will be right with you as you make your decision and happy to chat about it until you feel happy with your decision, and then while you go through it.

 

Delly - all the best to you for your various treatments/ops. I’m like you, I wouldn’t do more than one bodily thing at a time! Thanks again for sharing your implant research.

 

Hugs to all 🤗

Evie xx

Member

Re: Reconstruction doubts

Oh Delly I hope so this is someone with massive recurrence fears I've only every got a grip on. I hope I'm not rocking the boat my BCN just kept going on about infection and my sister keeps texting so are you doing it as if to say why are you bothering.I'im 50 should i be bothering or just grateful I'm here  Sorry just had to get feelings out xxx

Member

Re: Reconstruction doubts

Still no news from Tor. You okay, flower??

 

Typical Me - Has your earlier than expected appointment given you the eebie-geebies?? Coo, fantastic. I would strongly advise though, that you ask for the more natural "anatomically" tear drop shaped implants, I've mentioned. They make a big difference to the resulting shape, and probably a more natural match to your own existing one, in that they have/give a more natural "drape" or "droop" look, rather than an unnatural 1/2 sphere/ball "stuck on" look. But hey, I'm presuming there, that your own existing boob doesn't stick out like half a tennis or football?! It may do??!!, but I'm doubting it. No offence meant there, flower Heart

Well, I think that's great, and hope it goes well for you darlin'. Please, please keep us in touch with how it's all going with you, won't you. I'm dying to know. I think you'll be very pleased. Smiley Very Happy

 

Loads of love from Dellywelly xxxxxxxxx

Member

Re: Reconstruction doubts

Hi again Thankyou for all the advice. I received a letter today for Pre Op on Tuesday bit odd as he said it was twelve week wait may be they're just being super organised but we shall see. Think I'm keen on Implant though so hope it's right choice xx

Member

Re: Reconstruction doubts

Am still waiting, on myself really, to have op to replace expanders with permanent silicones. Keep putting on hold for other things, now eye lasering and knee arthroscopy tidy-up op. Previously, it was until I was in a better mental state and life more sorted. Am also conscious about anaesthetic - too much too frequently, knee op requires one, eye doesn't. I can only deal with one thing at a time, Evie. Unlike the majority of women are purported to be, I'm not a multitasking one!! Smiley Wink  xxx 

Member

Re: Reconstruction doubts

Hi Delly - thanks for your thoughts and advice, I appreciate that. Maybe I will speak to my consultant to see how easy it would be to change over the implant - I am in two minds, sort of if it ain’t broke don’t fix it, and I have got used to it now. It would be nice though to ditch the thin prosthesis. I will definitely think on it. 🤔Thanks for sharing your research - yes, now I remember about why they use textured implants.

What stage have you got to with yours and how much further to go?

Evie xx

Member

Re: Reconstruction doubts

Evie - Hello sweetie. I undertook a great deal of research into implants, prior to embarking on, especially the more "natural" anatomically tear drop shaped ones, made by Allergan, a British company, whose implants go under the name of Natrelle (I even stumbled on and applied for a job with them during my research in 2014, as a NW rep, but couldn't get my application in on time for the deadline Smiley Frustrated). The roughened outer surface shell is to help prevent "capsulation", a fibrous tissue capsule that can form, a bodily reaction that can occur more so with the smooth outer shelled ones. So I presume that is why smooth shelled implants aren't used in this country.

Evie, I feel that's such a shame that it's slightly larger than your natural one. Not having one to match up to, it isn't a prob when bilateral, more about getting them "level" Smiley Happy. I'm not so sure how easy it would be to have it replaced, with you also having a Strattice (tissue matrix) sling. I know without, it would have been very simple to replace to a slightly smaller one, through an excision in your existing scar. I wonder if it might be worth you asking about, get them evened up and get without the extra prosthesis you said you're having to use? Could be easier and simpler than you think?

Lots of love to everyone xxxxxxxx

Member

Re: Reconstruction doubts

Hi Everyone

First of all - TypicalMe and Delly, thank you for those lovely comments, you are both very kind 😊. The support from every single person on this forum is amazing isn’t it.

 

I’ve just read back through this thread and there is some great advice as always. Delly’s implant advice is very comprehensive and reassuring so I will just add my own experience in case that helps any of you - particularly Tor and TypicalMe - with your decisions. Reconstruction is such a personal decision, and there are so many options, including of course no reconstruction. Mystery Mouse makes a good point about seeing final results of other ladies who have been through the various reconstruction options. I wish I had done that, though I would still choose this option if I were to go back in time.

 

As Delly said, I had an immediate recon, at the same time as my mastectomy, rather than a delayed one. I’m 51 (to answer TypicalMe’s question), 49 at time of surgery. I’m small breasted and had a “pre-pectoral” implant, meaning it sits on top of the muscle in some sort of bag/sling thing. Yes, I am happy with it but mine doesn’t quite match my original one. The new one is more rounded and a bit bigger. I think my plastic surgeon could have put a smaller implant in - but I have decided against further surgery to replace it or alter my original breast to match. I use a thin prosthesis over my original breast to even them up under clothes. `I have no problems with sports etc.

 

I don’t know anything about silicone collecting in lymph I’m afraid. I was also told that my implant should last for a very long time - so I’m hoping that is true!

 

I did speak to my plastic surgeon after I read the media stories about implant safety and the link to a type of lymphoma (ALCL). He reassured me that there have been no reported cases with my brand of implant, and that the risk with “textured implants” (which is the usual type in the UK I believe) is apparently 1:24,000. To give you peace of mind it might be a question you want to discuss with your plastic surgeon. I can’t remember why they don’t use smooth implants here, but they do in other countries.

 

I don’t know if that helps at all - or confuses you more! Happy to discuss further with anyone if it helps.

Big hugs to everyone on here 🤗🤗

Evie xx

 

 

 

Member

Re: Reconstruction doubts

Tor - How are you doing? Are you still umming and aarh-ing, decision wise??

 

Typical Me - Hi again. Both of my masts (2006 and 07) included full ANC, so like you, no nodes at all. Personally, I have no issues or worries about today's implants. Again, I think you'll find, that all the scares of silicone in lymph nodes were related to the PIP "unapproved" silicone implants. There's a separate thread on the Forum, about some issues with silicone leakage and lymph nodes, but are from PIP implants that were installed a long time ago, 19 yrs in one case. Your own consultant sounded to be strongly supportive of, and "pro" implants, which surely must be of huge reassurance?

Yeh, she is a love that Evie woman Smiley Happy

 

Lots of love to everyone  xxxxxx

  

Member

Re: Reconstruction doubts

Evie Thank you for your answer you always seem so kind on here. I think Delly has addressed some of my concerns. Are you happy with the result ? I don't know how old you are I'm 50 so apparently would need small uplift on the other. I just hope it looks fairly natural  i have to be honest some of the Implant news scares me a bit  I asked about auto immune link as I have celiac and oncologist said he could swear with frustration when it's mentioned as there is no evidence and implants are perfectly safe but he can't blame me being concerned. Delly has again addressed some issues such as rupture . I'd heard silicone can  collect in lymph but as all mine are removed i wonder what would happen x

Member

Re: Reconstruction doubts

Tor - Hope you're doing okay and aren't getting and feeling too bogged down with decision options. Have you managed to reach any decision yet? Wondered if you might be able to ask see photos of previous reconstructions, both tissue and implant ones, at your beast unit. My breast care nurse showed me a whole load to compare.

My suggestion of "implant" recon, was based on your self employed time constraints, and other factors you stated in your previous posts.

 

Typical Me - I hope your skin IS suitable for implant recon, and that you go for it.

 

Evie - Hello again flower. Soooo, are you "happy" with your implant recon?? You didn't say. Think Tor may find it useful to know. Though immediate recon, is quite different from "delayed", which would be what Tor would be having, same as myself.

I've just edited my earlier post, to include, that some of the older type silicone implants had "unapproved" silicon (PIP), that caused a lot of recent scares and bad press. Current ones are that much more stringently tested, plus the outer shells are that much better, to prevent the risk of rupture.

 

Hope everyone is well. Lots of love to you all.

Delly xxxxxxxxxx 

Member

Re: Reconstruction doubts

Hi TypicalMe - I think we’ve chatted on other threads, I’m sending a hug as you go through the decision process. I also wanted to offer to try to answer any questions about implants if that would help. I too am small breasted and I had an implant put in at the same time as my mastectomy.

Evie xx

Member

Re: Reconstruction doubts

Hi all Thankyou for this thread it's nice to know I'm not alone. I had mastectomy and full lymph clearance November 2016 and was so traumatised at the time I just said no to reconstruction. I couldn't have immediate reconstruction at the time and as time went on i didn't want it. But now I've surprised myself by considering it  I saw my surgeon and BCN on Friday and breast surgeon kept smiling as I was so undecided  He eventually put me on list for Implant as it has a twelve week wait so he said I can still consider options. 

I swing between worry of an Implant and telling myself to stop googling and worrying for once. I am only small busted and am happy with prosthesis but two years on its getting a bit annoying to find bras and clothes. I often don't wear it in the day but then with the warm weather realise I'm out in summer top with one bust .

Thanks Delly for reassurance a bit about implants I'm still not sure but don't want tissue surgery really.I'm worried of messing things up and as I had radiotherapy worry about the skin. The breast surgeon said he's pushing things a bit but that my skin is healthy  I wish I had a Crystal ball to check i don't regret it xxx X

Member

Re: Reconstruction doubts

Mini mad - I hope you're feeling okay, after you're first chemo. Something I very gladly managed to "dodge". and threw an impromptu "no chemo required" party when I finally had my node results through. I have the utmost sympathy (can't empathise, as didn't experience) for you chemo girls. I know from speaking to others on the Forum, that it can have a cumulative effect, so I hope it doesn't get too much worse for you.

Lotsa love xxx

Member

Re: Reconstruction doubts

Hi Tor

 

Like you after going through all the treatment and surgeries the last thing I felt I could cope with was further surgery for a reconstruction.  However, also like you after 2 years of wearing a false silcone breast inside my bra, I was not particularly happy with it.

 

2 years after my mastectomy I had a PAP reconstruction.  It is similar to a DIEP but the donor site is the inner thigh area.  That was now over 2 1/2 years ago and it was without doubt the best decision I made.  My new breast looks so real and honestly I now think of it as my real breast.

 

I can now wear what I like and do what I like with no worry of having to have an implant replaced at a future date.

 

I certainly was not ready for reconstruction before the 2 year point and even though it is a big operation and does take a lot to recover from, afterwards I finally felt more like me again.  

 

When I was still unsure whether or not to go for surgery I went along to a Keeping Abreast meeting and there I saw final results of other ladies who had been through it.  I was amazed how good they were.  I also met a lady in her 70's who was also waiting to have it done and she had put it over for over 15 years but had then decided not to waste any more time. After speaking to her I decided that reconstruction with my own tissue was the right decision for me.

 

Good luck with whatever choice you make.  At the end of the day it is whatever you are comfortable with.

 

MM

xx

 

 

Member

Re: Reconstruction doubts

Hello Tor

 

I have lived lop sided for about 7 years for similar reasons to you. I picked up on one particular thing in your post, the spasms and loss of strength. If it's any help to you to know this, it took me a very long time to get feeling anything like comfortable on the affected side. It came as a very welcome surprise but must have been at least four years on and possibly longer.

I continued with the exercises and added heavier weights. Did you get the BCC DVD of exercises? It was a great help to me and I still put it on sometimes - I have added some other exercises, safe for osteoporosis patients like me,  and it has all improved the affected side.

Knitted knockers supply a lightweight and fun falsie, have you seen their website?

When you talk about your flat side do you mean when you are naked?  I warn any medics first that I have had the op- that way I do not catch any look of surprise.

Like you I just wanted to get on with my life and I know that the decision I made was right for me and that helps.

I am sorry that you feel so rotten. Believe me I wish the whole thing had never happened to me and looking in the mirror could be a better experience but no way could I have gone through more surgery. Please do take heart that the discomfort will pass. Online specialist companies have some very nice pocketed bras and I've found all the companies very helpful. 

 

 

Member

Re: Reconstruction doubts

Hi Tor

This is such a personal thing for yourself. Two years later and you don't sound very happy, despite reassurances from, an obviously, loving husband and children. You've stated "I hate it". So I guess you either go for some kind of help/therapy to improve your self image about yourself as you are. Or you bite the bullet.

I'm guessing your friends recon, was a self tissue one, as you said she still suffers with her scars. Have you looked into Implant recon, as a quicker option healing time wise, with no "extra" scars to your breast nor to whatever other part of your body a self tissue is taken from.

Implants are so much better than they used to be - longer lasting, anatomically shaped so that much more natural looking, as opposed to half a sphere that looks plonked on. The incision (approx 6 cm) to insert the initial expander is made along your existing scar, hence no "extra" scarring to the breast area, much shorter op, and quicker healing. Less risk of infection, because of fewer scars. Just requires a few short follow up appointments, to inject more saline to gradually expand to the required size, before another short op to replace with the permanent silicone implant. Then when healed again (not long) and settled, the option to have nipple recon is there. And then the final icing on the cake, when you're ready to, or again if you want it, is having the areola tattooed.

Yes, it's a lengthier process, in that it's done in stages, but the op times and healing times are shorter, with none of the risk of the self tissue dying. And an option to have your natural breast tweeked at some later stage, if it requires some matching up.

It could fit your self employed work situ better, and be less of a fear for you, while at the same time provide a long term filling of that empty space you seem to be missing so much.

I felt like you did without one breast for a year, then without two for seven years. Wanted immediate implant only recon with both. Didn't want extra scarring, healing time, extra infection risks or of tissue death, but it didn't happen due to surgeon thinking I wanted tissue recon. Long delay to finally embark on due to other life stuff/difficulties. Am still at expander stage, but I felt immediately better, appearance and therefore confidence wise, just from having those installed.

I'm single, had always been body proud, and just didn't feel very womanly any more, so it was important to me. Discovered I'd missed the outer underarm curve as well as the up front curve. 

Yes, implants "may" need replacing after 20 yrs, but, as said, they "are" that much better nowadays, longevity and shape wise, so may "not". But they have to warn you, just in case. All the recent scares with PIP implants leaks, were of a particular type of silicon and were never "approved". Current ones are that much more stringently tested, and ARE approved.

You may have already had discussions about self tissue options, but not the implant option.

Hope this may be of some help to you, Tor.

Good luck with whatever you choose to do, and that you feel better.

 

Lots of love, Delly xxx   

Member

Re: Reconstruction doubts

Hi, I have only just seen your post, but wanted to tell you that you are not alone!  I am had my op 6 months ago.  I refused a reconstruction for several reasons, mainly, I am 68 soon and didn't want to have to have more surgery when I am 80-odd to replace whatever, didn't like the thought of having something 'foreign' inside me and didn't want even more surgery to reduce my other breast, which is an 'F' cup.    

 

Anyway, I hate my scar, it still hurts 6 months after surgery and my first prothesis was very heavy, I went back and changed it to a 'partial' one which is silicone with a hollow space behind it, so it can be padded out with a bit of stuffing if needed but I don't do that, its just in a cotton cover and slips inside my normal underwired bras.  I can't say I like it but it is so much lighter and looks normal.  I forget its there.  Have you been back to the hospital to try alternative protheses?   By the way, I forgot to put mine in the other day and it wasn't until I was walking round Tesco that I realised!  I was horrified, but I didn't get any strange looks, nobody seemed to notice.

Member

Re: Reconstruction doubts

Hello Tor,

 

" ME ".....  i chose NOT to have reconstruction.....why ??   ...... surgery is much longer..... recvery is much longer....  but mainly i dont like the idea of having something artificial/not natural in my body.

do i regret not having it done.... a big NO...

Ok so the ' falsie 'feels quite heavy but i only wear mine if we're going somewhere special otherwise its my faithful ' softie ' tucked neatly into a crop top with a slit in side which i found in Peacocks.

like you i dont look at myself in the mirror until i have a top on although my husband and daughter reassured me that it was nice and neat and dont let it worry you.

its ok to say these things but they're not inside your head and cant feel what you are feeling.

my mastectomy was on the 16th april so its early days for me but i'm trying to get on with things although still have pain/twinges under armpit.

only you can decide but if you decide to stay lop sided dont beat yourself up about it... once we have had cancer we must all grab life with both hands and appreciate every second.

please stay in touch and big HUGS  💖💖💖💖

ps. You dont say how old you are ??  I'm a young 68 !!  And had my first chemo yesterday !!!

 

 

 

 

Community Champion

Re: Reconstruction doubts

Hi Tor,

Yes, there are others here who have chosen to stay flat & not have a reconstruction & hopefully will be along shortly to share experiences.

I understand from seeing posts here, that there is a facebook group called 'Flat Friends' which quite a few have found helpful.

Sorry to hear how you're feeling & wishing you well in moving forward with it.

ann x

Tor
Member

Reconstruction doubts

I've trawled some of the posts around here but can't find anyone who has talked about choosing to not have reconstruction.  I had an appointment with the plastic surgeon but bottled out a week before because I'm frightened, I just don't have the time to recover from the surgery, I cannot affort to take time off work (I'm self employed), and a friend showed me her scars and how she still suffers, and I was horrified.  So, I'm just living lopsided, and hate it - I hate the discomfort, the lack of decent bras, the weight of my falsie, the spasms around my scar, the loss of strength, and feeling that I have to present myself as 'normal' to the world.  I feel embarrassed if anyone sees my flat side.  My children (grown up) and husband try to reassure me and say I should just ignore the flatness and people will be understanding and even admire me.  I can't, it's just too personal. I'm exhausted and anxious and seem to be going downhill.  My treatment finished nearly 2 years ago, so I thought by now I would be getting used to it, and getting on with my life. 

So, is there anyone out there who does go 'au naturel'?!