21-04-2017 11:08 PM
21-04-2017 11:04 PM
21-04-2017 12:26 PM
sorry for late reply not been on in a while
i am having bilateral mastectomy with immediate reconstruction sillicon implants, they sent me to plastic surgeon to meet but he didnt think the tummy one was suitable for me ...i feel a bit better with it but still petrified to have it done, of what i will wake up to? also pain wise etc as to how much i can do ? brush hair wash loo etc, so hard to know xx
18-04-2017 08:07 PM
Hi again Argy,
Considering the whole of my last post was based on your "Delly, I don't think "anyone has suggested" that expanders are a permanent option"??, which it WAS suggested. And was also based on the info provided by the other "posters" on this thread,- I'm somewhat confused that you think "we're on the same page" when we aren't really. Hence my stressing to al othersl here, to ensure that you make sure you're information is correct.
Love to you though Argy , and all others
18-04-2017 05:56 PM
Thanks Delly. I think we're on the same page I agree that yes, methods do change all the time (thank goodness for progress!) and yes, hospitals do offer different options (although NICE guidance states that all reconstruction options should be discussed with patients even if they aren't available at the hospital concerned).
18-04-2017 05:41 PM
Ref expander implants and "leaving in", I was referring back to Carol M's post 10.04. where she's stating she'd have the "option of having the port removed and leaving the expander in, or changing it for a silicone one". I haven't heard of "expanders" being left in, hence my surprise as to whether this is now a new option, or concern as to whether Carol M may possibly have confused her information.
In my own post of 12. 04. I was referring to my own "expanders", which also have a silicone "shell" and have "frontal" ports, as opposed to underarm ports as with Carol's, and that mine DO have to be replaced with silicone - no option to leave them in.
The differences mentioned by others have confused me somewhat, as to whether methods have changed, and/or that certain different hospitals offer different options. OR that the persons posting may be possibly confused in their info, hence my stressing the importance for them to make sure their info is correct. THAT is my concern. Very easy when you're going through so much, at the actual time, to only half hear what is being said. Myself having considered all the pre-op options, 10 yrs ago, and it having "back fired" on me, have then spent 10 yrs POST diagnosis, looking into all recon options, albeit then with the differences of "delayed" recon, as opposed to "immediate", but WITHOUT being so overburdened with the initial shock of cancer diag AND all the possibilities/choices recon wise.
The whole point of this post, is that you NEED to make sure that all your information is correct. If you have any doubts or confusion about ANYthing, call a halt to get it sorted. Don't just get carried along on what the medics "think" would be best for you - question why on EVERYthing, make a nuisance of yourself if you need to - YOU need to be happy with your decision.It may turn out to be what the medics suggest actually IS right, but sometimes it IS'NT.
Much love to all of you
13-04-2017 06:29 PM
Pretty sure my surgeon said that both the expander and the silicone implants now have a lifetime guarantee. From what I remember he said I'd have the option of leaving the expander in permanently or taking it out when it's the right size and changing it for tearshaped silicone at that time. Think I'd definitely prefer to change to the silicone at that time.
He also talked about reducing my good boob and giving it a lift later on. I
13-04-2017 07:40 AM
Yes lots to consider Carole M. I've found it valuable to ask lots of questions, be comfortable to ask clinicians to repeat things and have a friend with me who I can bounce things off later. Best of luck with your treatment.
Delly I don't think anyone has suggested that expanders are a permanent option.
12-04-2017 08:35 PM
You haven't provided much info on what you've already had, BC treatment wise.
Immediate reconstruction means - at the same time as your mastectomy. I had mastectomies withOUT immediate recon, so have ended up having to have recon in later years, and from a different starting point of having no boob tissue to work with at all.
They are restricted as to what they CAN do, to provide you with a happy, acceptable result and size. I don't know what area of the country you are, but these days, there is so much more that can be done to provide you with a less "stuck on/ 1/2 sperical mounds" result, with the advent of the "anatomically, tear shaped" silicone implants.
Sounds like you're having to have a single mastectomy? and then they'll match your other healthy breast to your recon one, size wise, at a later stage, i.e. reduce it size wise to match? Is that right??
Can I suggest, that before you go ahead with any surgery, that you get as much info as possible, from the BCC info leaflets on reconstruction directly available from this site, your Breast Care Nurses, even seek/ask for a second opinion from a different surgeon, be that a specialist breast "plastic" surgeon, or another "onco-plastic" surgeon.
AND . . . there are sooo many other options available to you surgery wise, than just "silicone implant" surgery. I'm surprised ( shocked ) that you haven't had all the other options of "self tissue" recon surgery explained and offered to you, but I'm going off the small amount of info that you've provided us with.
Let us know
Much love to you
12-04-2017 07:49 PM
12-04-2017 06:21 PM
I've not heard of saline expanders that can be left in? only temporary ones to gradually stretch to the required size, such as those that I still have in, to then be replaced with the permanent silicone ones. Yes, the outer shell of these are silicone, with ports at the front that make them less likely to irritate the underarm area and easier to inject into. But are only advisable to leave in for a max of 1 1/2 - 2 years, which I've gone long over, due to falling off the recon horse at the 6 month desired expansion size stage, which was 2 yrs ago. Am presuming the "sell by" date is because their outer silicone shell is quite fine, and apt to rupture if left in longer. Fortunately, they're okay, albeit slightly mis-shapen now, but the replacement silicones are likely to pull out any of mis-shapeness.
The differences may be down to the fact that mine is delayed recon from mastectomies 10 and 11 yrs ago, so from a "nothing there" position. I'd wanted and asked for immediate recon, but had a switch of surgeon due to my initial one retiring, and miscommunication with the second surgeon, who thought I was wanting self tissue recon, which I didn't ever want, but he specialised in and tended to push. Would and could have been sorted out and finished, all those years ago, but not having ANY boobs and still being single, resulted in years of debilitating depression, with a few other major life factors delaying things further.
As you so quite rightly said, Carol, a load of info to get right, get your head round, and decide on.
Good luck girls
Much love, Dellypoos xxxxxxxxx
10-04-2017 04:29 PM
Hi Carole M. Sorry for butting in - just thought I would add that I have what you are describing. The implant does contain a certain amount of silicone, as well as an expander that gets gradually filled with saline to stretch the skin. It is "temporary" so when I have my final reconstruction (probably next year) it will be replaced. I could have a "permanent" silicone implant but more likely I will have a breast made out of my own tissue, either from my back or my inner thigh. I think the strattice will remain to support the final item. The important thing about the temporary implant/expander is that I will have radiotherapy after I finish chemo and that can cause damage, so better to damage a temporary implant than damage my own tissue. Hope that helps!
10-04-2017 03:47 PM
thanks for your reply. The plan is to do a mastectomy and at same time insert an expanding implant with a port on my rib, which will get injected with saline until big enough. He is also going to make a sling at the bottom with either synthetic or cow/pig fibre. When it is the right size I will have another op to remove port etc. I believe at this point we can either leave the implant in or change it for a silicone one. I'm inclined to think the silicone would be the better option. He said it would be too painful though just insert the full size silicone implant at the mastectomy as it needs to stretch out first.
at my hospital they do the SLN test during surgery and get results back while asleep, so if necessary they remove the other LNs there and then.
I am less concerned with how it looks than how it feels and most importantly my health. Been given 12 May for surgery but I'm questioning this as it will be 80 days from my first appointment at breast clinic and I think too long a wait.
09-04-2017 10:51 PM - edited 18-04-2017 06:32 PM
Are you sure your surgeon said "expander implants" and not expanders followed by silicone implants??!! Expanders are usually used tempoarily prior to implants,and gradually expanded to size, where a larger breast pocket needs to be created, prior to replacing it or them with the silicone one.
I'm at expander stage, 2014, from bi lat mastectomies (2006 and 07) and very delayed recon, been through all the expansions and about to have them replaced with the below mentioned "anatomical or tear shaped" silicones, end of this month. I'm the same age as you and never wanted anything other than implants, them being the "simplest" op option, with faster healing, fewer scars + less risk of infection (all my own personal preferences). Much better results can be achieved for you, with an immediate recon, but that's very much dependent on whether you need radiotherapy soon after, as that can affect the whole recon, whether self tissue or implants.
I'm 2 1/2 yrs delayed, in my delayed recon !! just due to other lifes brown stuff, nothing else. But, because I HAVE had a further delay, I now have the added extra benefit, that I asked for but was told wasn't possible at my initial recon consultation 2014, which is that of "Strattice" or tissue matrix. This is sewn/attached into the pectoral muscle and used to create a sling that adds extra support to, helps smooth the edges of the implant and reduces any rippling effects to the breast when the arms are lifted. It also helps reduce "capsulation" formation.
There is always a risk of capsulation with implants, which, yes, can occur sooner if rads are given, but may take years to form otherwise - if indeed at all. The tissue matrix helps reduce the development of this, as it reduces internal movement of the implant beneath the skin. As does the exterior finish/coating that's now available on the newer type implants.
Even if you do need rads, you can have extra corrective surgery later, once the effects of rads and skin have settled.
I can't stress to you enough, the need to get all the facts from your surgeon and BCN's BEFORE you have the surgery. There are some good BCC booklets available on the implant recon options from this site. But all of what I explained above to you, should have been explained to you anyway. I'm guessing the only unknown factor for you, is whether you may require rads or not, which I'm guessing will be dependent on your biopsy results at the time of surgery.
Carol, will you please keep us in touch with how you're doing prior to your surgery, and anything else you may be struggling with. Hope this has been of some help to you, despite me coming or going at it from a different starting position to you.
08-04-2017 08:34 AM
07-04-2017 10:50 AM
yes i agree my next appointment is on the 20th ages away i just want this done now......ask about teardrop implants someone sent me pics looks great x good luck xx
06-04-2017 12:59 PM
06-04-2017 11:45 AM
im similar too, consultant has said implants would look high and only get b cup plasic surgeon says implants better that the diep tummy one for me............so confused i dont want to look too fake lol and up by my chin !!
04-04-2017 08:33 AM
It seems worse I think when we are given options as then we get a choice and we'll forever be wondering if we took the right option. I have a friend that had the LD flap and she doesn't have any weakness and can hold a plank in Pilates for far longer than others that haven't had surgery. I have another friend that has implants and they are fine however she didn't have radiotherapy. I'm not sure what your situation is but it seems it is the radiotherapy that can cause capsulation a few years after. I've had the TUG flap using my thigh and am delighted with the results. I'm not sure where you live but the charity Keeping Abreast do show and tell evenings. If you are near East Grinstead they meet every other month and you get to see and talk to about 10 ladies that have all had different types of reconstruction. Good luck with whatever you decide on. X