I am quite new to this section after finishing chemo in Nov 07. I had a double mastectomy in June 07 and 6x FEC now on Tamoxifen for 5 years. Had grade 2 in one and 3 in other one non evasive one evasive both stage 1 early breast cancer. Have now seen a plastic surgeon re reconstruction but am no nearer deciding what to do. Have been given all 3 options expander, back flaps and tummy TRAM? How do you decide what to do? There are pros and cons with all three options that she went through with me. Has anybody else been in my situation and made a decision? I have been talking with my friends and they have all given me great input (even though none of them have been through this). My feeling at the moment is to leave it this year (last summer was real rubbish and I think the kids deserve some camping this summer!) but to invest in a more comfortable prosthesis (probably Contact), and to look into surgery after the summer. Any views good or bad would be gratefully acknowledged.
thanks
JulieG
Hi
In terms of which surgery to have, have you read Elaine Sassoon’s book called ‘The Boudica Within’? It’s a wonderful book containing photos and stories of 23 women who have had reconstructive surgery. Elaine S is the Plastic Surgeon at Norwich hospital (she had an article in the Sunday Times last November) and the book explains the different types of surgery.
I am lucky enough to have an appointment with her next month and I desperate to have my boob done asap because I hate the way my body now looks.I want to go for the type where they use your own body tissue (and hopefully get a tummy tuck at the same time!).
However, in terms of when is the best time for you-only you can judge that. You’ll have to weigh up the pros and cons of having surgery now or later-either way, it’s a long op and a long recovery time. Are your kids old enough to discuss this with them? What does your OH feel about it?
Whatever you decide-I wish you all the very best.
Love Gill
PS Think book is available from Amazon-I borrowed a copy from the local Big C centre library.
I had a single mastectomy in March 2005 and didn’t have the reconstruction until Oct 2007. It took me 2 years to decide. I weighed up the options and decided that I didn’t like the idea of an implant so I had a diep flap reconstruction. If your surgeon can do this, I think it’s better than a tram flap because they only use the fat from your tummy rather than using the stomach muscles. There is a risk of hernia and reduced strength there.
Unfortunately for me I am slim so my new boob is a bit smaller than my other one, but that wouldn’t be a problem for you as you’d get a matching pair! I am pleased with the result though - it is fantastic having something in my bra now and I’m not self conscious when wearing lower necked tops. I didn’t realise how much I missed the small cleavage I had and the mound you can see when wearing a vest. Also I look and feel more balanced. There is the added bonus of having an extremely flat tummy!
It’s now 4 months since the op and I’m planning on going back to work in March. The op was 9-10 hours long and I was in hospital for a week (3 days of that was in high dependency). I think I was a bit naive about how long the recovery was going to take and just how weak I was going to feel in the first few weeks. But I did as I was told and made sure I listened to my body. (Until 2 weeks ago I was still having afternoon naps!) I was lucky that my Mum came to look after me for about 3 weeks when I came home. I don’t have kids and you will have to consider the amount of support you’ll need. My husband was brilliant - he even overcame his hatred of supermarkets and discovered a hidden talent for cooking! I have some great friends who ferried me to and from the hospital for various appointments and did shopping for us whilst I wasn’t driving. You’ll have to think about the effect it’ll have on your family, but if you really want it, then go for it. They will manage. I don’t know how old your kids are but it could help them to become more independant and to appreciate just how much you do for your family.
I used the contact from Sept 05 until the op in Oct 07. I found it more comfortable than the ones which sit in your bra. If I kept it really clean then I didn’t have any problems with it coming unstuck even when I was very hot and sweaty. I used to wear it to swim, in the gym and in the shower afterwards.
You can have your reconstruction at any time and it sounds as if you would like to wait. You have been through so much in the last 9 months -coping with the diagnosis and then the surgery and chemo. I was still coping with the emotional side of things at 9 months. Give yourself a well earned rest. You’ll know when the time is right. You never know you may decide not to have it, there are plenty of women who don’t.
Hi Julie,
I know it is a big decision but before considering a Tram, ask why you can’t have a Diep. This is a similar operation but does not use any muscle so the recovery is faster and you don’t suffer the consequences of losing muscle strength. I had a Diep which is considered to be the gold standard of reconstruction. I was lucky enough to have it done by Elaine Sassoon and i actually feature in the book mentioned earlier. She told me it was every woman’s right to have a Diep if they wanted to. This was one of the reasons she did the book,to make women aware of the options available. She will only perform a Tram if there is an inadequate blood supply. I was really pleased with my Diep which was far less painful as i had expected and i recovered much more quickly too.
Kelley
Thanks for all you very valuable info - I think I have made a decision to leave it until after the summer for the boys sake rather than my own - they missed out on so much last summer and didn’t complain once (They are 7 and 10). The Diep sounds like one of the options they went through, and was my preferred one at the time. I am going to get Contact Prosthesis and see how that goes and then forget everything else for 6 months!!!
Best wishes to all of you
JulieG
It is a big decison and once you have made the one that is right for you, you will know. A year prior to me having my 1st lot of breast cancer a woman at work had it . So she was my mentor and I went to her with every single question I had. She had a reconstruction and had nothing but problems. It got infected, had another one in, that got infected, she was really ill, got another one in and her body rejected it. It the end she had the 3rd one removed as her body just wouldn’t take to an implant. So all along there was no way I was going to go through all that and just going to get rid of the lot. But pre surgery every time i looked down I realised I just couldn’t live there being nothing there. I decided i would go for the reconstruction and suffer the consequences. And you know what. Touch wood. No probs at all. I was so happy I made the right decision for me. So when I was diagnosed with breast cancer a 2nd time in other breast I knew straight away it would be a reconstruction (both have been from my back). No probs at all and even back doing jobs 7 weeks after surgery with my horse - lifting bales and feed, mucking out, sweeping up etc. I went back to work full time after 6 weeks and feel fine. Back driving, doing housework as if nothing had happened. Justing waiting for chemo start date. UGGGGGG. Have had the usual fluid build up and cording which i think most people get. But speak to the right people. Do your exercises )they are a must!!!) and rest when you need to. You go girl. Do what is right for you. And good luck.
Sounds like you have made the right decision for you for now.
Just wanted to say that I never wanted a reconstruction (Wasn’t offered one immediately as cancer very close to chest wall and had rads). It is 4 years since my surgery and I quickly got used to having one breast and find a prosthesis (non contact) very comfortable. I have never wanted to endure further surgery.
You don’t have to have a rceonstruction just beacuse the technology is there…not having one is every much as positive option if thats what you want.
I’m 51, dx 8 Feb, will have mastectomy and immediate recon on Saturday. I didn’t want a synthetic implant and opted for DIEP as I like the idea of the tummy tuck but I didn’t want to sacrifice a muscle. However, the plastic surgeon said it may be a ‘muscle-sparing’ free TRAM flap. He did a lot of diagrams and the elliptical section will certainly be taken from below the navel - this is where the tummy-tuck comes in - but the final decision on whether a tiny piece of muscle is used from above the navel will depend on the quality of the blood supply they find once it’s opened up. He said it is quite usual to make that decision during surgery, and the definitions of TRAM and DIEP aren’t cast in stone - he will do whatever he believes will give the best cosmetic result, with the best blood supply, and therefore the lowest possible failure rate. I’ve asked him to remove maximum blubber and leave maximum muscle and I completely trust them. I also endorse Elaine Sassoon’s book, lovely photos of brave ladies, got mine from Amazon. All the best to you xxx