A few questions....

Hi,

I am seeing a plastic surgeon next week about having a reconstruction (I had a Left mastectomy in Jan of this year) and have a few questions. Here goes…Firstly, I think that as I am very small - A cup - I may have to have expanders, how long on average do they have to be in before surgery? Secondly, Is it possible to construct a breast without using expanders? and lastly, how long did other ladies have to have off of work?

As usual, thanks for your help and advice - it is always valued and appreciated,

Tracy xxx

Hi Tracy

I am posting a link to a BCC publication about breast reconstruction which you may find helpful to read whilst you await replies from your fellow users, you can read it via the following link:

breastcancercare.org.uk/docs/breast_reconstruction_dec06_web_0.pdf

You are also welcome to call our confidential helpline if you need any further support and information on 0808 800 6000, it’s open Mon-Fri 9am-5pm and Sat 9am-2pm.

Best wishes
Lucy

Hi Tracy,

Having done this all, I was really frustrated with the lack of info on Recon, so here goes -

Generally you’ll be offered 2 options, either LD flap (using back muscle and skin) or TRAM or DIEP flap (using tummy muscle/fat and skin).

I opted for the LD because a) it’s a shorter surgery and b) I wanted a reworking of my rather sad breast fed 2 kids, 43 year old droopy boobs. (With the tummy tuck option they can rebuild your breast to be as close as possible to the remaining breast, using your tummy fat)

So, what happened for me was this - the surgeon removes a flap of muscle and skin from your back, removes the mastectomy scar and a flap of skin from your chest and replaces it with the flap from your back, and puts an expander implant in underneath the flap. They remove the flap from your chest partly because the mastectomy scar is likely to be a little messy from a PS point of view, and partly because of the damage done to your skin by rads. Op takes about 2.5/3 hours and you are likely to be booked off for 6 weeks - it did take me that long to recover! After 6 weeks you see your PS and you then have the option to ‘top up’ the expander. My PS has basically said, we’ll keep expanding until you say stop, so I’ve gone from an A to a C cup. The expander is topped up with around 50 ml of saline at a time, and you can literally feel your skin stretching tight as the saline goes in - all this is done on an outpatients appointment and you don’t feel a thing. Gradually the skin stretches to accommodate the additional volume and then you go back for the next top-up and so on. So, on the mastectomy side I have a really lovely new breast, but it doesn’t match the other side at all. However, on 11 December I go in for the last bit of surgery, where they remove the expander implant and replace it with a silicone implant, for a nicer look and feel, and also do an uplift and augmentation on the other side to create a matching C cup! At the same time they will build a nipple for the recon side and then in the new year tatoo the nipple and areola to match my existing nipple colour.

The tummy tuck option does mean you don’t have to have an implant, and I know some ladies prefer not to have the implants, but I’m very happy with the concept of a lovely firm pair - my physical restitution, thanks very much!

Hope this has helped? The process has been quite slow for me, through choice, so I had the mast in March 07, recon in April 08 and final bit of surgery in Dec 08.

Jane

hi Tracy.i had mast and immed recon with LD flap and implant in July this year.I wasnt keen on the thought of implants at the start but didnt want a long anaesthetic and major abdo surgery.had 2 caesareans and was also alarge42 d/dd and droopy!.I hope to get expander replaced nipple recon and lift and reduce on other side early next year. i was off for about 3months but i work parttime and it depends on your situation.i had no problem being signed off sick.havent had rads or any other treatment either so skin was ok.ithink it depends on the skill and experience of your PS what you are offered and your individual diagnosis.remember to ask lots of questions or write them down and take someone withn you to make notes during the appointment.hope tis has helped
doreen

Hi Jane and Doreen,

Thanks very much for your replies, the information is really helpful. I have my appointment next Thursday, so I have time to make a list of questions.

I am on Herceptin at the moment, so am also wondering whether I will have to wait until this has finished (next March) before I have the operation, although I can’t imagine I will as I’m sure the op can be fitted in around it.

Hopefully, there won’t be a great long waiting list either, although I have heard that cancer patients are amongst those that get priority,

Thanks again for your helpful info,

Have a lovely weekend,

Tracy x