Advice on the side effects of breast reconstruction

Hello everyone, I’m new to this forum and to cancer! My mother-in-law is in her 60’s and was diagnosed with breast cancer a week ago. She’s naturally in a state of shock (as is the whole family) and has information overload so I’m trying to get some info myself for her to digest in bite size chunks.

She’s been told that she has low risk cancer in four places in her breast, one of which is behind the nipple. Her lymph nodes have been tested and appear to be OK. She’s having a bone scan today and a CT scan in two days to see if it’s anywhere else. She’s been told that the best treatment is to have the breast removed and that she won’t need radiotherapy or chemotherapy (I assume that might change if they pick up anything else in the tests she’s having this week). Anyway, she’s also been offered reconstructive surgery at the same time as having the mastectomy (she got lucky and has private medical cover through her pension).

My question is can anyone tell me what the pros and cons are of having reconstructive surgery? From seeing some of these forums, I’m getting the impression that there can be long term pain/issues from having it done (for example when the tissue is taken from other parts of the body). Is my impression correct?

We don’t yet know if she’s being offered TRAM FLAP, implant or an autologulous tissue reconstruction so it would be good to hear from anyone who has experience of any of these. Also, are there different types of implants that can be used and are any “safer” or “better” than the others?

Obviously she (and my father-in-law) will be seeing the consultant and surgeon soon to ask some questions but I’m trying to arm her with some questions to ask in advance. At the moment she’s just in a bit of a whirl and is only taking in half of the info so I’m not exactly the medical terms for the cancer she has.

Hope you can help!

Low risk cancer - would that be DCIS by any chance?

I would say avoid LD flap reCON as there are many pitfalls (untold by surgeons) to this option.

D

Hi Token girl

Sorry to hear about your m-i-l.

V briefly - have to start work in a minute!

I had a TRAM flap 3 years after mx - fantastic result, inc flat tummy and neatened waist - long recovery time, big, big op - think it may have triggered my first lymphoedema (but this may also be true of other types of recon) - carried out by speciialist plastic surgeon.

A few thoughts…

X

S

Thanks Dahlia - yes, following further research from documents on this site, the LD flap doesn’t sound the best of options. I’m thinking the DIEP flap seems the most suitable for her needs.

Do you get to choose, I wonder?

She’s not clear on the name for the cancer, I think I’ll get my father-in-law to ask the question, next time they see the consultant.

Thanks once again!

Thanks S for the info. I’ve never heard of lymphoedema but will look that up and include it in a “pros and cons” list for her. Looks like TRAM Flap and DIEP flap are the best options. I really appreciate the advice.

Take care x

Token Girl

It is not necessarily just a matter of choice.

NICE guidelines state that every woman whould be offered all options even if it means sending her to another hospital. Google NICE guidelines for early stage BC.

Good luck
D

I was assured by my plastic surgeon that my diep reconstruction would not affect my lymphoedema which I had already developed.
Also, Diep is considered superior to the Tram as you do not have to sacrifice any muscle. My plastic surgeon will only perform Tram if there is an insufficient blood supply for a Diep.
Every woman has the right to have the reconstruction which is best for her and can go to another area to achieve this.
Kelley

Ultimately, it is up to the patient to decide what to have, having had explained the available options, i.e. what is actually possible to do with the raw materials, for want of a better expression, and suitability of length of surgery (especially for smokers).

I think there will be pitfalls to ALL options. For me, the LD flap was a breeze - I was back at yoga 16 days after surgery, back at work 6 days after that, and back at tennis shortly after that.

I had no pain whatsover, no seroma build up, and the scars have healed excellently. I have posted this on another thread, but I am on the waiting list for an LD flap on the other (healthy) side just to achieve better symmetry.

So, although my PS was keen on a DIEP flap initially as I did not have much fat on my back, I am glad I made the choice to have an LD flap because of (a) the quicker recovery time (less time off work), and (b) I don’t have to look at an abdominal scar for the rest of my life (my scar is on my back and is hidden under my bra strap)

Don’t make a decision until you are really, really sure that the option you have chosen is the right one for you.

Thanks so much for the advice everyone, this is all really useful stuff that I will report back to her. I feel less helpless if I can at least save her the job of gathering information, even if it is just finding out info about her options for surgery.

I think she’s seeing the surgeon next week so she at least will have an understanding of what’s out there when she talks to him. Forewarned is forearmed and all that!

I really appreciate all of your comments.

Thank you so much! xx

Sorry to hijack your post but I just want to say thanks to Bubs. I had surgery just over 3 weeks ago - LD flap. Feeling tight and only comments I have had back or read seem to be very negative towards LD. It is such a relief to hear from someone saying something positive about it.

Lyn xx

Hi All
Been reading the threads and thought I would make my comments. I am now just over two weeks post surgery after LD flap and reconstruction to right breast and implant to left breast to ‘even’ me up. I stopped reading the threads on this site just before surgery as I too found alot of them to be very negative.
So far I have only experienced some soreness and discomfort, which I expected, but every day seems to be getting better. I am religiously
doing my physio exercises, and, am starting to practise some gentle yoga stretches. I am finding some tightness under my reconstructed breast and arm, but nothing that I think a few more days of stretches won’t cure.
Some slight build up of seroma means I have not yet been cleared to go swimming, but it is getting less and less so hopefully with be back to swimming soon.
Although it is early days for me, I am really hoping that the only way is up, and pray that I do not have any later 'side’effects, and
am looking forward to the reconstruction of my nipple.
I had my surgery in Maidstone Hospital under Mrs Jones, and can only say she has done a fantastic job of matching me up as much as possible and once my nipple is on, I think my ‘new’ breast will look even better.
Thanks to Bubs for your positive outlook and your advice on Yoga. I am sure all will be well for you on your next bout of surgery,

Tricia x

Hi,

I had bi-lateral mx with immediate recon in dec 08, i had LD flap and have had no problems at all, hardly any pain. I know having the LD flap has alot of bad press and each person is different but i just wanted to share my experience of it which is a positve experience. Im sure you will gather all info for your m-i-l to make the best decision for her. Good luck.

Take Care

Leslee x

HI all, I had reconstruction on left breast 20 years ago aged 39. They used the muscle from my back plus an implant. The first implant went hard so they put in a different implant 2/3 years later. The breast has healed up nicely. My bra straps cover the scar on my back and the front scars changed from pink to the same colour as the rest eventually. While wearing a bra it is almost impossible to tell I have undergone surgery. I am very pleased with the outcome. The only “funny” sensation I have is this…if I scratch my skin below my left boob, I can feel it in my back! Quite odd but used to it now. I was able to return to work 4 months after surgery but took it easy for a while. Hope this info is of some use to you. Best wishes to all from Scottishlass X