advice on what to ask

Hi all

I am on here now as a new forum member because for some reason I couldn’t access my old login! I was irenem. Diagnosed in oct 2006, mast, chemo, rads, tamox. I have my appointment on monday at Newcastle to discuss a recon, hopefully the one that uses body fat and gives a tummy tuck too!

I was wondering if any of you out there had any advice on what questions to ask. I have a 1 hr app with the specialist nurse, followed by the plastic surgeon.

I was wondering if it would be very cheeky to ask for my remaining boob to be lifted to match the new one! Recovery time, how much time off work, exercise, wether I can cont losing weight (lost 2 stone in 4 mths), after op, or hope to lose remainder 3 stone before op. Or would further weight loss affect the sizes of each boob?! Any other Q’s would be good.

Thanks in anticipation.
artygirl

Hi Arty girl

So pleased you are getting near to the recon part of your recovery.I too had a TRAM recon on 29th June and its been a great option for me.Glad there is a specialist nurse as I think that would have been helpful for all the more practical info I needed, such as what undies to take into hospital etc.

I did as much info gathering before I went for the 1st consult and basically my surgeon asked what my choice would be and I said Id rather hear his recommendation first-thankfully he said TRAM so I was very pleased!!

Ive got plenty of tummy fat so no probs with the doner tissue.I think it depends a lot on your cup size which op is suitable. As for the uplift, its def a part of the service I was offered so you should hopefully be the same. My surgeon was also a plastics man, so he was very interested in the aesthetics and my new boobs match very well even this early, so Im probably not going to bother.

I was in the theatre for approx 10 hrs, in recovery for about 14 hrs and then in a single room(so they can keep you HOT to aid blood supply to new boob).I had a catheter in for four days and drains for 6.
I got out of bed in 2 days and started physio then too(very important)

I was surprised how quickly I got mobile and the staff are good at getting you moving generlly.
I am 5’6 and am now 14st 6 ilbs after loosing about a stone and a half but I concentrated on getting core fitness improved by swimming and gym and I def think that helped.
No driving for approx 6 weeks-I did 1st short drive y’day and was fine.

Im so pleased that you have been so successful with the weight loss-not easy so really well done. The surgeon will advise about further loss and may check your BMI, if youve had other tummy surgery and if you smoke.
I know Ive droned on a lot, but I found the info I got from others at your stage so very helpful to prepare for this big step.

Best wishes
Cathie x

Hi Artygirl,
I had an immediate LD flap reconstruction, so a bit different from you.

My PS explained the two options I (in theory) had and then checked me over. Even though I’m a bit overweight(5’4" and 10 st 10), I didn’t have enough fat for the ‘tummy tuck’ version so it was LD or nothing. The surgery is about three hours, with a night in high dependency (or it was at my hosp) to monitor the grafted skin and up to a week in hopsital (depends on how you go and how you feel about managing drains). As I had a skin sparing mx and node clearance at the same time it’s hard to know what caused what, but I had very little pain, a bit of a sore back when I lay on it, but otherwise, apart from arm stiffness/weakness for a few weeks absolutely fine. My affected side it still a bit weaker than it was - but I’m a bit wary of overdoing it as I don’t want lymphoedema.

I am awaiting nipple recon, tattooing and - yes - an uplift on my good side to make me match! It probably varies form PS to PS but mine is a perfectionist and sees symmetry surgery as part of the deal.

Ask you PS to show you photos - mine gets loads done for ‘teaching’ and ‘research’ which according to the medical photogrpaher means ‘to show to other patients’ Otherwise if you break the ‘golden rule’ and google LD flap (or DIEP/TRAM flap) before/after images youi will find some.

I am thrilled with my recon, it’s a good shape and is, in the words of my PS a “good C cup” (I was DD hence the need for balancing)

Hope this helps and that you get a brill result.

Hi, Artygirl

I agree with you - asking the right questions is important.

You may already have the answers to these, especially since it sounds like you’ve settled on the reconstruction method. If I had my time again (good LD reconstruction, but in retrospect could’ve asked more questions, and spent a bit more time exploring other types of reconstruction…) I’d be asking these:

  • What are the (statistical) risks of surgery going pear-shaped? How many patients come back for new surgeries (say if tissue did not survive or whatever)? Some types of reconstructions have lower risk than others.

  • Can an implant be avoided? Implants can mean long-term hassle - they can move, go hard, etc forcing new surgery.

  • Which bits of my body will lose sensation? (Discovering that a lot of my side has become numb was a big surprise for me). Again this varies by type of surgery. Some of the new methods like straticce sound particularly good on this score.

  • How big will my scars be?

  • How long will it be before I can go back to my normal life? (whatever that may mean for you… working or perhaps doing sport…)

Best of luck on Monday!

L

Revcat, can I ask a question? Presumably you have to go through a time where the recon doesnt match the other side … because the other side is tweaked or uplifted when the recon has settled. How do you cope with this ? Does it look odd? Is it very noticeable? How long is it before the other is matched?

Hi Angie

RevCat obviously hasn’t seen this. Can I answer - I have also had an mx and immediate LD flap +implant recon.

The simple answer is that it depends what you start out with in terms of both size and ‘droop’! I’m 49 and my boobs, tho pretty good, weren’t as perky as they once were. I’m a 34/36 B/C - depending on bra make and my weight.

My PS has done a fantastic job of matching my ‘new’ boob to the old one - down to the right level of droop, however I can see that it would have been difficult if I’d been very much bigger, etc. In that situation it depends on your individual circumstances and the preferences of the medical team as whether they do an immediate adjustment to the remaining boob, or whether they wait and do it at a later date.

Hope this answers your question.
Dx

Thanks DJ … am making appointment to see consultant to discuss when and what … but this has helped me greatly as you are the same size as me … Finish chemo at the end of this month and think I’ll have a break before reconstruction … and plan to have it early next year all being well …

Good luck with whatever you decide - but remember that diff surgeons/teams have diff prefs/specialities. If you prefer the idea of a diff type of recon to what you are offered, think about asking for a second opinion.

Dx

Thankyou all, even Everton Babe (I’m an LFC fan!). Only joking! Great advice. Well I went today and was really impressed with their professionalism. They were very thorough, and explained the process in full, including stats for things going wrong.

I am on the wait list (prob mid Jan 2012 for op, and am having the Tram or DIEP, using all or mostly fat, with a reduction in size and a tummy tuck. I am also having the other boob altered to match but this will be done once first lot settles down. I didn’t even need to ask for this, it was offered!

It sounds a pretty serious op and falls at a bad time for work, but I am putting me first for a change. I was told I could lose more weight, but not too much or the tummy fat will not be enough! Apparently if I lose weight after the op, both boobs will get smaller at a similar rate.

Nervous but excited too!

Thanks again, Arty Girl

hi arty girl
I am due to in in jan 12 in ncle -perhaps we will see each other ! they have a special care bay which is very hot to help the blood supply and I have just been on the ward as I chose to have reduction lift of my healthy breast now instead of after [still may need a bit of tweaking]
pm me if you want to discuss further - but good luck regardless x

Hi Enaid

Read this thread with interest, I had a reconstruction a couple of years ago (LP flap) but due to infections etc had it removed. I am know seeing a P S surgeon this Friday re: Diep/Free flap, not sure if he will do this but my breast surgeon thinks he will. I would be interested in how long the waiting lists are for this procedure. Also where you are having the op, I know you cant put that on the site perhpas you could send me a private message, I live South East

Sorry forgot to add this to my last message:

Have any of you other ladies who have had or seen a consultant re: Diep have any questions you would advise me to ask

Thanks

xx

Went for the appointment, the consultant said I was an ideal candidate for the DIEP. Told me the op’s about 6 hours and the stay would be about 1 week, went through loads of things with me and really put my mind at ease. I am still terrified of the op but nothing ventured nothing gained. Had a blood test, now waiting for scan appointment at Haywards Heath, he said the waiting list is up to 9 months.

Here I go, cant wait to see the results, this time next year I should have 2 boobs!!!

L

Hi Artygirl,
I had a free Diep Flap Reconstuction at Newcastle RVI last Tuesday 13th September. My surgery was 6 or 7 hrs, recovery for about 4 hrs. I only stayed in hospital until Saturday. Its a fantastic hospital, I had great care. My surgeon was fantastic too.
I’m at home now laying on the sofa being waited on hand and foot! Not in too much discomfort laying down or when I’m sitting, but still a little sore if I walk about. I know already how worthwhile it’s been. I love my new flat tummy and by boob and cleavage is exceptional!!
I was told they would look at uplifting my other breast when they have settled down.
Paula xx

Hi all

Interseting to hear from you PP as you have had it done in same hosp and so recently. Hope all’s well.

I am now going to have a tissue expander 1st for 2-3 mths, followed by diep jan or feb, so getting a bit scared now. not looking forward to the hot room as get very hot at it is, could I have a fan, or does that defeat the object?!

Hoping expander wont be too uncomfortable, or maybe I could finally get some sleeping pills (not slept a full night since mast in oct 2006!)

Hi, I’ve just googled recon and come across this forum.
It’s great to read everyone’s comments/experiences.
I have been on the waiting list for a year for bi-lateral DIEP recon at a hospital (nr Ediburgh). They’ve just called me and offered me 28th October, so I’m very excited and nervous.
I’ve really swithered about having recon or not, but at 46 I want to be able to dress without worrying about a prosthesis (I had a good laugh at the airport scanner comments!)
So I’m gonna take the plunge, so many women have come through it before me so that really helps.
Thanks for all the tips you’ve all posted, it really helps to know what to expect and plan for.
All the best
Susannah

Hi

i had my Tram Flap reconstruction in Dec 2010. It went very well and I am very pleased with results. My new boob is a very good match. The surgeon said he would put me on the list for uplift of the other side.

Take care

Carolyn x

Hi Artygirl

I’ve been travelling to Newcastle for appointments for double recon using tummy, been going up for around 2 years now, don’t ask… I had the tissue expander it was fine just uncomfie when being pumped. I went in for my double recon and unftorunately due to a nurse giving me a tablet she shouldnt my op was cancelled 2 mins before theatre, was gutted, however I opted to have a second mastecomy and expander but in fully expanded, have two very different looks whilst waiting for the op again. dont be put off by this Im going back in November to push for a date as dragging on but I didnt have to stay in the hot room due to lack of beds and it wasnt quite as bad as I expected and the nurses were lovely, I was out two days later.

So dreading the op as i had to stay in room with people that just had it done which was a bit off putting but Im still going ahead x Good luck