bi-lat recons with diep flap, radiotherapy to follow

Posted for new user, Lucy

Please could anyone help with advice on having bilateral mastectomies,radiotherapy to follow 6 weeks after.
I have to decide soon whether to have flap reconstruction or go flat chested. I have been informed by the plastic surgeon my breast cup will reduce two sizes.I am concerned the radiotherapy will further reduce my breast volume, may change breast shape,skin may tighten and whether I should have the reconstruction.
Has anyone experienced fat necrosis of the reconstructed breast and have had to have the flap removed? My plastic surgeon has advised me the above may happen.
Does the abdominal scar, in the long term, give any discomfort or limit any physical activities?
Thank you.
Lucy.

Hi, have had ld flap 2 years ago, just following end of chemo, my breast swelled and I was admitted to hospital for a week on anti biotics, turned out to be fat necrosis, the expander was taken out after 4 months going round with a leaky breast. But must say it turned out ok, I do have a smaller breast but dosnt look to bad. Sugrgeon dosnt want to do any more messing around with reconn just in case I ended up with no blood supply, and I am more than happy with what I have now

good luck x

Hi Lucy,

I can’t help re the treatment order or options, but I have just had a DIEP flap four weeks ago. I haven’t had any problems so far with my tummy wound, it was a bt sore in places after the dressig came off after nine days post op, I think that was where the seam n my support garment was rubbing. It’s all healed really well. My tum is still a bit tight and I can’t quite stand up straight yet…but then they took away the whole lower part of my skin and fat which as it happens had the pregnancy stretch marks, and now I don’t have any stretch marks so that was quite a big area!

I have read posts in cthe last month from ladies who had recons before treatment and they worked out fine, some surgeons are evidently risk averse and others encourage you to go for best option even tho there is some risk. I understand a common course of action is to have the mx and temp implants to keep the skin volume, then have the DIEP recon later.

I’m sure you’ll make the right decision and wish you all the best,

Hugs
Lynette

Hello,

I had a bilateral mx with temporary expanders put in and will have a delayed DIEP next year. My decision was based on my surgeon showing me photos of how the rads can affect recon (and in some cases ruin it) and I came to the conclusion that I would prefer to wait to give the best chance of a symmetrical pair! However, I pushed for temporary expanders as I didn’t want to be flatchested and as they could easily be removed should they be affected by radiotherapy.

X