Has anyone had the above mentioned surgery? I have been diagnosed with High Grade DCIS and although not really talked to the doc about reconstruction as yet this is what I am thinking I will have. Does anybody have anything good or bad to share about this method?
Hi
I had a double mx in April with immediate reconstruction using implants and the LD flap technique. I elected to have the bilateral as I didn’t want to worry about cancer appearing in the healthy breast and also because I knew the result of the reconstruction would nowhere near match my other breast. To cut a long story short I am delighted with the result. I now have two matching breasts with a good symmetry. My plastic surgeon was excellent and from the outset was determined I was going to look as good if not better than I did before surgery. The operation is long (8 hours for me) and it was a day or two before I could even think about climbing out of bed. But once I was up and moving I went from strength to strength. Fortunately up to now I have not suffered any problems and all the wounds healed really quickly. Two bits of advice - listen to what the surgeon tells you - she advised me to sleep in a sports bra on my back for six weeks so that the implants and everything could bed nicely. The other thing I recommend is exercise - I was a runner and am just getting back into my jogging. However I walk every day and also do arm exercises to prevent lymphodaema etc. My breast surgeon advised to try and stretch as much as possible because if you don’t then you could end up being slightly hunched. If you are fit and healthy you will have no problems.
Vicky
Hi
I had DCIS high grade in L breast, and IDC Grade II in r breast, following 2 x WLE 2 weeks ago I have to go back this thrusday for more tissue to be removed as the margins taken were not clear. I am now considering asking my surgeon about a bliateral mastectomy with immediate reconstruction. I am scared about having had cancer in both breasts, one of which was classified as “aggressive”, would rather not have them at all if it means I reduce my chances of getting it again in future. Was the operation what you expected, and what is the “flap” thing you are talking about? I don’t know enough about this yet.
Jackie xx
Hi Jackie, I also have High Grade DCIS in my left breast, mine presented as a lump which apparently is unusual for DCIS so I have had a further biopsy to see if they find anything more invasive there as well. At present we do not know whether there is anything in my right breast but I am requesting a bilateral mastectomy as I have a gene defect called Li Fraumeni Syndrome which means I have a highly increased risk of lots of different cancers and a 90% chance of breast cancer so even if there is nothing sinister in my right breast I want it gone with the other which will significantly decrease my cancer risk.
I’m concerned about the recovery time as my son, aged 4, is currently undergoing treatment (chemo) for Rhabdomyosarcoma as he too also has the gene defect. His tumour was on his face and in August he had the op to remove it and rebuild that part of his face, they use the LD (Latissimus Dorsi) flap technique to do that and then used a skin graft from his leg to cover it. It basically means they remove a muscle from your back to use for reconstruction, kinda below your shoulder blade.
I do really like the sound of the TRAM flap op as Ireckon I’ve got plenty of spare tissue in that area that I would quite gladly give up but my main concern is the recovery time and also the pain factor coz I’m crap at pain. I need to be back on my feet and back to ‘normal’ asap to be able to look after my son and help him through the rest of his chemo and also so I’m here to support and care for my two daughters too.
Hi mumof3,
I am thinking seriously about having bilateral mx. I’ve had a segmental mx but the area of high grade DCIS was large and there was invasive ductal cancer and several grade 2 foci within the DCIS, and negative margins. I am waiting for it to be completely healed before having an mx with immediate recon.
I had high levels of fertility drugs in IVF treatment 10-15 years ago, and although ‘the jury is out’ on the BC risk, I am concerned about cancer recurring in both breasts. I have family history too. I will need surgery on my currently ’good’ breast to reduce and uplift to match the smaller recon’ed breast, and feel that it would be more sensible all round to have the double mx. Similar thinking to Vicky really.
A contact of mine had bilateral surgery with expandable implants about 2 years ago and is delighted with the results.
I think implants would give the quickest and simplest recovery time, only involving one part of your body. I liked the idea of the DIEP flap, but my tummy isn’t big enough – damn!
Let us know what you decide
River
Hi ladies,
The only thing I can add which is not much, is that after my recent mx for ductal and lobular cancer, I was not offered immediate reconstruction as I will have to have radiotherapy after chemo. My Consultant said I couldn’t have reconstruction before rads and I am sorry to say that I can’t actually remember why. You know when they tell you loads and you can’t take it all in. I think because I didn’t want immediate reconstruction anyway that I kind of switched off. If I remember rightly it can affect implants and also if you have rads around your under arm then you can only have the Tram flap op and I certainly have enough there to fill a breast or two, or three!!! Of course hospitals do seem to differ slightly in their ways.
Take care, love to you all,
Jane
River, I have enough tummy for you as well!!!
Yeah River, I’ve probably got some tummy to spare for you too, lol.
Providing that my 2nd biopsy only shows the DCIS like the 1st one its highly likely that I will not need to have radiotherapy as I have to avoid any kind of radiation if at all possible as this even further increases chances of a future cancer and my odds are already high enough. SO the hope will be that the surgery will be successful enough to get away without having any other treatment.
Thanks both for you donation offers! LOL
If my first surgery had been sufficient, I would have had rads, but having the mx, it’s 99% that I won’t need it. They will make decision re chemo and hormone therapies once they have the pathology from the mx. I take it one step at a time as far as poss and try not to second guess too much. But we need to be well informed in our discussions and it’s impossible not to read ahead in these forums, forewarned is forearmed!
River x
hi there, I had this surgery in May. I had DCIS in both breasts, so a bilateral mastectomy was the only way to go really.They said I could have recon done at the same time, so I discussed this with the plastic surgeon. I wanted the tummy tuck option, as I could definately have made two good breasts out of my tum! However I chose implants (with no expander) as this was the least time in surgery (5 and a half hours, as opposed to about 8)and a quicker recovery time. I also didn’t want to be getting over surgery to both breasts and abdominal surgery.
I too was advised to sleep on my back for at least 4 weeks and wear a bra (I still wear a bra occasionally at night). I found this quite difficult, as I always go to sleep on my side. I have found the implants to be somewhat uncomfortable on occasions. The shape of them is fine and now the swelling is gone I have some clevage there, which is nice!I am now waiting for a date for my nipple recon to be done.
I had my lymph nodes removed from my right side, so now have the risk of lymphoedema, so I excerise my arms daily and moisturise them to. I think at the end of the day it is down to personal choice, whether to have implants or tram flaps etc. I was just really grateful I could have an immediate reconstruction done and my choices were made on the quicker recovery time really. Hope this helps a little.
Message to mumof3. The following may have been received via private mail. if not, here goes.
Hi
Sorry for the delay in getting back to you. I did compose a reply but it seems to have got lost somewhere in cyber space. Basically you can ask me any question you like either by private mail or on the forum. Prior to my reconstruction I was a 36D borderline 36DD. After reconstruction I am a 36B/C. To be honest with the immediate reconstruction I don’t feel like I have had a mastectomy. It feels more like I have had surgery to improve my breasts. My old boobs were heavy and were heading south at an alarming rate. My new breasts are firm, petite and I can actually got without a bra and still look good. Under clothing the new ones look much better. On the downside I lost my nipple and even though I will have a new one reconstructed after my chemo finishes, it won’t have any sensation. On the plus side the reconstructed nipples I have seen on other women look good and real. I was initially going to have the tram flap (muscle/fat) from the stomach. However was told by the Plastic Surgeon that I did not have enough fat to make two new boobs - one would be OK but not two. As I wanted the double mastectomy - I elected for the LD flap (fat/muscle from the back) and tear drop implants made up of saline and silicon. The implants are permanent and as I still have the portals in, saline can be added or taken out to adjust the size. I could go bigger if I wanted to, however I always wanted a smaller,neater bust so have elected to stop at 36B/C.
When I first had the surgery the doctors and nurses were obsessed with infections etc so checked me regularly (the first night I was checked every hour) and give me loads of antibiotics. Because of the fact they are over cautious I did not experience any problems. I also slept with a bra on for six weeks and on my back which was a little uncomfortable. At first the implants feel like aliens inside you but after about six weeks they start to move and feel like your own body. Now I don’t feel any different. Obviously I have scars which can’t be avoided but even these are smooth and fused rather than raised and hard. What I did prior to meeting the plastic surgeon was trawl the internet for pictures of reconstructions. How they do it is all dependent on body size, fat allowance and your overall fitness. Good luck and let me know how you get on.
Vicky
Message to mumof3. The following may have been received via private mail. if not, here goes.
Hi
Sorry for the delay in getting back to you. I did compose a reply but it seems to have got lost somewhere in cyber space. Basically you can ask me any question you like either by private mail or on the forum. Prior to my reconstruction I was a 36D borderline 36DD. After reconstruction I am a 36B/C. To be honest with the immediate reconstruction I don’t feel like I have had a mastectomy. It feels more like I have had surgery to improve my breasts. My old boobs were heavy and were heading south at an alarming rate. My new breasts are firm, petite and I can actually got without a bra and still look good. Under clothing the new ones look much better. On the downside I lost my nipple and even though I will have a new one reconstructed after my chemo finishes, it won’t have any sensation. On the plus side the reconstructed nipples I have seen on other women look good and real. I was initially going to have the tram flap (muscle/fat) from the stomach. However was told by the Plastic Surgeon that I did not have enough fat to make two new boobs - one would be OK but not two. As I wanted the double mastectomy - I elected for the LD flap (fat/muscle from the back) and tear drop implants made up of saline and silicon. The implants are permanent and as I still have the portals in, saline can be added or taken out to adjust the size. I could go bigger if I wanted to, however I always wanted a smaller,neater bust so have elected to stop at 36B/C.
When I first had the surgery the doctors and nurses were obsessed with infections etc so checked me regularly (the first night I was checked every hour) and give me loads of antibiotics. Because of the fact they are over cautious I did not experience any problems. I also slept with a bra on for six weeks and on my back which was a little uncomfortable. At first the implants feel like aliens inside you but after about six weeks they start to move and feel like your own body. Now I don’t feel any different. Obviously I have scars which can’t be avoided but even these are smooth and fused rather than raised and hard. What I did prior to meeting the plastic surgeon was trawl the internet for pictures of reconstructions. How they do it is all dependent on body size, fat allowance and your overall fitness. Good luck and let me know how you get on.
Vicky
Oops - sorry must have pressed the submit button twice. Apologies if this is boring.
Sorry to be posting a negative response here but thought I’d put the other side of the story. Last year I had a Bilateral Risk Reducing Mastectomy (for DCIS and LCIS) and Immediate Reconstruction with Tissue Expanders. Unfortunately I couldn’t tolerate the expanders and they were removed after 18 weeks of constant pain and spiking temperatures. Initially all of my pain disappeared but I’m left with tightness in my upper chest almost constantly. At my last Out-Patient appointment I cried as my chest is very disfigured and I can’t see it ever feeling any better either. This prompted a referral to the Psychological Medicine Department.
I saw the Psychologist as suggested by the Royal Marsden and guess what?? The Psychologist said that the way I feel is completely understandable and reasonable after the past year and a failed reconstruction and she has written to my Doctors to tell them they need to diagnose properly what is causing this continual tightness in my chest, put it right and get on with reconstructing me once and for all!!!
She was very surprised that I’d been referred at all (the letter said it was because I was still complaining of continuing chest tightness) and felt that unless something is done to alleviate the physical symptoms I will be “stuck” here forever. She doesn’t feel that I’m depressed, don’t need anti-depressants but do need answers and now!! She said that Doctors are very bad at diagnosing what a problem is and prefer to just reach for a tablet and if that cures it pronounce that it “must’ve been that then”!! She also tends to agree with me that my chest muscles were probably damaged in the original surgery to put the expander implants in and that I should’ve been taken more seriously when I said I was in pain and could feel the implant moving and catching on my ribs.
I wasn’t told of any long term problems that could arise due to this surgery but feel that it’s something all women should be warned about.
Trudie.