Can't decide ... diep or flat

Hello all
I haven’t posted on here for a while, finished chemo and rads several months ago. I had a mx with implant reconstruction a year ago, but the implant didn’t work well at all. It’s really ugly, with folds and stretching and swelling in the wrong places and feels very uncomfotable. They say I have a capsular contracture, my body rejecting the implant. So it needs to go. But I can’t decide whether to go flat or have a Diep flap (which my surgeon recommends). I’m small breasted and not worried about my naked body with just the one breast, but don’t know how I’ll feel wearing a prosthesis all the time - I’ve never worn one. But, I’m so pleased to be emerging from treatment/illness hell and don’t want another massive op and recovery time.
I know we’re all different and everyone needs to make their own decision, but I’d love to hear from others who’ve had to make this same choice, what you chose and how you feel about it, pros and cons, etc.
Thanks, love judes xxx

Hi Judes

Sorry you haven’t had any replies as yet, but I have put for you below the link to BCC’s publication regarding reconstruction, if you haven’t seen it I hope it helps. The helpline staff here will also be happy to talk through with you any issues you have regarding how to go with your reconstruction. Lines are open at 9am this morning until 5pm, calls are free, 0808 800 6000

www2.breastcancercare.org.uk/publications/treatment-side-effects/breast-reconstruction-bcc7

Hope this helps. Take care,

Jo, Facilitator

Hi Judes
I had DIEP/Muscle sparing TRAM however mine was an immediate recon. I am 6 weeks post surgery and although I would’ve preferred not to be faced with choosing which procedure to go for on top of diagnosis I can say that I am glad I made this choice. I knew that I didn’t want an implant and my Surgeon recommended DIEP. I needed tummy fat and as I had finished chemo I’d already put on some weight.
The cons are: long hours under general, long recovery time post surgery
The Pros: you have 2 breasts and both your own body, less complications with rejection and a flat tummy.
Hope you get more ladies posting on here for you.
Take care.
Dani
x

Hi

I had a delayed Tram flap reconstruction in 2010. I had my mx in 2007 and underwent chemo. I thought i could manage with a prosthesis but I didnt like it. Hot and heavy and didnt find it comfy. The op was a long one about 10 hours with a longish recovery. My husband took 3 weeks off to help me. After that i muddled through. It looks very good and I am going in for another small op on my good breast to uplift it and reduce slightly. As said previously you get a nice flat tummy. Wish you luck in whatever you decide.

Carolyn x

Hi Judes
I wasn’t able to have an immediate recon owing to the treatment so I’ve been using a prosthesis for the last 9 months. I know we’re all different and there are different ones but I HATE it. I agree with Carolyn - it is hot, heavy and uncomfortable and my skin itches, it’s a faff every day inserting into clothing and taking it out and putting it in its box every night (and I believe they don’t have a long ‘life’ so there would be added expense every so often). Even with a special T-shirt and/or mastectomy bras it doesn’t help. Because of the discomfort I’m aware of it all day which means I never manage to get away from thoughts of the cancer. So, personally, I can’t wait for the day when I can have a recon, even if it is a long operation and recovery time. I know someone who has recently had a tram flap recon and she’s overjoyed to have been able to get rid of the prosthesis.
It’s difficult to make a decision if you haven’t experienced both options but although I haven’t had the recon I know I can’t live my life with the prosthesis. I know there are different types of prosthesis but they’re expensive - I just have the one provided by the hospital and don’t want to go to the expense of trying a potentially better one as I have no intention of living like this for any longer than is necessary.
I hope the comments help but I dare say there are women out there who find the prosthesis OK.
X

Hi Judes,
I am really sorry that your implant has not worked out.
Its a diffiuclt decision. I understand completely your reservations about going through a long surgery after getting through your treatment from b/c. As you know, there is no right or wrong. Just trying to work out what you want to do, when maybe you dont really want either!!
I can add my experiences to the others. But like you have a ‘failed’ reconstruction.
I had breast cancer in right breast in 2009. Had the usual chemo. rads and surgery -WLE. In May 2011, learned I had a brca1 mutation (in case you dont know this is an inherited mutation which increases the risk of b/c bilateral b/c and ovarian cancer). I agonised for months over risk-reducing surgery. Like you, could not face a long operation and being ill again. But, did not want breast cancer again. I had limited recon options as I am slim, with small breasts and needed 2 breasts, not one! Had my surgery in Feb. - implants and strattice.
To cut a long story short, I had to have a completion mastecomy (ie removal of implant and skin/tissue) due to poor healing/infection due to previous rads of right breast in June. The op was relatively straight-forward but emotionally its been very hard, much harder than I thought. I dont really like being lop-sided, or that its so obvious in the clothes I would normally wear. I cant wear a proper prosthetic as I still have not healed - again this is due to rads (although planning a trip to Nicola Jane next week, so watch this space!). ATM just wearing baggy t-shirts/scarves but not really a long term solution.
My advice is not to rush into any decision (unless there is a medical reason). Take time to work out what you want. Maybe ask to talk to a counsellor, or someone on the BCC helpline? Dont know if it is possible to have implant removed and see how you get on, with the knowledge that you could have DIEP in the future?
For what its worth, if I could have reconstruction (atm this is doubtful due to poor healing), I would be really torn. As much as I hate being ‘one-breasted’, I think another op might be the end of me and so I have to try and learn to make the best of what I have. I know I might change my mind on this in the future and as things progress it might become an option, but I just dont think I could do it. Also, while there are many ladies who are happy with their reconstructions, there are others who have adjusted to living without reconstructions.
Good luck with your decision, Rattles x

Hi there,
I can understand your disappointment at having to go through more reminders of the BC…and potentially surgery. Like dani I was able to have an immediate mx/DIEP, but I’m in touch with several ladies who had delayed recons and I’ve seen their really good results.

The DIEP op varies in length, not always as long as feared…I think 6hrs is the minimum I’ve heard of. You could probably pick up my experiences last year in the DIEP thread, if you’re interested. I was terrified as I’ve never had surgery before, but can honestly say I wasn’t in pain, except from backache…which was soon dealt with when I saw a physio. I’ve just had nipple recon and am happy to share photo with you if you pm me with your email. I’m sooo pleased as it looks like my breast again. Recovery from the DIEP is quite amazing…you quickly pick up, considering. I live alone and coped afterwards…with a bit of planning and help from my friends. Walking is good, so i took myself to the local on the corner for a sandwich after 10 days! But I was driving after five weeks.

These decisions we make stay with us for a long long time, it took courage to go for it but I’m so glad I did.

Best of luck

Hi,

If you have small breasts maybe consider fat transfer? So long as you have some fat to donate from elsewhere you should be a good candidate. Not many places are doing this, though, it’s very new indeed but means you avoid a long op and recovery time is short.

Becky x

Hi
Im reeling from just being diagnosed with recurrence of bc after WLE 12 years ago. So its a mastectomy and Ive been offered reconsruction at the same time using muscle from my back (sorry I dont know the surgical lingo yet!) and reduction of my right breast at the same time. Yuk! Im so confused and absolutely perified. My consultant explained that its one general anesthetic and one recovery period but Im worried that Ill have three wounds and in surgery for such a long time. Ive just had an SNLB and waiting for the results and have an infection which is very sore. 12 years ago I had a similar infection, and the though of having infections in three sites makes me feel so sick! Its such a difficult decision an I just dont feel able to make it. best wishes to you all.
Carole

Hello Cleokeo

Welcome to the forums, maybe you would like to talk things through with a member of our helpline staff who can offer emotional support as well as practical information.

The free phone number is 0808 800 6000 and the lines are open Monday to Friday 9.00 to 5.00 and Saturday 10.00 to 2.00.

Best wishes

June, moderator

Hiya,
I opted to have second mastectomy as risk of reccurance was so high, after nearly a year of being lop sided and wearing a prosthesis i have now been " flat " for seven months and feel such a sense of freedom it helps me to be positive about my secondaries, I think this is such an individual decision to make you need to be aware of all your options and it helps to see what other ladies are/have gone through, at the end of the day ( I hate saying that) only you can decide what is best for you and your lifestyle I wish you all the best whichever you choose x

hello all, thanks so much for your comments. sorry i haven’t been here - i was away for a few weeks. in my absence i’d sort of decided that flat would be the best but now reading these comments i’m not sure again. the thing i’m worried about with the DIEP is that it might not be the final op, that there might be a need for more, perhaps because my immediate implant recon went so wrong i anticipate something going wrong again.
those of you who hate the prosthesis, are they big, heavy ones? my other breast is small so i’m thinknig maybe a small prosthesis wouldn’t be so bad.

thanks again, judes xx