Today I got my treatment plan. Mastectomy followed by radiotherapy, possibly chemo depending on surgery results.
I have to decide if I want immediate or delayed reconstruction. I also need to decide whether I want implant (only possible with immediate reconstruction), LD flap with implant or DIEP flap.
Looking for advice from others - are you happy with what you chose? Would you make a different choice with hindsight?
I really don’t know what or how to choose. Every option has what feels like huge cons and I’m not sure which of those I can live with most easily.
I do know that I want a reconstruction, it’s just which option.
I haven’t had it yet so don’t know how it’ll pan out but I’m planning on single mastectomy with immediate implant placement as the one that will leave me the least uncomfortable for recovery (I’m a carer for my dad). I’d prefer something natural in there but having the immediate implant placement will allow me to retain the skin so if I want something else later that’s an option and could potentially exchange the implant for fat grafting. I was initially considering flat closure to have the absolute minimum but thought I might regret it later and really didn’t fancy diep / LD knowing I’d have extra pain and scarring, especially taking skin from my back when I lie down a lot due to pre existing conditions related to Ehlers Danlos / long Covid. The consultant said she can easily match the remaining breast with an implant so I guess I must naturally have very generic boobs ! Basically I chose the option that would leave me the most options afterwards and the least injury to other structures, she’s going over the muscle too to spare messing with the chest wall. I’ve said I want full lymph node clearance even though there’s only one node confirmed affected as I just didn’t feel safe leaving anything with early ultrasound changes in there. Hope this is helpful in some way and you get responses from people who have finished and recovered. You might find some more opinions on r/breastcancer and the blog theyrenottwinstheyresisters about a young woman having prophylactic mastectomy for brca1 mutation. She provides a lot of details and pics throughout her journey and that was 10 years ago so she’s well past it (double mastectomy with immediate implant reconstruction but no radiation needed).
Hello kittens, you took the words right out of my mouth!
I have my treatment plan meeting on Monday and from the conversations ive had so far with the doctor I think I will be in the same position as you. Perhaps with some chemo also.
I have spent hours debating these questions in my head. Tonight’s another example, still awake at 3am, boobs on my brain again.
I have a family history, my mum had bc at 50 and now me at 39 so all signs point to me having the BACR gene. So I keep thinking double mastectomy is the safest bet for me. But do I go flat, keep things tidy, take out as much risk as possible and get the op done quicker or do I try reconstruction? If I have the BACR gene, would they take off both boobs and reconstruct immediately for me? Could they just reconstruct both to a very minimal size so I wouldnt need any implants? So many questions haha None answerable until Monday I suppose.
Well done for getting your treatment plan, it must feel like a relief to know whats next. And thank you for your post. I look forward to hearing the perspective of people on the other side of this journey
I have the BRCA1 gene mutation and found out I have TNBC at my first high risk screening. I had a double mastectomy with immediate LD reconstruction and implants. My implants haven’t been inflated yet as I’m going through chemo at present.
I had the surgery in July and it was tough going, but totally worth it as the pesky tumour was scooped out. I’m only having chemo to make sure that any micro-nasties that managed to seep out are fried. As for the LD reconstruction, I’m very happy with it. The sensation of having my back muscles in my boobs is still taking some time to get used to and building my back muscles back up is still a work in progress, but even without the implant inflation, I have perky B, bordering on C cup boobs!
I’ll have the implants inflated at some point after chemo and I like that this is my choice. If I decide I don’t want them inflated, that’s ok too
Hi 3 years ago i had single mastectomy followed by immediate diep reconstruction. the recovery is longer but the results are great. looks and feels similar to other breast. i had it tweaked a bit and had a nipple made and a tattoo. Im. very pleased with the outcome! hope this helps and sending big hugs x
When I was told I needed a mastectomy, it was assumed I’d want a reconstruction as I was 50 at the time. I also didn’t know if I’d need chemo afterwards. The only option I had was a DIEP with a small implant and a reduction on good side, according to 2 plastic surgeons…. I understand how difficult it must be to have a choice, because I didn’t actually have any other option.
Although it’s a big operation, I don’t regret it for a second… don’t dismiss DIEP - it may be tough, but it’s now a distant memory for me 2 and a half years later and even though I don’t have a nipple, in a bra you’d never know! And I couldn’t be happier withe results
I had an immediate diep reconstruction when I was 67.
I did find the surgery quite daunting- up at 8am mastectomy first then off for microsurgery and part of tum put on chest. I was woken up hourly on first night to check the flap was still alive. I was sick but the sick bag was excellent. I was in intensive care but I had my own room with en-suite facilities. I did not use these as I had a catheter collecting wee and did not need a poo as drugs they give you also mean that does not happen for a day or two.
I survived and I am now 3 years on. I don’t have a nipple on the left now and it looks bigger than the other one. This could be getting worse as I have been eating a lot of ice cream recently and it all seems to be going to my fake bosom.
Thanks for helping me get that off my chest so to speak! I did loads of exercises when I got home after surgery so I could keep my left arm from stiffening up. also I worked on other areas that needed physio. I was given a handout on doing lots of different exercises 3 or 4 times a day. I did it all so I could get back to “normal” as soon as possible.
Hi - I had immediate single implant reconstruction in June. I was quite large breasted and the surgeon reduced and lifted the ‘good’ breast at the same time. I had an over the muscle prepectoral implant with ADM mesh and a dermal sling.
I’m very happy with the result. The symmetry is very good and I actually don’t feel that the implant is alien to my body as I was warned might happen. The implant is firmer than the natural breast but day to day I don’t notice this. I also have full skin sensation over the implant but the surgeon did say this was not the norm. I lost my nipple and am planning a 3D tattoo next year.
I wasn’t really a candidate for DIEP because of low belly fat but I wouldn’t have chosen that because of the wound on the stomach, longer recovery and possible impact on core strength. I also have Ehlers Danlos, as does a previous poster, and this also affected my decision. It was absolutely the right choice for me as my only recovery issue was slow wound healing caused by EDS.
I had diep flap over the summer and unfortunately was one of the 5/100 statistics where the flap failed. After 10.5 hour surgery, I went back in for further surgery to see if the diep flap reconstruction could be saved. It couldn’t so I now have a mastectomy. I have had and continue to have lots of complications as a result of the surgeries and needed a further surgery as well. It’s not an easy decision but good luck with your choice.
! Basically I chose the option that would leave me the most options afterwards and the least injury to other structures, she’s going over the muscle too to spare messing with the chest wall. I’ve said I want full lymph node clearance even though there’s only one node confirmed affected as I just didn’t feel safe leaving anything with early ultrasound changes in there. Hope this is helpful in some way and you get responses from people who have finished and recovered. You might find some more opinions on r/breastcancer and the blog theyrenottwinstheyresisters about a young woman having prophylactic mastectomy for brca1 mutation. She provides a lot of details and pics throughout her journey and that was 10 years ago so she’s well past it (double mastectomy with immediate implant reconstruction but no radiation needed).
