implants and more

Hi Everyone

Finally I met with the breast surgeon and plastic surgeon re risk reducing mastectomy & reconstruction.

I’m still 100% certain that implants are the best option for me but thoughts keep cropping up…

apparently radiotherapy can alter the skin and make the chances of implants only less successful…has anyone any experience of this, good or bad?

has anyone had surgey at Whiston under Miss Chagla, Mr Graham and/or Mr Iqbal

what do I do about nipples - Miss Chagla recommends removal for complete risk reduction - has anyone had other advice - Mr Graham says reconstructed ones are far from perfect, so is stick on the best option?

I feel a bit dazed at the moment, I am just so relieved to know this will go ahead sooner rather than (too) later but I feel in a muddle.

Any comments or shared experiences will be most welcomed.

Sue X

Hi Sue,
I had a skin sparing mastectomy a year ago and had immediate reconstruction. I was lucky that I didnt have to have radiotherapy so could have the reconstruction straight away, was told I would have to wait until after radiotherapy otherwise as it can damage the implants. I had my nipple removed and later had one reconstructed and tatooed and am really pleased with the results although not perfect it looks very real and is preferable to a stick on one in my opinion.
Good luck with the surgery

Deb x

hi, i’m also in the process of having reducing mastectomy & reconstruction. i have chosen to keep my nipples as i want to and my surgeon has said as it is such early days with these operations they dont really know which is the best keeping them or removing them, so i have choose to keep mine. i have not had a date for surgery yet, is anyone else in the Exeter area, am really keen to meet with other ladies that have been through the same.

good luck

Michaela

Hi,

I am having my mastectomy in January 08, but have to wait until after my rads and herceptin for my reconstruction - plus they want it to heal fully before doing the op.

What I am wondering - and this sounds completely vain, under the circumstances - I am extremely flat chested and cannot believe for one minute that implants are available in such a small size, they would practically be naked to the human eye! Has anyone ever had both breasts enlarged a little for this reason? I will discuss all the options with the plastic surgeon when I meet him of course, but would like to hear other ladies experiences if possible.

I hope nobody thinks I am making light of the situation,

I wish you all the very best of luck and a very Merry Christmas.

Tracy xx

Hi Tracy,

I do remember a comment by a lady on a recent thread saying she had been offered an implant on her other side to take her up a size, so yes, it does happen.
I’m also smallish, 34AA (if i can find one!), but my attitude is that I still have one original left, so I don’t want anyone messing with it!!
Good luck with your plastic surgeon, I hope he can give you the christmas pressie you want, and no, I don’t think you are making light of the situatuion at all. I’ve discussed implants generally with my mum in the past, as I inherited my lack of size from her. She said if she was younger she’d go for it, I’ve never been keen. I’m now deciding if I want an implant recon, or something like an LD flap…my surgery should be happening in Jan.
I hope your surgeon can answer your questions and give you what you want - we all deserve the best we can get out of this situation!

Shannon
x

Hi Shannon,

Thanks for your reply it was really helpful, I can certainly understand your not wanting surgery on the both breasts, and I don’t think I would ask for it myself but would consider it if offered - but I guess that will depend on how I feel after my mastectomy in January, I may not want to go through with a double dose of surgery.

Good luck with your surgery and have a lovely christmas,

Tracy xx

Hi Sue

I have had a bilateral mastectomy on the 8th Nov of this year and had expander implants fitted at the same time. on my right side i had no option to have the nipple removed as the cancer was quite large. the left side my surgeon advised to have skin sparing mastectomy but to take the nipple to lesson the chance of cancer.

As you a felt that implants were for me 100% . The doctors for a while were trying to talk me into have the LD flap because of me needing radiotherapy, which they kept reminding me of the risks and the chances of failure. After reading up about the different recon i still opted for implants as there are risks and chances of failure on any recon, which the doctors quite nicely forgot to tell me. They have said that if the implants do fail then i can always opt for the LD flap as a safety net. My plastic surgeon told me that the failure rate for implants with radiotherapy is 25 - 50 %. I’m determined i’m going to be that 50-75% success. Please read up about it, i’ll let you know how i get on. my radio starts in straight after the new year.

They have fitted the expander implants and at the moment going every week to expand them as much as possible before my radiotherapy. They are expanding me every week as it is much harder for your skin to stretch after the radiotherapy. The expanders will be replaced by permanent implants later next year.

Wishing you well
Karen xxx

hi my name is jade im 21 and have two children both boys 4 and 19 months my mum has had breast cancer twice now in opposite breasts each time and has had radio and chemo both times also she recently found out she has brca2 gene (not sure if any of you are familiar with this?) i was then had genetic testing and have unfortunatly inherited these gene also… i did think before had about gettin my results if i did have brca2 i would like to have a double mastectomy and reconstruction… i am now waiting for an appointment in the new year to discuss double mastectomy further … if any of you could help me out with a little info that would be great… im aware it will be painfull and as you know i have two young children and am wondering how long it normally takes to recover after having a full mastectomy (and if you have also had ) reconstruction also… as vain as this may sound im quite worried about having some horrific looking breasts also as im guessing they will look quite fake and im around a size 38d/dd so they couldnt be hidden :frowning: please help if u can give me any info ive tried looking for more info and pics and havent got very far… thankyou and have a lovely christmas xxx

Hi

I am a 32 AA (although consultant said Im actually smaller then that!!!) I have low grade DCIS in my right breast. Cause of my small size a clear margin will not b possible so a masectamy was recommended. He also suggested if I did want to increase a size I could have a bigger size reconstructed with an implant in the remaining breast. However cause both my Gran and Aunt had breast cancer i do not want to leave any risks of it comming back at the other side, so have decided on a double masectamy with reconstruction on both breasts up to a B. This will involve tissue expanders. I was thinking if Im having to go through this I might as well end up with something to show at the end of it :stuck_out_tongue: OK maybe vain, but it gives me something to look forward to at the end of all this and will hopefully help me to stay positive throughout it all.

Hope ure all having a nice xmas!

M

Hi Tracy

I too had extremely small breasts and have just had a mastectomy with immediate reconstruction using LD flap from my back and implant in my right breast and silicone implant in my left. I am now looking down at breasts for the first time in my life! My surgeon was more than happy to enlarge both breasts as th LD flap alone would have been larger than my other breast and it made his job of balancing them up much easier. It added just 20 minutes to the length of my surgery and I have only gone up to a b cup as i didnt want them too big. So my advice is go for it girl!! Why not get something positive out of this. I would never have had the courage to go for a boob job if it wasnt for my cancer - every cloud has a silver lining. I wish you well.

Annie

Jontymum - there is a board dedicated to preventative measures on another forum (edited by Moderator). . After a certain number of posts on the main forum (genetics) you can access the preventative measures section, also there are some very useful photos from brave ladies who’ve shared all! It helped me a lot after I was dx’d last summer but decided to have the other side removed as well. I’ve currently got the tissue expanders in but on chemo and awaiting rads so not sure how mine are going to turn out. I’m 36 now and have two boys aged 3 and 6 at the time of my op.

Cosmetically, some of the results are really good. I think a lot depends on how you view it though. I compare the results to the only alternative for me which is nothing there at all.

Good luck!

Nicola

Hi Emma,

No, I don’t really understand why that rule is being so rigidly applied. This forum doesn’t have photos of reconstructive surgery and I haven’t found anywhere else where you can see stage-by-stage photos apart from the forum I was referring to. I found it a huge help to find another site that showed me what to actually expect at each stage. Dealing with bc (or the threat of it) is bad enough without unnecessary further obstacles in our path.

Jontymum - at your appointment, you could ask to see photos of completed reconstructions. On the day of my dx, they offered this to me - it was useful although it doesn’t show what you will look like immediately after surgery or during the expansion stage.

Nicola

Hi

I had a bilateral risk-reducing mastectomy 7 months ago… I had 34a breasts before the op. I had a skin-sparing procedure, kept my nipples and had fixed volume silicone implants placed under the chest muscle with no expansion. I didn’t have radiotherapy but I understand that yes, it does affect the quality of the skin and can slow down the healing process and also, if you have implants with radiotherapy, it causes the implant to harden so it becomes painful and has to be removed. I understand you have to wait a year after the last radiotherapy session before you can have implants.

One word of warning: I asked my surgeon to reconstruct me to a 34a and I have ended up as a 32/30d! This appears to be because of the width of the implant - in clothing I don’t really look very different but bra shopping is a pain. I am very small build and apparently, for implant-only reconstructions (ie where it’s being placed under the chest muscle and not among transplanted tissue like an LD or DIEP with implant), the implant has to be a certain width to prevent slippage. This means that recreating an a-cup is extremely difficult and, for the lady who only wants a single sided mastectomy, you should keep this in mind. Often what will happen is the surgeon will “adjust” the other breast accordingly and usually with a smaller implant to bring it up to size. In other words, you will probably end up having surgery to your “good” breast anyway.

One final comment: a reconstruction will never look like your original breasts although one that uses tissue will look a lot closer. If you are choosing an implant only recon, I would thoroughly recommend a bilateral for symmetry.

I had a mastectomy Oct 29th; Aged 50; petite and fairly fit; healing well and luckily no subsequent therapies. I did not have skin sparing surgery. Unfortunately the information from one of my breast care nurses focused mainly on LD reconstruction. I was reluctant to have this type of invasive surgery and due to a lack of information at the time I hadn’t fully appreciated the possibility of alternative options e.g. tissue expansion surgery. I’m not sure that I even understand “fixed volume silicone implants placed under the chest muscle with no expansion” mentioned by darkfairy. I am anxious to make a better informed choice now and considering tissue expansion . Worried about a number of things:- how long might it take; the pain; the look of it during expansion and the final look of it. Wonder how it compares to the other breast? Any help would be appreciated

Hi Clare
Welcome to the forums, I am posting a link to a BCC publication about breast reconstruction which you may find helpful to read, you can read it via the following link:

breastcancercare.org.uk/docs/breast_reconstruction_dec06_web_0.pdf

You are also welcome to call our confidential helpline for further support and information on 0808 800 6000, it’s open Mon-Fri 9am-5pm and Sat 9am-2pm.

Best wishes
Lucy

Hi,
I opted for immediate reconstruction with expander implant one year ago (on the basis the chances of needing radio were small due to my tumour size), just before finding out that I would need radiotherapy after all since my tumour was grade 3. I had chemo and then radiotherapy, which has now affected the options I was hoping for in terms of final reconstruction (the expander implant was always going to be replaced by a permanent one and I was hoping for a implant on the other side as I also am flat chested).
Although my implant does not seem to have suffered much after radiotherapy (I got a low dose to prevent this kind of problem), the surgeon says that it still had some kind of effect on the tissue, even if quite minor.
I am now thinking about having a LD flap after all to replace the expander implant (which is an op I had ruled out at first as I did not like the idea of affecting another part of my body, if avoidable) as I find the implant quite uncomfortable and very firm compared to normal breast tissue (plus the fact it is slightly bigger than my remaining breast!)
I was hoping for LD flap + small implant on the reconstructed side and implant on the other to increase the volume, but, as per my surgeon preference, I will now have to have a straight LD first, and then possibly another augmentation or adjustment op in the future…which I may not bother with by then.
I need to make up my mind on Friday this week.
So, it is something to bear it in mind in case you need radiotherapy. At the end of the day, something can always get done but your options may be limited or more long winded (requiring extra ops) if you end up getting radio on implants, even if there is no obvious bad reaction.
Good luck