My double mastectomy and strattice reconstruction operation

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There have been various threads on here about strattice reconstruction.

Two weeks ago I underwent a bi lateral mastectomies followed by immediate strattice reconstruction on both sides. I thought that it would be useful to detail my experiences about this form of operation which I believe will be gradually being used in place of the LD Flap.
Strattice reconstruction is a relatively new procedure (and very expensive!), instead of using the LD flap to cover the bottom part of the implant it uses a form of tissue matrix to hold the bottom part of the implant in its place by a kind of internal ‘bra’. The pec muscle is still used to cover the top part of the implant.

lifecell.com/patients/369/

The advantages over the LD flap are mainly that your back muscles are not touched, the operation is quicker (about 4 hours for a double one), and the stay in hospital and the recovery after are much quicker.

I had my operation on the Monday evening, it took about 4 hours, which I believe is much quicker that a double LD Flap reconstruction would have been. I had four drains, two each side, one at the top of each breast and one at the bottom. Additionally, as the strattice needs to be stretched and against the skin, the implants were expanded quite a lot during surgery, and it was really comforting to wake up to breasts, smaller than before, may be A cup size, but so great to have them there initially. I cannot pretend that my stay in hospital was comfortable, I was in discomfort, and walking to the bathroom a huge deal, however even 12 hour after the operation I was up and slowly walking a few steps.
I was allowed ( and expected) to go home 2 days after the operation, which was much earlier than I imagined. I did have to go home with the four drains in place, as it is very very important that the fluid that is draining from the breast is at a very low level before they remove the drains, as they do not want the fluid forming a barrier between the strattice and your skin, as it is very important that they stay in contact. So for this reason they left some of the drains in for just over 2 weeks. This was really hard, being permanently attached to drains, it was such a relief when they were removed. The drains that stayed in the longest were the hardest and most painful to remove, as my tissue had ‘healed’ around them. In fact the removal of the fourth drain was the most painful part of the operation.

When the final drain was removed, the expanders were topped up again, it was amazing to see them filling up my breasts!.
All in all, this has been an amazing journey, I have total confidence in my surgeon, even though it is the first one that he has done!.

Fingers crossed that the long term recovery is good
Hope this is useful to someone.

Crystal

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Crystal, thank you so much for sharing your experience. I am due to have double MX with immediate reconstruction on Tuesday 24th using Permacol which I understand is a type of strattice. As it’s such a new procedure I have struggled to find people to speak to who have had it, so reading about your experience has helped me a lot!

Shenagh xx

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Shenagh

Glad to be of assistance.
One exta thing I should have said, do not worry about coming home with the drains. Initially I did worry, especially as there was no nurse coming out to check on them!.
All we needed to do on a daily basis (same time each day) was mark on the bottle how much fluid had drained in to the bottle. Three times my husband had to put a new bottle on, this was really easy, not messy as I imagined, so no worries there.

I wish you all the very best, and if I can help please let me know, as I too looked for information and found very little.
In fact 1 hour before I left home for the operation was when the hospital called me to say how about a strattice operation instead of the planned LD Flap!!! so I had very little time to research too!.
x
Crystal

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when i saw you were posting about your op Chrystal i thought ill need to let shenagh know if she hasnt seen it already… but lo and behold she has LOL

im on the waiting list to have this done in about 6 months but my surgeon is still trying to sway me to LD as it has a better cosmetic effect than permacol which is strattices cheaper wee brother which takes longer to mesh… but i think overall id be happier to have the implant only recon at the present and if in years to come im not happy with it they will do an LD… if they do an LD and im not happy then its more difficult to go back to implant only.

thanks for sharing

Lxx

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Hi Crystal
So pleased you are doing well with the strattice reconstruction. I have seen my plastic surgeon again and he has measured me with a full implant which will be a C cup (I am currently a D). He also said it is his first strattice operation although he has done around 100 reconstructions, and there will be a technician from the cell company in the theatre. As my surgeon is so good at reconstruction anyway, I dont have a worry that things will go wrong during the op, but of course I think they will monitor me closely afterwards. He also said if things dont work out, I can always go back to an immediate delayed recon then on to a LD flap recon.Obviously hope all is okay and your experience seems to have been good so far. I am sceduled for my op (only 1 side thankfully) for Friday 3rd Sept, so still very nervous but hey, at least I wont have breast cancer!!!
Please can you tell me whether you are still wearing your support bra as the bcn has suggested I get a cotton front fastening bra, or 2 to be going on with.
Thanks very much for your post,take care

Annabelle xxx

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Crystal

I’ve just looked at the link you provided too and think the results look amazing!

Have you been told how long you might expect to be off work?

Thank you again : )

Shenagh xx

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Shenagh - I think if all goes well with the ealing, which it does seem to be so far that I will be off for around 6 weeks. I have an office job, so nothing physical. I am amazed with my results too, I have one nipple and that side looks fantastic, the other side, not so great, but it will do once they sort out a nipple at some point in the future.

Annabelle - great to hear someone else having it done soon. I was told no need to take a bra into hospital as the strapping would be so tight I could not wear a bra. True enough it wa like I was in a straight jacket, I was so tightly strapped up that in fact I have developed a few sores above and below the strapping. 10 days after the operation they removed the strapping and said to just wear a cotton soft spots bra. Mine is back opening, and I still need help to put it on. The thing is that the new boobs are so pert they just will not move. So in the house, which I am most of the time ( apart from hosp visits) I do not wear a bra, which is what my surgeon is in agreement with, I just wear a sports bra if gong out at the moment.

Lulu and all - I believe that the physical look of this operation give the same visual look as a LD flap, so personally I am pleased with my decision to go with this strattice - even at £1800 for each piece of strattice!.

I am now trying a few light exercises to try to improve my mobility, but I can asure you all that after over 2 weeks of carrying around drains, it feels fab to be able to move around a bit more.

thanks

Crystal

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Hi crystal, i am due to have my expander implant changed to a permanent one, after i have had radiotherapy. I am also hoping my surgeon will agree to a risk reducing mastectomy on the other side, as i have extensive family history of breastcancer. I am waiting for the results from the braca gene test. But my mind is already made up, with or without a possitive test result, i want it done, at some point in the future. So rather than having a implant and uplift on the good side, i am hoping he will do it all at the same time. Anyway to cut a long story short what i was wondering, when you had the mastectomy on the good side, what do they actually remove. Do you keep the nipple and all the skin.

Sharon x

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Hi Sharon

I’m having a skin sparing and I think nipple sparing MX on both sides so I’m hoping that means I keep most of the skin and both nipples. Can update more after the op on Tuesday!

Still so grateful to Crystal for starting this thread!

Shenagh x

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Hi girlies
Crystal - thanks very much for the information, it has been so helpful knowing that others are going through the same, and we can share experiences with a new type of reconstruction. The info about the length of time your had your drains in is very useful as I have lymphodema in my breast which is being removed. Hopefully keeping the drain in longer can reduce the risk of seroma or more fluid buildup - fingers crossed!
Shenagh - Good luck with your procedure next week, keep us updated on your progress, if Crystals progress is anything to go by, it at least is not as daunting as first thought.
By the way, where in the country are you both, I am in South East Staffordshire and use Good Hope hospital in Sutton Coldfield.
Cheers
Annabelle xx

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Ladies

I think that this site is absolutely fantastic, and it has given me so much useful information, that I just had to document my operation and it is great to know that it is useful to you all.

Sharon - On the side with the tumour I had skin sparing MX, but on the good side I had skin and nipple sparing, and I can honestly say that the good side looks great, the side without the nipple looks as good as it can without a nipple. I think that I will have the nipple reconstructed at some point - not sure how yet. FYI I am BRCA1.
Can youplese tell me why your expander is being changed to a permanent one, as i was lead to believe that I will keep my expanders?

Shenagh - wishing you the very very best luck with the op. For me the few days at home before the op were the hardest. My emotions were all over the place, however feeling so much better about it now the op is over!.

Annabelle - I had my operation in London, I live 30 miles outside, so had a rather long journey home after!. Glad to be of assistance.

xx Crystal

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Hi thanks for the replies girls, i feel like i am armed with enough info now, for my appt with the plastic surgeon tomorrow.
Crystal, i am having my implant which is a saline one, replaced with a silicone one, after i have had radiotherapy.
Sharon x

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Sharon

Is that because the silicone one should be more comfortable?

Thx

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Hi, yeah i think so, my expanders have saline in, and it sits quite high, its very round and very over inflated, so to stretch the skin alot. I think that the silicon one will be more of a tear drop shape, and much softer. I also have a port that needs to come out.]
I saw my surgeon yesterday, he wants to see me again in 3 months, to arrange the changeover op. He wants me to be 100% recovered from the chemo and well in myself. Only finished chemo last week.
Sharon x

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Gosh I think you ladies are amazing. To have this surgery done whilst going through chemo/ radio takes some doing I should think. You have given me hope that my reconstruction in March will go well. I am keeping my nipples which I hope is the right decision, my specialist is fine with it. So heres to better boobies I hope.

Best wishes

Hannah x

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Hi everyone
It seems this type of surgery is taking off quickly now. I had double skin sparing mastectomy with strattice mesh done on 2nd July (4 weeks ago) and couldnt find much info before I went in. But had total faith in my surgeon as this was my 2nd go with breast cancer had lumpectomy and radiotherapy 8years ago. I was a double d previously and my surgeon has said I will be again so don’t be put off when the literature says it’s for smaller sizes. I was in hospital for 3 days although to be honest I felt fine and was pestering to come out the morning after. I had drains in for 10 days and had to empty them myself every morning. It wasn’t difficult other than I’m a bit squeamish. I did find a really good solution with my drains though as the hospital gave me bags to carry them round. I found if I wore a tshirt and pinned the drain bags to the top they moved with me all the time and I could hide the with a baggy shirt or Cardigan and because the were on the side of my top I had plenty of play with the tubes and didn’t pull them. In fact one of my nurses said she would recommend this to future ladies. I’ve had one session of inflating done so far and it wasn’t painful just mildly uncomfortable. Mild pain killers were recommended for a couple of nights. And will be going back every 2 weeks for further fills. My worst bit is the boredom. Unfortunately I own and work with horses which is a physical job and I’m just not ready or confident enough yet to go back to riding as I don’t want anything to fail because of my previous radiotherapy. But as I feel better every day I’m hoping I would be up to it soon. Hope everything continues to go well with you all and if anyone has any questions or just needs a bit of reassurance please get in touch. Good luck to all you special brave women xx

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Hello, I had skin sparing mx with strattice and implant on 24th August(6 weeks ago). Can anyone tell me if the implant ever feels like it is part of you or if it continues to feel like something that is bolted on. I didn’t know anyone with implants but wish I had researched how they felt before having it done

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Hi Debz,
Don’t know about the “bolted on” feeling but it definitely felt huge for quite a while even though in a bra it didn’t necessarily look it. I had mine done on the 5th July so am a few weeks on from you. It started to feel a lot better around 9-10 weeks. I think there was still swelling up till then. I tend to forget about it now during the day when in a bra (unless I knock it or it aches) but can’t stand the feel of it when in bed and it just sits there, or, now that it has loosened up a bit it it is uncomfy to lie on my side for a while. Gone back to wearing a bra in bed. I had hope I might be back running by now but if I try I can feel a horrible sensation of the implant moving around and possibly rubbing against my ribs. I almost wish it did feel bolted on. You can see the outline of the implant now which is a real shame as before I guess the swelling covered it. It is a lot softer now and moves and has dropped a bit too.

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Hello captaininvincible. What sort of implant have you got, saline and gel or just gel? I was originally an A cup and had initially thought I would have an implant put in the other one and go up a couple of sizes but I have now decided to wait and see if this one settles down and feels ok. Also I am concerned about how they can see tumours around the implants.

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Gel.Was told she took me down in size by 100mls which I was quite happy with.