Own fat vs Implants?? Really big decision

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Hi all

 

I’m starting a new thread as my journey hasn’t quite gone in the direction that I once thought or anticipated, or was lead to believe.  When I was diagnosed with tubular ductal invasive carcinoma last November, the treatment plan was to have a lumpectomy then radiotherapy.  I decided to delay until after Christmas, so my op was on 9th Jan.

 

The results from my sentinal node biopsy was clear, but the tumour was bigger than they though (3.5cm rather than 2cm) and they didn’t have a clear margin.  So now I’m having to have a mastectomy.

 

It took ages for the plastic surgeon appointment to come through due to lack of communication between the hospitals, but finally I got to see him on Friday.

 

During the wait, after many chats with other women that I know in a similar situation and my own research, I decided that I wanted to have a double mastectomy, then recon with silicone implants.

 

My reasoning behind this was that I know I would be permenantly terrified of it coming back in the other breast, would I spot it in time???  The results from my op showed pre-cancerous cells and calcification, well if this wasn’t picked up during the mammography, mri , ultra sound or CT scan, then was it missed in the other breast too?  Also the recovery period - I have three boys, my youngest being particularly tiring (slightly hyper) - it would be so hard for me to listen to my husband struggling to cope, feeling powerless.  It was bad enough after the first op with a shorter recovery time.

 

However the surgeon talked me around to his way of thinking (I knew it would be that way), which was that using my own fat is the best, for feel and look etc and that the recovery, although longer, is worth it in the long run (implants need to be replaced etc).

 

He also said that it wouldn’t be wise (although he would do it if I really wanted) to have a double, as the type of cancer I have ie ductal, isn’t typically bilateral, whereas perhaps lobular is, therefore it is really rare for ductal to travel to the other breast.  My answer to that was that tubular (particularly in someone of my age - 43), is rare - but it’s happened, therefore rare can happen.

 

The picture that he showed me to allay my fears of my breasts not being even and matching, wasn’t the most attractive either, so it didn’t really sell the whole using your own fat concept at all!

 

There is also the picture going around facebook, and was in the Guardian, of a very attractive Australian mother of 4, who bravely posed naked to show all of her post op scars.  My friend said that it is a good match for how she now looks and is having to come to terms with it.  Therefore, my thinking is that surely with implants, at least there is no tummy scar to contend with.  Whereas another friend of mine, is perfectly happy with her results and is just now waiting for an uplift on her other breast and for a nipple to be tattooed on.

 

I am now so confused.  My head is spinning and I know I have to do what is best for me.  The surgeon makes it all sound so easy, but when you come onto a forum like this, you hear both nightmare stories and positive ones.  I really don’t know which way to turn.  

 

Help!!

 

H x

 

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Hi HFK1234

I am sure your fellow forum users will be along soon to help you with your decision making, plus I would suggest that you give our helpline team a ring when they are open again tomorrow and have a chat with them about your thoughts and feelings, they’re here to support you through this.  Calls are free, 0808 800 6000 lines open weekdays 9-5 and Sat 10-2.

Take care,

Jo, Moderator

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Hi HFK1234,

You do have a dilemna, I don’t envy you.  There are so many pros and cons aren’t there.  The model on facebook you mention, was being discussed on Loose Women a couple of days ago, so I saw that photo.  Not for long though, as I had to turn it off - it was a bit too close to home. She did look badly scarred.  I am just recovering from a mast with diep recon and do not think that my scarring is that bad. I’ve ‘only’ had a single mast tho.  The breast scar is around the areola, so in time i’m hoping that with tattooing it will merge in with the rest of the skin.  The tummy scar is wide but falls below the bikini line. In fact, I will look better in a bikini than I have for years as i’ve now got a nice flat tummy too.  Obviously, it’s a personal choice and you’ve a lot of thinking to do, but hope this info can be of some use amongst the mass of other info that must be running round your head. Xx

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Hi h,

I’m 44 and a bilateral mastectomy with implants in October. I’ve not regretted this at all but things haven’t really gone to plan for me either.

I chose the bilateral as I’d already bc in my other breast 10 years ago. Totally different to the one I had in October. So just because you’ve had one type of bc doesn’t mean you can’t have another - and I don’t want to scare anyone as it doesn’t happen that often. But it can happen.

My reasoning for the implants was that the op wasn’t as hard as having recon using my own fat. It’s not easy to have it all one go. I have a friend who had natural recon, then opted for implants with great results. My surgeon has always said I can have them replaced for natural at a later date if I want.

I honestly don’t think I could have coped with natural recon at the time of the mastectomy.

Good luck with whatever you choose.

Melx

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Hi
I had a mastectomy with immediate strattice recon on Thursday. Like you I researched all the recon options and went in to see my surgeon with an idea of what I wanted only to find that none of the body fat options weren’t available to me. She could try an LD flap but would still need implant as not enough tissue. And I am not big breasted b/c cup at best 32. So I decided on strattice with implant as this gives better shape and I did not have to have the expander . Nhs would not do the strattice in my area but luckily had med insurance cover. Had to have nipple removed but had skin sparing masectomy as lucky to have dcis though high grad and 5cm so no option for breast conserving surgery. Am told it looks good shape and will reduce once swelling goes. Surgeon is going to recon nipple and then lift other breast to same level as new perky one. Though this will all take time. It’s hard to make decision as you just don’t know what’s best . In a way having my options reduced helped immensely! Hope that you reach a decision you are comfortable with and wishing you a speedy recovery and best wishes. Take care x

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Hi, in September I had a single mx with an LD Flap reconstruction… The recovery was longer, but I’m really pleased with the result… After reading your letter, I googled the picture in the Guardian… The picture certainly doesn’t mirror my reconstruction… The only scarring on my boob is circular around the nipple area… The scarring on my back, I can’t see, but has faded a lot… The picture is very upsetting and does not show a true reflection of all reconstructions… I’m having my nipple reconstructed in April. We are all different… You must do what is best for YOU!
You are still very young (I’m 55)… But, it was still a big decision… Whichever operation you decide on, you will need help in place. It really helped my recovery… I’m based near Chelmsford… If, I can help in anyway, please let me know… Take care Denise

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H i know just where you are - iwas there in october last year.

 

I had DCIS, but too large for a Lx, so had to have mx.  I wanted “natural impants using my body” so preferred the back idea -could not cope mentally with all the stuff needed for a DIEP - tummy buttons moved etc and scarring.  When the plastic surgeon saw me he said i was slender and wouuld need an implant and back for a result .  So in dicsussion with my other half - who is a less is more man, and the Recon Nurse I opted for the Implant.  They all feel different to what you have now.  They are all numb.  So what do you gain? 

 

In asking how I could ensure my implants lasted the 20 years rather than  10 ( which I would need in the back op too) I was told not to play rugby or karate.  So I hope they do last the 20 I have never played rugby and am not likely to start karate!

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Now that’s good to know. I do have a bc nurse but she never calls back. Im aware that she is trying to do two people’s jobs but where does that leave me in my hour of need.

The nurse I spoke to today managed to help address some nagging questions so it really helped.

Another friend told me that the nurses at the hospital are supposed to call regularly and visit. Is this true? I do get the impression it’s a post code lottery.

H x