reconstruction advice?!?!?so many options?!?!?

Hello all, I got my results yesterday from the wle and snub I had two weeks ago for high grade dcis.its not spread to lymph glands and no invasive cancer found but they didn’t get clear margins so consultant has advised a mx over the wle again plus radiotherapy etc.going ahead for that as my boobs are not even a a cup anymore after breast feeding.I’m 3p And wondering which of the immediate reconstructions others would suggest or 've able offer advice on.got the booklet and done some internet research and know it’s probably down to the individual involved but want to get a heads up on the pros and cons before meeting the plastic surgeon next week…any advi e is greatly appreciated thankyou x x

Hi
I had a LD recon in Jan 2012 and have to say the op and recovery time weren’t too bad. I also had an ANC and that probably caused more long term problems with restricted movement in my arm. All fixed now though…just need to remember to do my exercises.
Couple of things i found with the ld recon - Im left with an area of permanent tightness in my back…and also when i touch my reconstruction i can feel it in my back - where the muscle used to be. I dont think this happens all the time but my plastic surgeon did say that it can happen in a few cases. All that said i dont regret having it done…it looks pretty good!
Good luck
Loubel

Hi hobbittoes, I am almost post 4 weeks since my mx and immediate reconstruction. I had chemo first which didn’t do much, then a WLE And full node clearance as it had spread to lymph nodes. Still didn’t get clear margins so went back in but found more tumours (multifocal) hence mx. I was very confused by all the “choices” - given a choice I would opt for no cancer, no chemo, no surgery and a normal life! However I was sure that if possible I wanted an immediate reconstruction. I couldn’t have the LD flap (back flap) as not enough fat on my back. We discussed an implant, but given my history (x2 lots of post-op. Infections and a seroma) thought this was probably not going to work. So I went down the DIEP route. I had quite major surgical complications (all unforseen! ) but in the end came out with a good result. I am ready to drive and although tired still and with a bit of tummy pain, I am feeling a lot better. My advice - research your options, find out about your surgeon and his experience, try to speak to other ladies who have had procedures done especially at your hospital and by your surgeon. If you want a DIEP this is really specialised microsurgery and not every hospital can offer it. Ask your surgeon /plastic surgeon how many ops has he performed personally, look at before + after photos and discuss possible complications. My surgeon was brilliant and I couldn’t have asked for better care. However, no matter how good my result is , the main goal was to get rid of the stupid cancer and I am happy the boob has gone. Anything else is a bonus really!!

Hi,
I was diagnosed with DCIS in July 2012, had a DIEP Flap recsontruction in Septemeber, however blood supply failed and had an expander implact fitted. Went okay for couple of weeks and then was re-admitted with infection in wound. Was in for 10 days had to bite the bullet on 7th day and have expander implant removed due to the infection. 25th April 2013 had LD Flap reconstruction, have an issue with seroma but this is not uncommon. This op I think is more painful than the first one, even doing the excercises for my arm, it is still painful 5 weeks later. I wish the first operation had been a success and I had not gone through this one. So having had both of these types of reconstruction in the last 9 months I would rate the DIEP above the LD Flap.
Even though the first one failed suring surgery I still went through the surgery which lasted 9.5 hours before by surgeon gave up and fitted the implant, (had told them I did not want to wake up with nothing so had MX at same time).
AS yous ay everyone is different and it depends on your was of ;ife, I love to play golf and amnot sure how far down the line that will be. I have not had any of the effects of feeling that my breast is a muscle, no twitching or anything like that, only difference is it feels slightly heavier.
Hope you make the right decision for you and good luck with everything xxx

Thankyou all for your messages of advice and support. Meet with consultant and going ahead with nd and immediate reconstruction with Becker implant in left and Becker implant in the right to valence things out.got pre op Apr tomz ans surgery the following week.still very nervous about it all but best options as I’m slight and Surgeon said he wasn’t certain the akin flap options would be the best. Worried about the end result and future surgery…suppose still the fact that I have cancer and need a mx is still a bizarre concerpt to me to be honest. Guessing it’s still going to take a while to properly process it all. How so yout all cope with getting your head around it???beat way I can describe it is my head is in a fog, like a dream or tv drama that I’m watching from the sidelines unfolding in front of my eyes and I can’t do anything about it

Hi, I think I might have got my results on the same day as you hobbittoes. For me it’s also a recurrance which they found after a routine checkup and at the moment I’m still struggling from that sense of unreality.
I’ve found myself in the position of needing to decide which reconstruction to go for (and which hospital) and finding it really difficult to decide; LD flap, TRAM pediculed flap, TRAM free flap, DIEP. Feeling scared that the surgery could go wrong and worried about the end result.
How to make a choice for something that I dont want to be happening. The easiest decision was that I really want an immediate reconstruction.

Hiya Jenny, sorry to hear your news. It’s so hard to get your head around it all ans I doubt anyone ever really does. I sis alot of research into the different reconstruction options but didn’t decide until speaking to the consultant.had thought the back flap was the best for me but after seeing his folder of past patients, which was very out dated I changed my mind. He gave me details of the different ops and checked me over.said he would struggle to get enough skin from my back and stomach because I’m slight. I initially was scared of implants due to the need to have them redone,leakages etc…the surgeon will advise you what he thinks is the one whinch will be the most successful for you.its hard putting your life in someone else’s hands but they do ops often and have experience etc.where about are you?have you a strong network of support? I’m here anytime of you need anything, take care x x

Hi Hobbittoes
Thanks for those words od support. I’ve finally had a meeting with a local consultant who looked me over but it’s just left me more confused. Potentially I could have shoulder or back. Yes I’ve got the same concern over implants. One the one hand it sounds a simpler operation but on the other hand it will probably need to be repeated at some some in the future. I’m in the north-west and I have been told that I could choose another hospitial so I may look at liverpool or manchester. Yes as you say there is something very frightening about putting my life in the hands of a stranger, however skilled. My network were supportive last time but I’m also aware that they’ve all got thier own lives to lead.

Hi LAdies
i finally signed up to BCC site today and its my first time on the live chat forums. I don’t know why it’s taken me so long I guess I was scared of what I might read and see… Did you all feel the same? i am 34 years old was diagnosed in Dec 2012 and have just finished 6 rounds of chemo which were pretty crap and I now have to think about what reconstructuon I will be having. I will be having a double mascetomey with recon at the same time. I am thinking of the implant as it seems quicker op and less recovery time. I’m sh!t scared and so confused about it all.
in the words of spooky moo given a choice I would stay no to all and having my life back pre BC. I’m scared and really don’t want the op but due to the 2 tomourns I have one in each breast and me being th 5th women in my family to have Bc I’d be silly not to have them both removed…
Keep well all x

Hi all
I agree the choices are mind boggling. I am also considering an impant as it semms simpler and less recovery time. I have DCIS and after two WLE still haven’t got clear margins, so need MX. o further complicate things I have also had a WLE to other breast and this needs radiotherapy, or could have a bi-lateral MX. Can’t make my mind up about this. Am going through the pros and cons of single MX and RT or Bi lateral MX. Any thoughts?