Hi there this is my first post but to fill you in: I was diagnosed Feb 2011 age 26. Been through left mastectomy and LN clearance, chemo, rads and now on tamoxifen and zoladex. 18mths on and Im out the other side and starting to consider reconstruction…
Surgeon has given me two options - LD flap without implant or DIEP flap. The thing is Im really active- climbing, gym, walking, kayaking e.t.c and have managed to stay this way so far through treatment. I am worried about weakness from both ops and no longer being able to do these things that I enjoy and have at times kept me going. I wasnt that bothered about reconstruction but I am due to marry in 2014 and the thought of trying to find underwear and a dress to fit just terrifies me.
Thoughts and experiences greatly appreciated.
Hi Cattyfizzle, (rather splendid name btw!)
I had an immediate LD flap reconstruction in Feb 2011 and cosmetically it is excellent. I am - and was during treatment - pretty active. My recon was my non-dominant side. It is not entirely clear to me which restrictions are about lymphoedema risk and which about the surgery itself. I have been told not to put my weight through the affected arm - so no push ups (shame!) but also has implications for other exercises and would be significant for climbing, as you presumably would sometimes use that arm as a lever for your body weight? In terms of weights, I have used light hands weights, but again have been told not to go above 1.5kg if lifting over head height, and to avoid too many reps (the reps thing is definitely about lymphoedema).
I have swum (very old fashioned breast stroke and a bit of back stroke) since my surgery and my recon gets very stiff! I tend to swim skew-wiff (diagonal) as my arms are very mismatched. I learned from watching the paralympics that the LD muscle is key for swimming… I also find after a day of serious hill walking with poles my recon gets stiff, so presumably the msucle is still trying to do its old job in my back. I think kayaking should be fine, indeed, among the recommended forms of exercise are dragon boating and fly fishing!! For me, a bit of stiffness/discomfort is worth putting up with to do the things I enjoy.
I would speak to your surgeon about your sporting interests - mine certainly asked the question - it may be that they can advise or put you in touch with someone who can.
I hope you get some helpful advice, a great reconstruction, if you opt for one, and a magical wedding day in two years time.
Hi Cattyfizzle!
Well, I can offer advice on wedding dresses (I have a bridal shop 
)
Don’t worry! Any bridal shop worth it’s salt will have excellent dressmakers whose job it is to alter the fit and shape of the dresses for each bride. Today’s wedding dresses are constructed so well, and so well boned and corseted, that you will have a smooth curved bustline regardless of what’s underneath body wise. The neckline will also be fitted to sit against the skin, so no gape down the front! Some styles will work better than others, so treat yourself to a couple of mags and see what you fancy. The good news is that style wise wedding dresses are more built up at the neckline for the next couple of years, more ‘modest’ so please don’t stress about it. Find a shop you like and feel comfortable in, explain clearly what you need, and enjoy trying them on!
We’ve fitted a lot of BC brides over the years, some with implants, some recon, some boob free, all have looked gorgeous! Met one of them on her final herceptin when I was having my first FEC, and another bride’s mum went through chemo with me. To cap it all one of the chemo nurses was a past bride too, so I had lots of company!
I had a mastectomy and immediate DIEP reconstruction in October last year. It took a while to get my strength back but now I am pretty much back to normal. I go to the gym 2 to 3 times a week, run, cycle use the rowing macine, cross trainer etc. and do weights all with no problems. I also ride my horse around 4 to 5 times a week. I just make sure I have a well fitting sports bra and I’m fine. Any other questions please feel free to give me a shout xx
Hi Cattyfizzle,
I had an LD flap with implant two years ago. I swim regularly and can honestly say that it has not made one jot of difference. I do mostly front crawl (with the occasional length of breast stroke thrown in so I’m not too repetitive in my movements just in case of lymphoedema) and despite being 50 the only ones who beat me in the pool are the serious young male swimmers.
My PS told me that the LD muscle is the one used in the pulling motion you would do when rock climbing (ie when pulling yourself up), so he thought that would be affected. Not that I climb. But I am a church bellringer, and he thought that would be affected in the same way. Again, there has been no difference, I am not aware of any loss of strength.
Hi Cattyfizzle,
I am due to have a delayed reconstruction on Tuesday next week. I was offered an LD flap or a Tram/DEIP; after discussion with my surgeon about the type of and amount of exercise I do she advised that I have a Tram or DEIP. (she will decide which is the most suitable during the operation but I am hoping it will be a DEIP) I have been told not to exercise at all for 3-4 months which I will really struggle with. However in the long term I have been told that I can resume my full exercise programme with no restrictions. This includes triathalons ( I have one booked for June 2013) body bump, step, swimming, long distance walking (have also booked to do the coast to coast again next year).
I woudl suggest that you talk to your surgeon about what you do and how important it is for you. Hope your wedding plans are going well, it must be a really exciting time for you.
Best wishes,
Sian x
Wow triathlons! And I was worried about getting back into badminton! I wish you all the very best on tuesday. My op is next monday. Good luck with yours
Greengage
I was going through similar agony about three weeks ago. I had the choice of the ld plus implant or the SGAP. SGAP is where they remove buttock tissue as oppose to tummy. I couldn’t have the tummy flap as I have had surgery there and it wasn’t possible to use inner thigh tissue - not enough fat! ( surpsied me as my thighs are like tree trunks!
Anyway, I wasn’t happy until I had exhuasted every option and dissected it in terms of pro’s and cons with the onco plastic surgeon. i found at every meeting with the surgeon though that I was one meeting behind where he was! It wasn’t till I had a really teary cry to the lovely breast cancer casre team that I felt better. They gave me the confidence to ask the questions and to make sure I was 100 % sure about the options and then the choice.
I went back for yet another meeting with the surgeon - i am so glad I did. I had wrongly assumed that the ld flap could be done without an implant. Well it can be, but only on small breasted women! I am a ‘d’.
I am really sporty and was very worried about loss of stength and flexibility for badminton.
My final meeting helped enromously. You have to think of you and your surgeon as a team - you are in it together to get the best outcome. Ask his advice. I did and I dont regret it. Ever since then i have been happier - my op is next monday. Scary thought that the surgery is long, but happy that I feel confident about the choice.
Good luck
Dont rush that decision. Make sure you are confident with it. Then you can settle and start preparing.
xxxxxxxxxx
Hi Cattyfizzle
I’m going through a similar process at the moment. I was initially recommended an LD with implants but having looked into the impact on the muscle I have decided against it. I am currently debating implants without an LD and instead ADM or a thigh flap these being the options recommended to me instead as I can’t have DIEP nor is the surgeon keen on SGAP.
I’m a kayaker too. I don’t know how seriously you kayak, but you probably know that you will be putting a fair bit of strain on the pulling muscle as well as the rotary cuff muscle for bracing etc.
S
xx
Hi Cattyfizzle
I’m going through a similar process at the moment. I was initially recommended an LD with implants but having looked into the impact on the muscle I have decided against it. I am currently debating implants without an LD and instead ADM or a thigh flap these being the options recommended to me instead as I can’t have DIEP nor is the surgeon keen on SGAP.
I’m a kayaker too. I don’t know how seriously you kayak, but you probably know that you will be putting a fair bit of strain on the pulling muscle as well as the rotary cuff muscle for bracing etc.
S
xx
Hi Cathy, a good friend of mine (with five horses) had a DIEP three years ago. Unfortunately that failed so a week later she had LD without implant. I can’t remember exactly how long it took but she was back riding and competing pretty quickly despite having major surgery involving tummy and back muscles!
She went on to have implants in both sides (decided to take advantage and have boob job on good side!) and was back in the saddle within weeks - frowned upon by surgeon but she did it anyway!
She has a couple of very feisty horses and broke her back during all this, but is still riding!
With regards to radiotherapy, my hairdresser had chemo followed by mastectomy with immediate DIEP and then rads. She said that rads affected her DIEP boob and she wished she’d had the option for rads before the reconstruction.
I had rads with an expander implant in which was later changed to permanent implant. My skin is very thin which restricted the size of implant and I’m a quite uneven so having a DIEP at the end of the month.
Discuss all options with your team and make sure they fully understand your level of activity and that you are happy with your choice of reconstruction.
Hope that helps, and good luck with your op xx
Hi, Sorry for the delay in replying the reply button wasn’t working so I had to contact the moderator. I had my operation in Cambridge. During the operation, he actually decided to do something different and sort of pulled the whole ‘piece’ round as he thought it would give a better result. Each side of the flap is plumbed in separately and I have s scar line vertically through the centre. It took 16 hours! I am amazed at what he was able to do and am very happy with the result. It’s wonderful to be able to get up and put normal clothes on. Two things I would say. First that the cut on my stomach had to be much higher as the little fat I had was higher up. I knew it would be but it was a little higher than I expected so if you want to cover the scar up with a bikini or pants it’s more difficult but not impossible. The whole area also a year on feel very tight still even though I’ve been exercising and stretching it. It’s softened a bit but from my last clinic check up it may be that this is how it will be because of the deep stitches. Second, ironically given the little fat I had my reconstructed breast is slightly larger than my other so finding bras has been tricky. I have been offered a small re-balancing operation with liposuction on the reconstructed breast to help this but haven’t decided whether to go ahead. I hope this helps with any decisions you make.