I had my first appointment with the surgeon last week and came out feeling more confused than when I went in!
I have decided to have prevenative surgery after finding out I have the BRCA1 gene. I thought the only option for surgery for me would be to have an implant but he suggested taking muscle from my back.
I know going down the LD route will mean a longer and more painful recovery but will mean no more surgery afterwards (i hope) and having implants would mean a shorter recovery time but then maybe more surgery down the line. I am very nervous about the thought of the surgeon using my back muscle mainly because of the recovery time afterwards but at the same time I have read a lot of things about women’s implants moving or having ripples and this puts me off.
The research I have done seems to show that most women who have had LD surgery have still needed an implant and my surgeon suggested that I could have it done without an implant but have fat injected afterwards if I wasn’t happy with the size.
I am not overly active but live on my own with my son who is 6 and is very energetic!
I got back to see the surgeon in January and would really like to have made a decision by then.
I am hoping people won’t mind sharing their experiences with me as I need all the advice I can get!
I have moved your post to a thread on family history as more users may see it there.
Whilst waiting for other users to come along, maybe you would like to talk things through with a member of our helpline staff who are there to offer emotional support as well as practical information. The free phone number is 0808 800 6000 and the lines are open Monday to Friday 9.00 to 5.00 and Saturday 10.00 to 2.00.
Hi Claire,
I had a mammioplasty? (partial mastectomy and reshape using own tissue) in June 2012 and a reduction on my other breast to match but unfortunately they didn’t get clear margins so after my chemo I went in for a mastectomy with immediate LD reconstruction on the affected breast in January. As I was now a B cup size I had enough muscle and fat from my back to construct new breast without an implant. My plastic surgeon was not keen to use implants because of my age (At 37 she thought I would have to have them replaced in 10 years or so). In terms of recovery time I didn’t find the recovery from the LD recon too bad. I think I was in hospital for three days and went home with a couple of drains still in – they were removed a few days later. The scarring isn’t bad either – although immediately after the operation my back looked as if someone had swung an cleaver into me. I’m going to a charity dinner this weekend and I am wearing a backless dress because my scar is almost unnoticeable. I think I may have been lucky because my physio and GP have been amazed by it – but top tip for you if you decide to go ahead with the LD is tape up your scars for three months with micropore type tape. My plastic surgeon insisted on it but none of the others in my hospital do (they just say to use moisturiser on the scars) It is a bit of a hassle but I would say definitely worth it – apparently it stops the scar from stretching so you end up with a very thin line rather than a fat one.
One other thing I will mention and my plastic surgeon says it does happen but rarely (so I’m just a bit unlucky) but now when I touch my reconstructed breast I can feel the sensation in my back where the muscle used to be….took a bit of getting used to but I can cope with it. Thought I’d mention it because I wasn’t told about it being a remote possibility before I had the op. That said if I had been I probably would still have gone with the LD option.
Also I had a five year-old and eight-year-old boy and managed after the op although I wasn’t on my own – if you have got relatives and friends you can call on for help you should definitely do that and not feel like you have to cope on your own. I can honestly say that I didn’t find the recovery bad – in fact I was up sitting in a chair within a couple of hours of coming out of theatre.
Hope this helps. Good luck with your decision and for whichever op you go for.
L x
Thank you for your reply, it is really helpful and some useful tips I would never have thought of.
It’s good to know someone has had the LD surgery without using an implant. I had started to think what would be the point in going through a longer operation if the surgeon was still going to use an implant.
I am happy to be a smaller cup size than I am now as I was a B cup before I had my son. Are you happy with the way your breasts look?
I will have lots of support after the op and plan on moving in with my parents while I recover. Do you feel you have less movement or any weakness in your back now? My son broke his ankle this year and spent 10 weeks in a wheelchair and had to be carried around quite a lot and this has effected my back but is not something I notice on a daily basis but think it will be worth mentioning to my surgeon.
Thanks again.
Claire x
Claire,
I am again in a different position to you, but might be able to give a different perspective, as I have had a version of both, if only temporarily. I had breast conserving surgery (about 2/3 of my breast removed). After the first operation I had an implant temporarily for 4 weeks, before haveing my reconstruction. My reconstruction only used skin and fat from my back, not any muscle, so the recovery was a bit different from the LD flap, and my scar is very long (about 11 inches).
My feeling was that the recontruction with my own tissue feels a lot more natural that the implant, I am really pleased with the result. It also moves a lot more like natural tissue, particularly when lying on my back, I felt like the implant shape was specifically shaped for one body position (vertical) whereas the tissue recontruction moves better.
I know that the implant was not specifically fitted, and was only there as a space saver, and that with it being only one breast, my need for it to look, feel and move like the other one was important to me. If you are having both done at the same time they will match whatever they do. Also the implant was in at a time very shortly after diagnosis, so I may not have been emotionally accepting of it, whereas I have now had 2 years to get used to the reconstruction.
Although I have not yet gone down the discussions about preventative mastectomy (I am BRCA1 and wanted to sort out the BSO side of things first due to family ovarian cancer), I would want if possible to have reconstruction with my own tissue rather than an implant, but this again would need to match the one that has already been done.
I know there are lots of people out there who have had one or the other and are happy with the results, hopefully they will be along soon.
Hope you start feeling less confused soon
Jen
Hi Claire,
I honestly can’t say I notice any real weakness in my back on a day-to-day basis – although I think my cartwheeling days are probably over now! I do have slightly more limited movement in my arm – can’t stretch up to reach the top shelf – but I think that is more to do with my node clearance op. In general I am happy with the way my reconstruction looks and I agree with Jen – it feels quite natural and has a bit of movement…but I have also had radiotherapy which can make the tissue slightly harder and it also means that breast won’t drop with gravity over time – so not looking forward to old age with one pert and the other droopy . This won’t apply to you as your op is preventative so radiotherapy isn’t necessary. I have also lost most of the sensation on the breast but I can live with that! One other thing I should mention is that because it is your muscle you do sometimes feel it kind of twitching/flexing although that has decreased as time has passed and no-one would notice other than you.
Hope it helps
Lx
Bumping this thread for you Claire.
You might also get some replies if you post in the thread- Living with Breast Cancer/Reconstructive Surgery and you can go there yourself and read how others have got on with their surgeries.
Good Luck! Rattles
Thank you Rattles. I did originally post this in the reconstructive surgery forum but BCC moved it in to here as they thought I may get more replies.
Really appreciate the replies so far, they have been very useful so thank you ladies.
After having had a first mx after chemo following my bc diagnosis in July last year I then had rads and genetic tests which showed I was BRACA2. I went on to have a 2nd mx and double reconstruction on 21st Sept this year using the LD method with implants on both sides. It is early days yet and the op was pretty daunting to be honest with the first week or so decidely tough because I didn’t have a good side at all to pull up with and 8 drains - 4 on each side for a few days afterwards which didn’t help. I am gradually feeling much more positive about the whole thing now though and, although the side that had the rads doesn’t look or feel as good when I am undressed, in a bra you can’t tell at all and I have to say they look pretty good in clothes - in fact, better than when I had my own. There is a little rippling on the side where I didn’t have rads too but that seems to be getting better now that I am able to massage it a little. Psychologically I really think it is helped me to move forward. I also had an oopherectomy in November (just 4 weeks ago actually - time flies when you are having fun doesn’t it? ) I don’t feel incapacitated because of my back although I am not particularly sporty and although I have tried getting back into a bit of yoga as I used to enjoy it, it is quite difficult right now but hopefully that will get better as time goes on.
x
. This won’t apply to you as your op is preventative so radiotherapy isn’t necessary. I have also lost most of the sensation on the breast but I can live with that! One other thing I should mention is that because it is your muscle you do sometimes feel it kind of twitching/flexing although that has decreased as time has passed and no-one would notice other than you.