Surgery Dilemma

Hi all

I was recently diagnosed with DCIS, my treatment plan is ever evolving after each time I have a scan or another biopsy, but I have seen surgeons to get everything in place for when we’re at the point of operation - as it stands a single mastectomy on the left with immediate reconstruction - I was keen for DIEP surgery thinking it would be the most like the original, but the surgeon has said that I would not be able to continue with strength training or anything that predominantly used my core if that was the route I took, is there anyone on the forum that has any experience of exercising after DIEP surgery?

Also anyone that has experience of 1 original breast and 1 implant? How different they look & feel? I feel a bit ashamed that vanity is coming into play at all in my choice but as someone that lives on the beach in the summer I feel like it would knock me having one firm implant and 1 that hangs down to the side when I’m lay down on the beach ? 

I’d appreciate any pearls of wisdom xx

Hi @Strawbs 

Nice to meet you (although sorry it is under these circumstances).  Your situation sounds very similar to what I have recently been through.

I had left side mastectomy with immediate reconstruction and right side reduction/symmetrising surgery on 12th June.

Originally I was keen for immediate diep flap but after a few consultations with the surgeon and then a plastic surgeon I was advised that I did not have enough tummy fat.  I was told that I could always revisit autologous surgery later down the line if I was unhappy with the result but obviously the main aim was getting rid of the cancer.

I made sure that I told my surgeon that I thought I would struggle emotionally if I was left with lopsided boobs and so she arranged that I could have symmetrising surgery at the same time (the other side has been reduced and lifted to match nicely).  I am so glad that I was able to tell her this (despite, like you, feeling a bit vain!).  I just told myself no one would have chosen this diagnosis so I was going to try to make sure I had the best result possible and she was totally understanding. 

The implant is still settling but in a bra, you can’t tell the difference and my recovery has been really good so it is a bit of a relief that I have not been through the bigger op now.  My surgeon used the pre-pectoral mesh sling technique which does not affect the muscle with the aim of creating a more natural droop.  There are also things they can do later to improve the look (lipo filling, nipple tattoos/recon) further.

I am a month on and feel pretty much back to normal and feel good about my shape.  I hope this helps a bit and that you are able to talk through how to get the best result with your surgeon.  

Best of luck and hoping that all goes well for you.

xx

Thank you so much for taking the time to reply, I’ve been checking in on this forum for the past couple of months just reading and taking strength from all the incredible people on here, but not putting myself out there.

I should receive my genetics results this week (fingers crossed) and I have another biopsy on Wednesday - this time MRI guided - once results are in for that providing no more changes in diagnosis it should be full steam ahead.  

Your story has definitely eased my concerns, thank you again for taking the time.

I hope your recovery continues positively xx

I haven’t had any problem exercising with the diep. It uses fat from the abdomen, not muscle. Your surgeon maybe doesn’t do the diep so is maybe not as well informed as he/she might think

Seagulls

Thanks for the reply ?

The surgeon my appointment was with specifically did the diep but after further contact it was more specifically because I weight lift 4 times a week, she said the diep would leave me at risk of hernia’s which isn’t a simple fix after the diep surgery.

I think now I have my head around the implant, MRI guided biopsy was yesterday and genetics are clear so hopefully I won’t have long to wait now?

I must admit I do have a few lumpy areas now under my diep scar which could be hernias! So maybe i should cut back on exercise. I’m not one for weight lifting but I have been using some machines at the gym to pull down bars which may well be almost the same thing.

seagulls

Oh I hope I haven’t worried you. The surgeon asked me what my hobbies were and I when I said weight lifting and Yoga she asked what I lift and said unless I stopped diep was out of the question x

It’s good to be alert to the danger! Thanks for letting me know. I’m nearly 68 so lifting heavy weights is out of the question.

Seagulls

Seagulls, it could also still be seromas. I have one that seemed to pop up a couple of weeks ago. Wearing a compression belt again part of the day to see if that helps. At any rate it can take up to a year to completely heal from a diep. 

Thanks for the tip Kay.

Cheers

Seagulls

I think I was imagining it as I looked at it this afternoon and it really doesn’t look that bulgy. It isn’t completely flat and I do have a bit of a dog ear at each end! Scar looks nice and silvery  - still a bit red in parts but improving all the time. 

Cheers Seagulls

Hi Strawbs, I have had a very similar path as Shinebright. Left mastectomy and sub-pectoral implant - hasn’t effected movement etc, though had to have tissue expander placed before implant exchange which I have just had along with balancing surgery on other side to uplift remaining breast.

I was told I was too slim for Diep, so could have a LD flap or implant - I chose the latter as didn’t want to risk my mobility and I like to do Yoga. I figured I’d see how the implant went and keep any options open for later. I hope it works out as so far I am extremely happy with the results. The implant is more comfortable and warm than I expected and it looks the same in a bra. If I lie down flat the implant doesn’t move like normal breast but it is a natural teardrop shape. I have been offered lipofil in the future as I am quite boney round my chest which should smooth any edges. I will have had 3 operations in total by the end of it taking a year but the recovery from this last op is only 2 weeks.

All the best with whatever you decide, it’s tough trying to make a decision on top of a cancer diagnosis. Wishing you a speedy recovery from your mastectomy x

Thank you Squirrelly for sharing your treatment story with me ?

I’m a planner so I keep setting my mind to the next steps in the journey and then something changes and I have to adjust, which I’m not great at! But hearing other people’s experiences definitely helps with the process. The only implants I’ve seen have been cosmetic and nothing like my existing boobs, at 39 I have to live with my choice for a long time so want it to be something I’m happy with, it’s good to hear adjustments can be made too.

Thanks again for taking the time to reply I’m in awe of all the strength and compassion shown on this forum x