Surgery / Reconstruction at same time

I was diagnosed on 20th May with HER2+ breast cancer in my right breast and also one lymph node. The lymph node at the time of diagnosis apparently measured 18.5mm.

I have had 7 weekly session of Paclitaxel and a 3 weekly injection of Phesgo, last week prior to my 7th chemo session I had an MRI scan and I have been informed that the 3 areas in my breast have significantly improved and are barely visible and the lymph node has decreased in size to 5mm so things are moving in the right direction.

Next week I have been called to meet the surgeon to discuss reconstructive surgery which will have to be carried out at a much larger hospital than the one I currently attend.

I was wondering what peoples thoughts are on the reconstructive surgery, Iā€™m assuming that the surgeon is talking of removing fat from elsewhere in my body, does this have to be stomach or back area? Iā€™m reasonably slim (size 12), maybe have more fat on my bottom than stomach, can fat be removed from your bottom area or does it have to be stomach.
My next question is I was told the recovery time from a mastectomy would be around 2 weeks, I thought this was a bit optimistic, does the surgeon just mean getting out of bed and moving about. Also would reconstructive surgery at the same time as the mastectomy require extra recovery time, I suppose my biggest concern is how flaming painful is it. I used to be a whimp when it came to needles and injections but itā€™s something Iā€™ve had to get used to, is it extra extra painful having reconstruction at the same time or is it better to get it all done and dusted at the same time.

Many thanks for any replies

Hi, I had a mastectomy and LD reconstruction on 26th June so Iā€™m nearly 6 weeks in. It is a big op but my pain was managed well with pain killers. After 3 weeks I didnā€™t need any pain killers at all.

I wish you all the best x

I had mastectomy with implant reconstruction and breast reduction to healthy side (was a big girl!) at same time.(Feb 2024) Drains were out and went home after 48 hours. Was a bit sore (managed with paracetamol but had been given some stronger tablets). Dressings off after 7 days then healing checked at day 14 (also got pathology results that day) was a bit tender, but up and about - I was careful with not lifting anything with any weight for about 6 weeks (full kettle etcā€¦) and was religious with gentle exercise/physio prescribed. Iā€™m retired so no children or work that needed consideration. Implant involves less surgery than using your own muscle or tummy/leg so guess getting back to ā€œnormalā€ may be a little faster but a lot depends on your health, how you heal, and lack of complications or infection so everyone will be different.

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Thank you ladies for your replies. Jooliepie30 was your implant carried out at the same time as the mastectomy, and what sort of implant was it, was it liposuction from your stomach. I was told that I couldnā€™t have silicone as thereā€™s a chance I might need radiotherapy at some stage after the mastectomy.

I suppose Iā€™ll find out more on Thursday at my appointment with the surgeon, Iā€™m just hoping he doesnā€™t want an answer there and then on the options.

Thanks once again and wishing you all the best of health x

Hi @juxined,
Firstly, Iā€™m so glad the treatment youā€™ve had so far has been so helpful. Thatā€™s great news :+1: I havenā€™t got all of the answers, but Iā€™m sure you could ask the nurses on here/call your breast are nurses/look on official websites (eg MacMillan, Cancer Research UK etc) for more information. I had a unilateral mastectomy with immediate diep reconstruction (using tissue from stomach) three months ago. I was a size 8/10, but there was no issue with providing adequate ā€˜materialā€™! The recovery time from the mastectomy is certainly longer with the immediate reconstruction being done too. I guess itā€™s a personal decision as to whether to get it all out of the way or to get the mastectomy done, heal and have delayed reconstruction another time. Iā€™m also not great with medical stuff (eg. blood tests, injections) and am very squeamish, so it has been a challenge. But I found that your tolerance levels definitely shift, as Iā€™m sure youā€™ve already experienced. In terms of the pain, it honestly wasnā€™t as bad as I thought it would be. Mine was managed mostly just with paracetamol, especially after the first week. They aim to get you out of bed the day after your surgery. I couldnā€™t get out for a few days as my blood pressure was so low, so that delayed things a bit. I stayed in hospital for six nights, and the day I went home, I managed to walk (shuffle!) from my room to the car park. Normal walking took me a few weeks, but I could still get around during that time (I just resembled The Hunchback of Notre Dame!). Heavy lifting needs to be avoided for a while. I hope that covers some of your questions. Feel free to ask more though. Itā€™s good to feel as prepared as you can be, although your surgeon will discuss it all further with you, Iā€™m sure. Wishing you all the very best x

Thanks so much for your reply dorri, itā€™s really put my mind at rest especially when they managed to find enough material for your new boob on someone as slim as yourself.

Wishing you the best of health and thanks again for taking the time to reply x

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Hi
It was silicone implant and carried out at same time as mastectomy. When I had the surgery I was assumed to have no spread to lymph node but post op sentinel nodes (2 of 3 positive). I was concerned about radiotherapy (have just finished 40gyn 15 fractions but only a week ago) my breast care nurse assured me that new techniques mean there shouldnā€™t be a bigger risk I accept itā€™s early days but all ok so far. If I get contracture they can replace implant or at that stage I could opt for diep reconstruction. I got given the Breadt cancer now booklet on options for surgery (most covered here. Breast reconstruction | Breast Cancer Now)
which helped me make my decision. Thereā€™s always a risk and had I known that my lymph nodes were going to be positive I may have made a different decision.
Good luck with your surgery Iā€™m sure youā€™ll make the right decision for you. Xx