I have been told that I will need a mastectomy of one breast and am very concerned about having the best type of reconstruction. I’m not keen on having an implant, but my surgeon has told me that I don’t have enough tummy for a DIEP flap reconstruction. I would have thought after 2 large babies there would be plenty! he says he would use muscle from the back and put in an implant.
Can anyone share their experiences of different types of reconstruction, advantage and disadvantages in terms of apppearance of breast, scarring of back and tummy etc.
Also has anyone had a nipple made that is a really close match to the other side?
I would be really interested to hear your experience.
Lotty
Hi Lotty
Firstly, I would like to welcome you to the forums where I am sure you will find lots of support and advice from our users.
Also, whilst you are waiting for other users to advise and share their experiences of reconstruction, here is a link to the Breast Cancer Care factsheet on the subject of reconstruction, which I hope you will find of help:
breastcancercare.org.uk/docs/breast_reconstruction_dec06_web_0.pdf
I do hope you find this publication useful.
Kind regards
Louise
Moderator
Breast Cancer Care
Hi Lotty
There are lots of posts on here about different types of recon. My daughter had the one using black muscle just over 2 weeks ago and is doing really well and feels good. Just a little build up of fluid around wounds and stiffness in arm, not surprising seeing as it has only just been done. She is amazed at the result and says that she feels as if she still has her breast apart from the nipple area … no other scar on breast. She is now doing her normal chores at home but being careful about using arm too much and can’t lift yet. I have posted under the heading " Lisa had her mastectomy and LD Flap…" if you want to read how she felt a couple of days after op. I must admit I was more than surprised how good teh new breast looks and that Lisa had no pain what so ever.
Good luck whatever you choose to do
Love Sue ( Lisa’s Mum) x
Hello Lotty,
I already replied to your mail under ‘emotional trauma’, so if you have seen it you will know a bit about me. Here you are asking about the different types of recon. I have implants and they were put in at the same time as my mastectomy (bilateral) was done. The breast surgeon did the mast, and the plastic surgeon the implant/recon. The implants are under the muscle. They could not save the nipples, so these were done nine months afterwards. The plastic surgeon said to wait at least six months so that the implants could settle into position. I had on each breast a scar from side to side, right across the middle, but you can hardly see them - after two years they have just about completely faded. It seems that implants are not a favoured option in the UK, I don’t know why. The surgeon offered me the option of back muscle or from the tummy, but she actually recommended the silicon implants for me. There are all sorts of shapes and sizes and I was glad to have the counsel of this really expert surgeon. I had no lymph glands touched, I might add. I had no pain after the op, some discomfort but nothing awful. I stayed in a week for personal reasons, but could have gone home on the 4th day when they took the drains out. I had to be careful for a month, not lifting heavy things, not stretching too much, but I was driving a week after the op and went on hols three weeks after it. I can swim and ride, have a friend who had the same op and she waterskis. The nipple recon was done using the skin in the middle of my reconstructed breast and the aureola (sp?) was done with skin taken from the upper inside of my thighs. They look really good, though I say it myself! This was a short op, I spent one night in hospital afterwards as I had had a general anaesthetic, but all in all was away from home barely 24 hours, and a week later enjoying a few days in Madrid! Of course this solution means I have no scars anywhere else. The scars inside my thighs have faded and anyway were quite small and extremely high up.
I hope this helps you in your search for info about the road to take.
All the best
petitepart
Petite part
Thanks for the info
You’re probably wondering why I’m saying on one hand I am finding it hard to adjust to the idea of mastectomy and on the other hand - here I am asking about reconstruction!
Part of my fact finding misssion to equip me better for what I know in my heart is probably the inevitable, I suppose.
forewarned is forearmed.
I am wondering whether anyone knows whether your muscle builds up again if taken from your back? Also I think I noticed that someone had mentioned somewhere that they were worried that muscle taken from the tummy area on a DIEP flap recostruction weakened the abdomen for lifting etc.
My surgeon had only mentioned LD reconstruction when we spoke briefly about it. As I think that’s what he mainly does. I’m sure I would have some choice in the matter, I just need to gather more info before I meet him again.
Thanks all for sharing your experiences.
lotty
No, Lotty, I’m not wondering! It’s absolutely normal that you should want to find out all about all aspects of the mastectomy and possible follow ups beforehand. It makes things a lot easier to face if you are well-equipped . . . I expect you will have plenty of replies to your questions on the other forms of recon and I hope we shall all have been able to contribute to making your decision a little bit easier. petitepart
Hi especially petitepart you are the first person to mention the type of reconstuction I had. I had a subpectoral implant following mastectomy. My plastic surgeon said it wasn’t silicone it was more a sort of jelly.He said if I didn’t like it I could have a diep flap reconstuction later.
I am now 10 weeks post op. I did have a problem initially with haematoma and needed one lot of fluid to be aspirated. It wasn’t painful just uncomfortable.
Cosmetically it looks fine, apart from being nippleless, and higher than my existing breast, (although the surgeon said he can sort that out when he does the nipple) but it is a bit static. When I am in the gym I only have one breast bouncing. I wear a very supportive sports bra to really hold the bobbing right boob.
When you lay down my right breast goes naturally towards my armpit whereas the left reconstructed one stays put…
I now have full movement although I can still feel a little pull across the chest when doing something like pulling up a full clothes line.
My surgeon has also said not to use weights or row in the gym until Jan.He will see me again in 4 months as the implant still needs to settle.
I would be interested who else has this type of reconsruction as I rarely see it mentioned.
Hope this helps Lotty
Sandra
Hi Lotty,
Some surgeons tend to suggest the type of reconstruction that they can do best. Generally speaking, a DIEP is considered the gold standard. It doesn’t use any muscle. If you really don’t have enough spare flesh and skin on your tummy you can have tissue taken from your buttock. Not many surgeons are skilled enough to do this but you have the right to be referred to any other area if no doctor locally is able to offer this to you. Please make sure that you have all the information about all the possibilities before you make a decision and don’t allow anyone to pressure you into having a reconstruction which may not be the best for you. I researched all the various types and decided i wanted a DIEP which, luckily my surgeon was able to offer. She has performed the operation on women from all over the country because they were unable to have the operation locally. It is your right!
Regards
Kelley
Hi Kelley
I’ve just been looking at DIEP flap and IGAP flap reconstructions on the webpage of Dr allen, who trained Elaine Sasoon in Norwich - Was she your surgeon? It doesn’t seem as though many other surgeons offer those procedures. I don’t really know how to go about getting the best advice on what would work best for me - as you say, I think surgeons probably do tend to offer what they’re best at and I wouldn’t want a surgeon to try out a procedure on me they weren’t familiar with. I am also anxious to have reconstruction done at the same time as mastectomy and not later, as I think I would find it hard to handle the one breasted look. Just wondering with the DIEP flap, how low on the abdomen the scar is? I would be interested to hear more about your op.
thanks for the info and advice
lotty
Hi again Lotty … the reason my daughter wanted the LD Flap op using back muscle was that she felt it left less scars to be seen. The breast has no other scar except the nipple and she will have that done in about a year. She could wear a really low cut top already if she wanted to. The scar on her back is about 6 inches long along her bra line and even after less that 3 weeks it is just a fine line, they don’t do big ugly stitches or anything, it must be some sort of running stitch because you can’t see anything apart from this fine line… certainly doesn’t notice with a bra on. Then a scar under arm where lymph nodes were taken. I think they split the muscle in the back and say that you can manage quite well without it. I think surgeons like to do it because there is less chance of rejection because the muscle is still attached and so the blood flow continues. The nipple area is flat ( but starting to get a better shape already due to wearing a surgical bra) and covered with a piece of skin from the back taken at the same time as moving the muscle. I must stress that Lisa has been in no pain at all with any of this. The most she was given was ibuprofen or paracetamol to help with the stiffness. To say she was surprised is an understatement. Last night she showed me how she can now reach her arm quite high too and as i said this is less that 3 weeks after op. She is more than pleased with the result of this op. Hope this helps a bit. Ask to see some photos at the hospital of different recons.
I know how horrid it is not knowing what is going to happen. In the end Lisa trusted the surgeons advice after finding out what a wonderful surgeon he was with a really good reputation in all recons.
Love Sue xx
Thanks sue
yes I had thought about the scarring on the breast probably being less in this type of reconstruction. I’m worried about losing the back muscle as I have to lift and carry for my job and my back is a bit dodgy anyway! I also wanted to try and avoid having implants. I don’t like the thought of having to change them every 10 years and would definitely prefer using my own tissue if poss. It’s a very difficult choice, but probably will be clearer when I’ve had more of a chat with the surgeon. I need to find out all the good and bad sides of each type of reconstruction really, scarring included! So would welcome any imput or further info from anyone who has had a different kind of reconstruction, as I gather my info.
love lotty