Delayed Strattice Mesh reconstruction in Scotland following radiotherapy

Hi

I am considering a strattice mesh reconstruction; I had a MX followed by Chemo and radiotherapy last year. However the surgeons in my area do not perform this type of surgery.

I wonder if anyone has had this type of reconstruction following radiotherapy in Scotland. If so were you happy with the outcome?

I don’t want to sacrifice the muscle on my back for a LD and I don’t have enough of a spare tyre for a DIEP.

I am posting this agin - so sorry if it comes up twice but I’m new to forums and cant seem to find my origional post

Dear Hopeful Highlander

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hi
i’m also in the highlands, so my hospital is inverness, is this where you will be going?
angie xx

Hi Angiepops
I am being treated in Inverness although I live over 80 miles away. The joys if living in a remote area!

Could be worth asking around. I was told twice I did not have enough stomach fat for DIEP, and could only have an extended LD Flap (which would not be large enough to match the other side). Eventually heard of a surgeon who is supposed to be good with slim ladies, and I think he will be doing me a delayed DIEP with reduction.

hi hh
yea, i’m 125 miles away, great travelling isnt it! Thats the price you pay for space
angie xx

Thanks Sdfmeg,
I will ask again about a DIEP as I’m not that slim. Although I had to wait 4 months for my last appointment . Are you based in Scotland?
I haven’t got round to asking for a second opinion yet . How many second opinions can you ask for?

Hello Hopeful Highlander,
I’ve been uncertain about whether to reply to your post as my experience may not be what you want to hear. But, I think its really important that when you are where you are-doing research-you get a balanced view. I had bilateral mastecomies in Feb 2012. This was following a diagnosis of breast cancer which was treated with chemo,surgery (wle),rads and then following a brca1 mutation diagnosis I decided to have risk-reducing surgery. As I was slim (though thought I had a fairly large tummy tyre!) was only suitable for reconstructions using implants and my surgeon was keen to avoid using back-muscle. To cut a long story short, the reconstruction on the breast treated with rads failed four months after the surgery and my surgeon’s opinion was that this was as a result of the radiation treatment I had had (albeit 2 years previously). He told me this was rare but when I did my own reserach, I found that this type of recontrsuction can be problematic post radiation treatment. I am not sure that it was the strattice, or the implant, but it was probably a combination of issues. I’d also had a very dose of radiation treatment.
Lots of poeple will tell you that you only hear about the bad-news stories on sites like this, but I was reluctant to share in case it put anyone off. I am raising this, not to put you off, but to urge you to ask any surgeon about risks given that you have had radiation treatment. If you know, you can weigh this up for yourself and make an informed decision. I would ask specifically about healing and delayed infection. To be honest, i would ask this whatever type of reconstruction you have as infection rates can vary from hospital to hospital!
The strattice and implant on the breast that did not have rads is amazing. It looks wonderful and I have had no problems with healing.
There is a really good book on breast recontruction which is mentioned in one of the other threads. PM me if you want it, I will dig it out.
Its a very personal decision. Only you can decide what its right for you.
Good luck, Rattles xx

Hi Rattles
Thanks for taking the time to let me know about your experience . I’m sorry to hear that your reconstruction failed but that’s really what was worrying me . I do think the PS’s play down the possible problems.
Thanks again
HH

Hi,
To the best of my knowledge there isn’t a limit on number of opinions you can ask for. Wish I’d known. I had initial consultation, went for second opinion the month after, and only much later found that I could ask for a third. I’m not in the Highlands. Live in the South West. Think my round trip is about 210 miles.

My rads were in 1992, and everyone has said I have to go for autologous reconstruction (possibly with implant inside, but it would need to have a basis of my own tissue).

I spoke to a lady from the Keeping Abreast website. She rang me back, and was very helpful. Another option would be to ask BCC to get some of their volunteers to talk to you. It is well worth asking around.

Hope everything works for you,

Margaret X

Thanks Margaret
I’m almost finished with my Herceptin treatment only two more to go. I would like to have my recon sooner rather than later so I can move on. I know I’ll never be able to completely put BC behind me but feel that if I can get this sorted out I’ll have a better chance .
Living in a rural area is great but the downside is your so far away from all the services. Thank goodness for the Internet .
l’ll check out the keeping abreast website and I’ve already spoken to a lovely woman from BCC who had a strattice recon but she hasn’t had any rads.
Best wishes

HH

Hi Highlander
Inverness was also my “local” hospital. I was told by the surgeons there that I had to have a mastectomy, which i said fine but I wanted immediate reconstruction - they said it wasn’t available and they only did the LD flap reconstruction, which wouldn’t be until after chemo & rads. I pushed and said I knew it was possible using other methods so they referred me to the Western General in Edinburgh who have a big breast unit and plastics unit and can offer ALL the types of treatment & reconstruction.

I saw a plastic surgeon there who asked one of the top surgeons there for a second opinion and in the end they were willing to do a WLE rather than MX. I had to have 3 WLE’s to get it all out, but very happy with my decisions. I had lipofilling along with each WLE so the result now is great. We discussed other options such as MX followed by immediate recon using pig skin mesh & implant (is this what your referring to?)

Anyway I would say ask to be referred as I have received great support & been well looked after in Edinburgh. I also got admitted onto the ward the night my surgery before cos of the distance to travel or on the other occasions before surgery I was given accomodation in the (very nice) patient lodge within the hospital .

Good luck
Vx

Thanks VJ
I’m glad to hear that you are happy with the outcome of your surgery. I was referred to a PS from Edinburgh and he didn’t think I was suitable for a DIEP . I was offered a LD but feel that for me this is not an option. My GP has now referred me to Glasgow for a second opinion as the PS unit there is one of the best in the UK. Hopefully I won’t have to wait too long for an appointment , as I was initially referred last November and feel that I’m back to where I was six months ago.
The strattice is a pig mesh although im now hoping the Glasgow surgeons will be able to use some of my own fat from somewhere ( my thighs look an ideal candidate to me ) and lipofill if I am a bit short.
Thanks for getting back to me

best regards
HH

Thats great to hear that you are getting the necessary referals. Don’t give up hope, keep at it and push for what you want. I think its appalling we have to be pushy - especially when in a weakened and emotional state, but you’ve got the strength to hang in there.
I know it doesn’t feel like you have moved forward but think long term, it will be worth the wait and stress now if you can get the reconstruction that is right for you - you’ve got to live with it all your life after all.

Hope you hear from Glasgow soon.
VJ

Thanks VJ
I do feel as if I’ve been running up a hill backwards for the last year and a half and was hoping to get to the top soon. If feel that once this is all arranged I can begin to plan for the future even if I have to wait a while for the actual op.

Best wishes
HH