Thanks for all your replies. After reading those and more research I decided against the lipo and fat grafting to fill my whole breast after reconstruction. I spoke to my original PS re delaying the reconstruction, I have high chance of needing further treatment due to cancer cells found in the lymph nodes and he explained that the spacers also contain silicon and wouldn’t be the best option if radiotherapy needed.
I really didn’t want the abdominal surgery and so came full circle back to the lat dorsi flap, I knew I might not have enough fat to make a good match and an implant may also be needed but under the muscle would not damage during rads.
So here I am.. 9 days post surgery and really have to say delighted and all very straightforward so far. Drains came out after 3 days and I was home on day 4. The breast is amazing, and no implant was needed its actually larger than my healthy boob, have been told size will settle and is still swelling at moment. My back is stiff where the muscle was taken and oddly lower down too, but I understand this is common, the muscles need to readjust. Really I have had zero pain and home on only paracetamol and ibuprophen which I am now reducing. Most discomfort is coming from under my arm where lymph nodes were taken, tingling and just very sensitive down to my elbow. Trying to do excercises to help with movement.
Pathology results are due on Tuesday and I’m apprehensive of course, but feel I have coped well this far and really to tackle it head on.
Thanks to everyone who took time to tell me their story and maybe mine will in turn help or reassure.
I was 49 when I was diagnosed in Oct 2012 IDC and DCIS.Had Mastectomy and node clearance.
I was saved the quandery you are in as the Surgeon felt I might require Rads and so delayed recon.
I am now waiting for a tram flap and am glad I had the time to consider my options.
I also had Chmo and Herceptin so feel the wait has afforded me time to adjust pschologically to the diagnosis and treatment.
We have to trust our instincts and do what is right for us.
Hope you feel able to ask the questions you need before having to give your answers.
Hi again Moira - glad something helped.
It's no wonder you feel your life has been turned upside down - it has. It's devastating to hear you have cancer. It's nearly a year since I was diagnosed and I still think about it every day, and lurk here, even though my outlook is good. I also could think of nothing else in the first few months - every waking moment, actually even dreaming about it too! I suspect it was my poor old brain trying to process the shock. And I also switched into manic research mode like you - I think it's a way or regaining some control over the process when everything feels like it's totally out of control. Do you find that? So - you're allowed as many meltdowns as you need.
It sounds like a great idea to delay the reconstruction - especially if you might need more treatment. I've heard radiotherapy and implants aren't a good mix. And it's one less thing to worry about right now. You're also right about the implants - the flap options are much more natural looking - really worth holding out for that if that's what you want. I just couldn't bear the thought of surgery to another part of my body - and as I'm quite small I'm getting an implant in the unaffected side as well, so thanks to the surreal world of breast cancer I'm getting a mini boob job, and the two sides should match better than if I was a bit "saggier" 🙂
I have to say I cringed when I read about the room full of medical students! No wonder you felt uncomfortable. I was treated at a teaching hospital, and I thought baby doctors just came with the territory, but after a while of having everything on display to allcomers I now say I'd rather not have an audience. It's never a problem. They need to learn, yes, but not on me!!
The best of luck with whatever you decide.
Yes, I’m starting to think I might delay the reconstruction, like you my DCIS is extensive, the boob with the DCIS is now visually bigger than the other, might just be all the poking and prodding it's had though!. I need it out but this rush and worry I make the wrong reconstruction decision is making me panic. I have another appointment this week with PS but if I don’t feel 100% that I have made the correct informed decision then I will delay. And yes I may need further treatment after the pathology comes back so it makes sense to have everything gone before starting to rebuild.
My surgery is scheduled for the 5th May, will keep you posted and good luck with yours.
Thank you for your reply, It’s easy to write a book in 5 mins on these topics!
Yes, that’s it exactly, I have this overwhelmed feeling.. partly due to me asking for the mastectomy asap and then I found that plastic surgeons were very much in demand, the NHS appointment was rushed and a room full of students, it was the day after my sentinal node biopsy too so I was sore and I felt very uncomfortable, I go back to see him on Thursday to talk through the options again but had wanted a clear picture in my head, a decision made before I go. Every day I wake I think a different option is best, and I really want all this behind me to begin to repair. I’m worried about work and my children coping and I don’t want this to turn my life upside down, but I’m realising I have to accept it has and it will for quite a while. Perhaps the filler option is wise at the moment, I am still all over the place. I don’t know where I’m going, just feels I will never know really…..
Implants I had heard look less natural than the flap and muscle options and at my age, 49 can be difficult to match, one will be perky and the other will age. I need to do more research and chat to PS again, my BCN is also very helpful, it feels like this is consuming my life and I know I will be more chilled once I make my decision, but yes you are right I need to adjust my thinking to treat this as a journey.
I have private healthcare insurance with work so I went to see a PS through that too and she suggested the total filling with fat, sounded too good to be true at first but then I read about the pain involved and I haven't checked if my insurance would cover it.. I have come complete circle with all these options but I guess that’s the only way to fully understand each one and the pros and cons for each individual.
This forum is excellent, will look at the US one too, thanks for your help, Janet.
I'm in a similar situation - DCIS diagnosed a week ago and mastectomy scheduled in a couple of weeks.
I'm a 36F however so any reconstruction would need an implant. And none of the options sound appealing. I've decided to delay. Partly because it's all happening so fast and I can't even make decisions on what to have for dinner let alone what sort of boob I want!
I did waver a bit - It sounds appealing to get it all over with in one go. But I've been told my DCIS is quite extensive and there's a chance I might need further treatment. So I'm taking it one step at a time. I do think there is a bit of an assumption by the surgeons that you will want reconstruction.
Take your time and make the right decision for you.
It's great we're given the option of immediate reconstruction, but it's all a bit much isn't it - having to decide on the reconstruction and deal with the cancer rubbish at the same time? I can really relate to that overwhelmed feeling.
I had my mastectomy last June, and felt under a lot of pressure to have an immediate reconstruction - in fact the alternatives were never even mentioned to me - delaying the reconstruction, or skipping it altogether and using a prosthesis. Also - the small local hospital where I was treated only offered implants or the LD flap - I was never told I could be referred somewhere else for other options. I also never saw a plastic surgeon - the breast surgeon did the whole thing. I remember feeling really stressed and anxious - and the end result wasn't good - massive relief the cancer was out of me, but left with a wonky implant in the wrong place. The point I'm making though is it was a nuisance, but really hasn't turned out to be a long-term problem. I've been referred to a great plastic surgeon, had the implant replaced, and am now half way through my fills - and it's looking good.
My BCN said after the mastectomy that most cosmetic problems can be corrected, and that reconstruction is a process - sometimes a long one, and I think she was totally right. If I'd known that at the time it would have taken a lot of the pressure off. So maybe it would help you to think of this as the first step in a bit of a 'journey'? You have so much to deal with already.
Also - are you not keen on implants? They're far and away the least invasive option, and the results can be pretty good. Even with my tale of woe I'm glad I had that wonky implant placed because it meant my skin has been kept in pretty good nick. Touch wood - that's going to make for a better result now I'm hopefully on the right path. Could you have the implants placed as a 'holding' device while you explore your options further? It means you would never be entirely without a breast, and could buy you some time while you look at other possibilities. I've been told I can still have a DIEP flap if the implants don't work for any reason. Also - we're all different but I really haven't found the fills of the expander painful - it can feel a bit tight and achey - but no real pain.
As for fat grafting - my plastic surgeon wants to try this to smooth over some ripples and dents in the implant - it sounds like a great option for this. From what I've read, though, it can be very difficult to build a whole breast this way - maybe a teeny, tiny one - but not a 36B. I've also heard a lot of fat can get reabsorbed by the body - and it HURTS! Would you be getting this done privately? I also doubt it's available on the NHS.
I've found this forum a real godsend - but there's also an American one with a lot more in the way of personal experiences of different sorts of reconstruction. It's called breastcancer.org or something - Google it. I found it really helpful.
Wow - I've written a BOOK! Hope some of it's helpful, and really hope things turn out well for you. Good luck for your surgery and let us know how you get on.
All the best,
Hi All. I’m new to the forum, diagnosed with a large lump of DCIS 3 weeks ago and mastectomy planned for next week. Initially I weighed up all the reconstruction options and had planned to go with immediate latissimus dorsi flap, I was disappointed then when I met with my plastic surgeon and he told me I didn’t have enough fat on my back for a good match, he is suggesting the abdominal surgery. Really not wanting to go down this route, I have a friend with the hip to hip scar and she had many complications, I know everyone is different and it may be a good option for me. Anyway I obtained a second opinion and the private plastic surgeon suggested fat grafting, a newish process at first it sounded less invasive but now I read on here that many people have bruising and pain on the lipo site. My PS said it may take 4 or more sessions to fill the breast. Does anyone have experience of this form of reconstruction, or has anyone ruled it out and why? I am relatively small, 36B and I know the breast after nipple removal will be a lot smaller than the other and will need expansion too which I have heard can be painful but I would love an option that does not involve any additional cut and healing. I’m really lost and now with surgery just a week away am thinking maybe I should just go with mastectomy and no reconstruction, I hate these decisions it consumes your life and what if I make the wrong one, having a last minute wobbly and don’t know what to do… Any advice would be appreciated, thanks so much.