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.
Hi Moira,
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,
Janet x
Hi Moira,
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.
Hello I was diagnosed with high grade dcis jan 14 and had a mx in February 14 I did not have enough body fat for anything but implant recon which I had as an immediate recon with strattice. I was in hospital for 3 days and came home with one drain which was removed a week later. I have since had symetry surgery on my good boob a lift and a small reduction, I also had fat trasfer red from my thighs into a large dent above my implant. This was incredibly painful and I have permanent nerve damage to one of my thighs resulting in a numb area but also burning pain. My thighs also have visible dents where the fat was removed- definitely not a cosmetic result for them. I still have some of the fat but some has been lost. I would not repeat this, the up, lift on the other hand was easy to recover from. I hope this info helps with your choice.
Hi Moira,
Thinking of ypu at this time. I am one year post diagnosis, had wide local excision using a breast reductiom style technique. My surgeon (onco-plastic) offerred immediate matching surgery to non affected side, but also explained rads could reduce yreatment side and it could bevome smaller. I opted to go one step at a time and pleased i did. Clear margins were obtained, but had to return for SNB. Rads completed in sept, and just had matching surgery.
Have you been offered the chance to see photos of the end results?(All confidential, no faces)
Good luck with your choice, whatevet you do decide it will be rigjt for you at this moment. The moments we cant change, be kind to yourself , you know you best.
I am happier now i nearly match (some swelling still to settle) but know this staged option was right for me last year. It also meant i had one side i could sleep on wuthout too much discomfort !!!