Own fat vs Implants?? Really big decision

[hijaqs]

Hi,

It's good to hear that you are getting some answers from somewhere at least.  The bcn at my hospital have not rung/ visited me and was not aware of this being the norm, however, I guess i'm lucky that they have always responded fairly quickly whenever i've left a message.  Your bcn must be very over-stretched, which isn't her fault but then that's no consolation to you is it.  All I can suggest is that you continue to be persistent but use all the avenues suggested by Helen to get the support you need.   Jackie xx

[Helenbythesea]

They have never called me at home - but i have rung in whenever i needed it.  They always responded that day, but sometimes quite late on - and they always addresseed my question - even if it was to direct me to speak to someone else.  They are onto the next batch of patients arent they 

I have to say that post op, Macmillan have been a super support and the local Maggie's Centre - is there one near you?  The BC nurses are so busy in the hospital and do have to return answer machine calls - so you feel that you are waiting - again.  I live in the north East, and it is only since my op that i have found out about maggies, about macmillan and and about a Care cancer charity - yet to contact them

[HFK1234]

Now that's good to know. I do have a bc nurse but she never calls back. Im aware that she is trying to do two people's jobs but where does that leave me in my hour of need.

The nurse I spoke to today managed to help address some nagging questions so it really helped.

Another friend told me that the nurses at the hospital are supposed to call regularly and visit. Is this true? I do get the impression it's a post code lottery.

H x

[Helenbythesea]

So pleased HFK, I know the waiting - is HORRIBLE, waiting for biopsy results waiting for appoitments, waiting just appears to take over - then it all starts to happen,  Both the waiting and the happening are all out of your control too - that is what i have struggled with as i am in control at work!  However, use and ask all the people you meet - and if you have no Breast Cancer nurse contact Macmillan as they have commmunity nurses in areas who may even visit you at home

Pleaase use others - a trouble is better shared,

[HFK1234]

Little update - I ended up calling the helpline on this site and it's really helped me.

I think after sleeping tonight, I will feel heaps better. I think really I'm experiencing grief, which I thought I'd already done, but seems it wanted to strike again!

H x

[HFK1234]

Hi
I still feel quite stressed out today, it won't take much to bring the tears on again. I'm glad I've been signed off from work, although I do feel bad that I am letting work down - although I know that that should be way down in my list of priorities.

I feel quite abandoned actually by the team that are supposed to be caring for me. I'm supposed to make this decision by Friday for my next Plastic surgeon appointment, but I still have so many unanswered questions - but I can't ever get hold of anyone! I left a message for my breast cancer nurse on Monday (her voice mail said she was on annual leave - no one to stand in for her). She didn't call me back yesterday on her return. I know she's flat out as they haven't yet reappointed another nurse, but where does this leave me and people like me?

Can I change teams? I chose this hospital due to how close it is to home, not thinking that my lump would actually be anything, but now I'm wishing I'd have chosen another one, which is slightly further, but with a better reputation.

I've now been referred to Charring Cross, but only for the plastic surgeon - not an oncologist.

Have any of you experienced this? Is it because of where I live? It seems that on your initial referral, they see you within 2 weeks, which is the target set by the government - box ticked. But then you are simply left alone and have to make your own way.

I can't just call a breast nurse on one of the sites as the questions I have are specific to me, not general questions.

Aaarrrrghhhhh!!!!!

H x

[hijaqs]

Hi HFK1234,

Sounds like you've had one hell of a day.  I've had days where I've hardly got out of bed and blubbered on and off all day.  Then, the next day i've found myself walking my dog and looking at how beautiful everything is and feeling happy with life.  As Helen says, the thing is, we don't have that much control over our emotions, however much we try and think positive thoughts there are times when it's all too overwhelming.  In my 49 years on this planet I can honestly say that i've never experienced such an array of emotions in such a relative short space of time (that in itself is exhausting!).  Tomorrow, the next day or even the day after that you will find that you have the strength to take the next steps and decisions on this journey.  Sending you lots of hugs. Jackie xx

[Helenbythesea]

Try not to resent it - if your body needs tears let them out, if it needs to scream let it out.  Mine has just needed to be very angry - and i lost it but feel so much better now!  these tidal ways come and once over your begin to heal better i believe and hope

Helen

[HFK1234]

Thank you!

I had a real wobbly day today. I had a CT scan in the morning and while I was lying on the bench, the tears just poured out.

I then stupidly went straight to work, which was a big mistake. I made a real clanger of a mistake and the reason was that I was there body, but my mind was elsewhere. I completely broke down!!!

This waiting is absolutely wearing me down. I've been functioning, but today, I just couldn't.

I just can't get rid of the worry of it being in the other breast. They've removed the tumour from my breast, but due to not having a clear margin - DCIS and calcification, have decided to remove the breast - well what if it's in the other breast too!! Mammograms don't show up for women of my age, so how can I tell - how can they tell?

I keep going back to having them both removed.

This isn't why I lost it today, I just think the CT scan just made my emotions raw - it's now 4pm and I haven't stopped crying all day.

I've been signed off by the doctor now for the rest of the week, but resent giving into this!!!

H x

[Acorn59]

Really pleased to hear it.. I really hope all goes well.. Any questions, please don't hesitate to ask.. Take care Denise x

[HFK1234]

Hi
Yes, I think it really is a mixed bag in terms of recovery - I've just decided now to go with it! I was back to work after 2 weeks after the lumpectomy, which was pretty text book, I'd also had the sentinal node biopsy, which was the really sore part. I had a phased return and the option to have a laptop at home if I wanted.

I've been offered the same this time around in terms of being able to work from home, so at least they will know that I'm willing. But that's only if I'm up to it. Who know what, if any, complications there will be!!

I think really I'm more anxious about home life rather than work. There's not much I can do to change my home life, there's certainly no option of a phased return!! Work I can deal with, yes, I may be skint if they drop me to SSP, but I won't be having much of a social life and the kids will just have to go without their luxuries for a few weeks.

Thanks for all your replies - it's helped me to get to where I am in my head, rather than it all just swimming about.

H x

[hijaqs]

Hi,

Re the recovery time after mast and recon.  Like some of you ladies have mentioned, i've no idea what the actual recovery time is, seems to be anything from 5- 10 weeks.  I suppose it depends on whether or not you experience any probs along the way, and if lymph nodes are removed, aswell as the type of job you do and the support you could expect once back at work.  I know that I will be expected to give 100%, if not on day one, certainly by day 2!  So, when I do feel ready to go back, I will be negotiating a phased return.  I think that employers have to allow this (but I haven't read up enough to confirm it).  Surely, this benefits everyone, rather than rushing back to work prematurely only to find yourself back at the Drs.   If we can't prioritise our own health now, then we never will.  Jackie xx

[Helenbythesea]

H i know just where you are - iwas there in october last year.

I had DCIS, but too large for a Lx, so had to have mx.  I wanted "natural impants using my body" so preferred the back idea -could not cope mentally with all the stuff needed for a DIEP - tummy buttons moved etc and scarring.  When the plastic surgeon saw me he said i was slender and wouuld need an implant and back for a result .  So in dicsussion with my other half - who is a less is more man, and the Recon Nurse I opted for the Implant.  They all feel different to what you have now.  They are all numb.  So what do you gain? 

In asking how I could ensure my implants lasted the 20 years rather than  10 ( which I would need in the back op too) I was told not to play rugby or karate.  So I hope they do last the 20 I have never played rugby and am not likely to start karate!

[HFK1234]

I rest my case! Surgeons and books say 5-6 weeks, real people say 8-12! I think I will tell my employers 5-6, then just see how I feel, if I don't feel ready, I will just stay off.

He has said that as I don't smoke, am fairly fit and healthy that it should be quick, but then the people I speak to are all non-smokers and in the same health as me.

It's got to be done, not much choice really.

You have made me feel better about the end results and perhaps the photo that went around was a bit extreme!

H xx

[Acorn59]

Hi, in September I had a single mx with an LD Flap reconstruction.. The recovery was longer, but I'm really pleased with the result.. After reading your letter, I googled the picture in the Guardian.. The picture certainly doesn't mirror my reconstruction.. The only scarring on my boob is circular around the nipple area.. The scarring on my back, I can't see, but has faded a lot.. The picture is very upsetting and does not show a true reflection of all reconstructions.. I'm having my nipple reconstructed in April. We are all different.. You must do what is best for YOU!
You are still very young (I'm 55).. But, it was still a big decision.. Whichever operation you decide on, you will need help in place. It really helped my recovery.. I'm based near Chelmsford.. If, I can help in anyway, please let me know.. Take care Denise

[kitten_mad]

I suppose it really depends on your job. If you have to do a lot of lifting, bending, driving etc. I had the LD flap and was off for 8 weeks, but doctors etc were annoyed at me and wanted me to take more time off. It was very hard to carry stuff and people had to help me, and although it is improving my right hand arm is still not coping with anything very heavy (although it has made my left side stronger).  Is the recovery time quoted in publications etc., similar for LD and DIEP?  I was only ever offered the LD scenario, but didn't know I was getting a Mx until 30 mins before the op so it was a big shock to the system!  My cancer came back less than a year from previous op, but the 2nd time it was Lymphatic, this was despite having chemo, and 25 sessions of rads.  

I think both of these ops will take a lot out of you, some people heal quicker than others, need less painkillers and so on. Just be guided by your own body and hope you come to the best decision for you.

All the best

K M x

[HFK1234]

Hi again

Thanks for your replies!

Sounds like you are a very happy customer Chillipink. The only thing that confuses me is that the surgeon says I should be back to work in 5 weeks, then jokingly said I'd be back playing rugby in 6, ha ha ha! However, every real person I speak to says 8-12 weeks!!

I've told work 5-6 - should I prepare them for longer do you think?

H x

[chillipink]

Hi.I had diep last September.implants were a no no for me .I wanted a boob that grew with me ,that lost weight with me and that aged with me.and was as natural as possible.forget about the op time after all you are asleep.yes recovery is longer .I went back to work 13weeks after diep and am on re hab hours at the moment .my tummy scar is very low my stomach is completely flat,all my old c section scar has gone and all my stretch marks are gone.my result is nothing short of amazing.my female plastic surgeon at wythenshawe is fantastic.don't think about the quick recovery or the back to normal activity as soon as poss,it's for life and it's how you will look and feel.it's the best decision I made and I'm so pleased you are thinking of diep.I go back to have the other breast slightly uplifted and I'm having nipple graft in the summer.the scar on the new breast is a tiny circle where the nipple used to be .

[jillybee]

I did like your post,HFK,I had DCIS 14 years ago,then again last year.no connection,but in my mind the cells migrated along the ribs and chest wall.They hadn't !!

[HFK1234]

Thanks to all of you for replying.

I feel reassured by those of you who have had the diep recon, that your scarring isn't so bad and that you are happy with your results - even though it probably takes some adjusting to.

I think I'm going to go with that option, I will just have to go with it and hope that I have a speedy recovery!

I'm still confused about having a double or not - the surgeon really feels that it's unnecessary, but I know I will be forever scared or it returning.

Does it reduce the chances of it coming back or going to the other breast? Or if it's going to come back, will it just go to the chest wall or something?

H x

[samos]

It is a big decision isn't it.

I too saw those photo's and was quite shocked both at the amount of scaring and also at the actual shape of the breasts. I wasn't overly impressed.

My situation is that I chose to have a prophylactic mx alongside the bc mx. I was not in a high risk group, but I felt strongly that I wanted to reduce my risk as much as possible of getting bc again.

I had a double DIEP with immediate recon and I'm very pleased with the results. I've had some 'tinkering', but to be honest that's because I'm a perfectionist and not because there was anything that really needed doing.

Sue x

[RoadRunner]

Hello,

I think you can only go with your gut instinct here.  I had a mx in 2007, and an LD flap with implant in 2010.  I knew all along that I didn't want a big scar across my tummy, even if that would give a better result for the recon.  It just wasn't for me.  I know someone who had that before me (fat from the tummy), she was certain she wanted it that way, even tho' the surgeon was pessimistic about it as she had so little fat on her, and she is delighted with the result she got.  So it's very much an individual choice.  As it happened, my surgeon only offered me the LD flap with implant, as I had no spare fat to use, and this was before strattice came on the scene, so that is what I had.  I am happy with the result, it was the right choice for me.

I have always thought of a recon as a compromise - nothing is ever going to be the same after a mx and you have to accept that.  Your choice is to decide which compromise is right for you.  No recon means living with a flat chest.  Using your own fat means a more natural recon, but surgery to another part of you.  An implant means easier, less invasive surgery, but a less natural result. Each of us will make a different decision, each equally valid.

[Yvie178]

Hi
I had a mastectomy with immediate strattice recon on Thursday. Like you I researched all the recon options and went in to see my surgeon with an idea of what I wanted only to find that none of the body fat options weren't available to me. She could try an LD flap but would still need implant as not enough tissue. And I am not big breasted b/c cup at best 32. So I decided on strattice with implant as this gives better shape and I did not have to have the expander . Nhs would not do the strattice in my area but luckily had med insurance cover. Had to have nipple removed but had skin sparing masectomy as lucky to have dcis though high grad and 5cm so no option for breast conserving surgery. Am told it looks good shape and will reduce once swelling goes. Surgeon is going to recon nipple and then lift other breast to same level as new perky one. Though this will all take time. It's hard to make decision as you just don't know what's best . In a way having my options reduced helped immensely! Hope that you reach a decision you are comfortable with and wishing you a speedy recovery and best wishes. Take care x

[Bean14]

Hi h,

I'm 44 and a bilateral mastectomy with implants in October. I've not regretted this at all but things haven't really gone to plan for me either.

I chose the bilateral as I'd already bc in my other breast 10 years ago. Totally different to the one I had in October. So just because you've had one type of bc doesn't mean you can't have another - and I don't want to scare anyone as it doesn't happen that often. But it can happen.

My reasoning for the implants was that the op wasn't as hard as having recon using my own fat. It's not easy to have it all one go. I have a friend who had natural recon, then opted for implants with great results. My surgeon has always said I can have them replaced for natural at a later date if I want.

I honestly don't think I could have coped with natural recon at the time of the mastectomy.

Good luck with whatever you choose.

Melx

[hijaqs]

Hi HFK1234,

You do have a dilemna, I don't envy you.  There are so many pros and cons aren't there.  The model on facebook you mention, was being discussed on Loose Women a couple of days ago, so I saw that photo.  Not for long though, as I had to turn it off - it was a bit too close to home. She did look badly scarred.  I am just recovering from a mast with diep recon and do not think that my scarring is that bad. I've 'only' had a single mast tho.  The breast scar is around the areola, so in time i'm hoping that with tattooing it will merge in with the rest of the skin.  The tummy scar is wide but falls below the bikini line. In fact, I will look better in a bikini than I have for years as i've now got a nice flat tummy too.  Obviously, it's a personal choice and you've a lot of thinking to do, but hope this info can be of some use amongst the mass of other info that must be running round your head. Xx

[Jo_BCC]

Hi HFK1234

I am sure your fellow forum users will be along soon to help you with your decision making, plus I would suggest that you give our helpline team a ring when they are open again tomorrow and have a chat with them about your thoughts and feelings, they're here to support you through this.  Calls are free, 0808 800 6000 lines open weekdays 9-5 and Sat 10-2.

Take care,

Jo, Moderator

[HFK1234]

Hi all

I'm starting a new thread as my journey hasn't quite gone in the direction that I once thought or anticipated, or was lead to believe.  When I was diagnosed with tubular ductal invasive carcinoma last November, the treatment plan was to have a lumpectomy then radiotherapy.  I decided to delay until after Christmas, so my op was on 9th Jan.

The results from my sentinal node biopsy was clear, but the tumour was bigger than they though (3.5cm rather than 2cm) and they didn't have a clear margin.  So now I'm having to have a mastectomy.

It took ages for the plastic surgeon appointment to come through due to lack of communication between the hospitals, but finally I got to see him on Friday.

During the wait, after many chats with other women that I know in a similar situation and my own research, I decided that I wanted to have a double mastectomy, then recon with silicone implants.

My reasoning behind this was that I know I would be permenantly terrified of it coming back in the other breast, would I spot it in time????  The results from my op showed pre-cancerous cells and calcification, well if this wasn't picked up during the mammography, mri , ultra sound or CT scan, then was it missed in the other breast too?  Also the recovery period - I have three boys, my youngest being particularly tiring (slightly hyper) - it would be so hard for me to listen to my husband struggling to cope, feeling powerless.  It was bad enough after the first op with a shorter recovery time.

However the surgeon talked me around to his way of thinking (I knew it would be that way), which was that using my own fat is the best, for feel and look etc and that the recovery, although longer, is worth it in the long run (implants need to be replaced etc).

He also said that it wouldn't be wise (although he would do it if I really wanted) to have a double, as the type of cancer I have ie ductal, isn't typically bilateral, whereas perhaps lobular is, therefore it is really rare for ductal to travel to the other breast.  My answer to that was that tubular (particularly in someone of my age - 43), is rare - but it's happened, therefore rare can happen.

The picture that he showed me to allay my fears of my breasts not being even and matching, wasn't the most attractive either, so it didn't really sell the whole using your own fat concept at all!

There is also the picture going around facebook, and was in the Guardian, of a very attractive Australian mother of 4, who bravely posed naked to show all of her post op scars.  My friend said that it is a good match for how she now looks and is having to come to terms with it.  Therefore, my thinking is that surely with implants, at least there is no tummy scar to contend with.  Whereas another friend of mine, is perfectly happy with her results and is just now waiting for an uplift on her other breast and for a nipple to be tattooed on.

I am now so confused.  My head is spinning and I know I have to do what is best for me.  The surgeon makes it all sound so easy, but when you come onto a forum like this, you hear both nightmare stories and positive ones.  I really don't know which way to turn.  

Help!!

H x