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Surgery - how did you decide?


Re: Surgery - how did you decide?

Hi it really is a personal choice and everyone will feel differently but you have to go with what feels right for you at the time. Jokely I really feel for you especially having a toddler and going through all of this. I was similar in that I agonised for months over what to do and was scared of the length and implications of the diep op so went with the ld flap and implant. I am now on capsular contracture x2 and the implant has to come out I  am on the waiting list now for a diep 2 years later. Hindsight is a wonderful thing but I did what I felt was right for me at the time. I am also taking more of a risk now as I have had lipo to the abdomen as part of the reconstruction but feel I have to try as otherwise I will never know and I prefer to try than not try at all. Millasmummy I know it is difficult but we have all been there and you have to go with your gut feeling about what feels right for you xx

Re: Surgery - how did you decide?

It's a huge decision to make, isn't it!  I lost many hours' sleep over it.  


In May, I had to have a mastectomy of my right breast and I was given the choice of an implant or tissue reconstruction.  What influenced my decision is that my weight fluctuates quite a lot - I can lose or put on 20lbs over the course of one year, and I was worried that if I lost too much weight (or vice-versa), an implant would no longer look right. However, a reconstruction using your own tissue will grow and shrink with the rest of your body.  So I went for the DIEP option - initially I was dreading the 8-hr surgery, the 6 days in hospital, the 3-months off from work, etc but now I am happy with the decision I made.  My recovery went well - I was fairly fit before my surgery (albeit quite overweight) and made sure I kept safely active throughout my sick leave (ie daily morning walks, regular physio/stretching exercises) but rested a lot also.   I live on my own, so although after coming out of hospital I had to fend for myself a little as far as daily chores and shopping went, it also meant I was left in peace to recover at my own pace and rest as much as I needed to.  


I did get a seroma (fluid build-up) in my new boob but this was painless, and later drained during one of my follow-up appointments with my plastic surgeon. 


I am happy with the shape of my new boob - and although I was initially worried with having to live several months with two boobs of different size (my new boob is one or two cups smaller - with prior agreement with my plastic surgeon - than my healthy boob), it's not really noticeable when I am dressed. I will need further surgery - to decrease the size of my healthy boob, lift it and generally make it match the new boob once the latter has settled into its final shape and location (!) - but that's all part of the overall surgery, it's not something that has to be done privately.


Good luck with whatever decision you make.  

Re: Surgery - how did you decide?

Hi Millasmummy.


It took me many (understetment) sleepless nights to decide, I found the whole thing quite torturous. I had quite large breasts and was very sure that I did NOT want to be completely flat, I mentally couldn't handle it. So I was also concerned that to have an implant would look very strange in comparison to the large sagging one next to it. The 1st consultant I saw recommended I had a DIEP and I was referred to a different hospital in the next county. They told me it was possible and they could create a C cup (I was a G/H) but they would also do a reduction of the healthy breast at the same time. I went to a breast reconstruction awaresness meeting at the hospital and met some of the ladies who had had it done and they showed us their "new" breast and they really did look amazing. It was quite inspiring. The match to the original breast was incredible but none of them had had to have a reduction so I still couldn't picture it.


Then I was seen by a 2nd consultant in my original hospital and she really put me off the DIEP, scared me in fact and if I had any doubts to not go through with it. She pointed out the recovery time from such invasive surgery and that she really wouldn't recommend having the reduction at the same time (which was a big selling point to me- getting a matching pair and not having to go through it again) as there would so many large wounds to heal from there would be more risks of complications. She also talked about Angelina Jolie and the option of having implants in both breasts.


I felt really uncomfortable with the extent of the DIEP surgery and the recovery time involved (I have a 3 year old), I was scared at how small the breasts would be (I was worried that to get a C cup would leave me bent double as there wasn't that much extra skin and the surgeon really had to pull and stretch me) so after agonising about it and with advice of my friend's mother who had the DIEP and another cancer scare 10 years later- I opted to have a double mastectomy with implants. I had already had a cancer in my 20s and wasn't feeling too lucky about avoiding  round 3! At the time I was pleased and relieved to come to the decission.


However I have had complications with the implants and have had 3 lots of surgery to try and save them. I got a bad infection, they cleaned it and put it back and it seemed great, but despite using PICO dressings the wound just wouldn't heal. 2 weeks ago I had them both replaced with Becker implants (silicone expanders to give the skin chance to heal). Unfortunately I got another infection in the other breast this week and I'm now hoping antibiotics can save it.


I have been very depressed. I really don't want to be flat but I have had 3 months of discomfort (and only just gingerly getting proper toddler cuddles), the implants feel so alien and unatural and have been nothing but trouble. I really regret not going for the DIEP but hindsight is a wonderful thing isn't?I was supposed to start chemo on 5th Sept but it keeps getting pushed back. I keep trying to tell myself the DIEP may have had its own problems and may not have worked and that I was happy at the decision I'd made at the time.


But everyone is differnt! It doesn't mean you'll go through a similar thing. I've met some amazing ladies on intagram who have shared their photos - some privately. hashtag breast cancer/ reconsruction etc. They have really helped me and are very supportive. (Much better than googling before and after pics!).


Good luck




Re: Surgery - how did you decide?

Hi Milasmummy,


it's such a personal decision, isn't it. We're all different in how we feel. For me I could not imagine being without one breast so knew from the outset that I wanted a recon. I was very concerned about DIEP - length of op, length of recovery, complications etc but in the end asked to have the op. Mother Nature then intervened and I was told I was not suitable. To be honest, I am now relieved not to have put myself through such surgery. However, I then had to choose between straight implants (with supporting mesh) or LD flap. I wavered for a while - LD flap sounded terrifying what with moving a muscle and most likely also needing a small implant to match my new boob to the remaining one. But I eventually decided that as I would be getting an implant either way I might as well go for the better looking end result of the LD flap. So pleased I did. I have a very well matched new boob. It's only just over two months ago that I had the op, but everything is settling down so well now that for most of the time I am not aware of my new boob or the scar on my back. All the scars are so well healed and I've been back doing everything as normal now for at least the last 4 weeks. As you say you have a smaller bust you might not need an implant at all if you keep to your current bust size. 


Anyway, hope you settle on a decision that feels right for you and that everything works out as well for you as it has for me.



Re: Surgery - how did you decide?

Thanks for your replies Kiki2 and Riversidedawn. I am thinking of going for the flap options although I know it will be longer recovery. I will also ask about the other non affected breast as Id like them to look the same and bigger if at all possible! As I am quite small and wouldn't mind a bit more tbh! Xx

Re: Surgery - how did you decide?

Difficult decision. I too went for immediate implant reconstruction as it seemed the least invasive. (2 years ago next week! I had chemo after surgery and th implant got infected when my resistance was low. Had a temporary expander put in after chemo to save the skin as had rads. Then had replacement implant 6 months ago.

Must admit mine is not pretty to look at. Dressed and in swimwear it is hard to tell - except for lack of nipple. I had an uplift on the good side for symmetry - it's part of the service and you don't need to pay privately.

I have struggled with the appearance this year, but finally came to terms with it a month or so ago. I was considering a DIEP flap (tummy) but have now decided I've had enough of hospitals for the moment. I will reconsider in a few years when Mother Nature has done her worst with the help of gravity on the natural one!

I friend of mine had the ld back flap recon with an implant, and an implant in the good one for symmetry - she looks amazing!

There are several books and publications which give in depth information and images for all options - definitely worth a read to help you with your discussion with surgeon.

Re: Surgery - how did you decide?

Hi there, I had mx 18 months ago and initially thought I didn't want recon but then decided I was only 50 and if all went well it was a long time to be lopsided so decided to go for it. I was given all the options but decided to go for the implant operation which uses an acellular(pigskin) mesh so that they put the permanent implant in straight away. It was all over in one operation. The surgeon was able to save my areola skin so I still have the appearance of a nipple though it is a flat one. 18 months on the result is pretty good, it is a good match though obviously the natural one droops more. I felt I definitely didn't want the other one messed with but if I had wanted it I think they would have done it!  For the first few weeks after the op it is painful in your chest as all is stitched to the chest wall muscle. It is important to do all the exercises they give you to keep the mobility in your arm. I have normal use of it now apart from things like press ups or using anything really heavy. I can still feel the stretch if I put my left arm up and over my head, think that will always be like that. I run and play badminton again now. I was off work for 8 wks then went back on a phased return. There was extra risk of rejection having the pigskin but the surgeon said he had done 50 and 2 had rejected so I felt they were good odds! Hope this helps, get them to show you before and after photos, the hospital took them of me so they must build up a bank of them. Good luck with your decision, Nic xx

Surgery - how did you decide?

Hi Ladies, I am coming up to my last chemo in a couple of weeks and then need to decide on my surgery. I will be having a MX of left breast and ANC. My consultant has given me literature and gone through my options for reconstruction or delayed reconstruction, but I'm finding it hard to decide.

How did you ladies decide who've already had surgery. If I'm honest I've probably never been happy with the shape of my breasts so was originally thinking implants, but as its only left side MX they wouldn't look the same, unless I guess I paid to have the other one done privately.

I also have thought about having immediate reconstruction using tummy or back tissue bit I feel uneasy about that and the scarring I'm left with and the shape of my new breast.

It would be great to hear from you ladies and how you decided and if you would now do anything differently. Thank you xx