Tissue expansion and symmetry

[rebeldog]

Thanks Kate. If I have to I will ask for another surgeon but I really hope he will do it. It has taken 3 years to get to this stage and he has been marvellous so far.  I have had 3 lots of fat injections over the implant to try to get a good shape and I was surprised when he didn't seem to want to match the other one. Just wondered if anyone has had the operation?

[kate48]

My surgeon was clear that symmetry in a bra and symmetry out of a bra were 2 different things and that I had the right to make the choice. I don't understand why your surgeon shouldn't give you the same choice. Don't be fobbed off. Reconstruction choices are so personal and you deserve the support to get the best outcome for you. Kx

[rebeldog]

Thank you. When I broached it with him he said the aim is to look good in a bra, which I admit I do but it is what I see each day that brings back those awful memories

[kate48]

Hi Rebeldog. I hope that your surgeon is more understanding than you fear. it is part of our emotional recovery to feel like we look ok, and i think an emotional recovery boosts our physical recovery.So be asssertive!! Kx

[rebeldog]

Spoke to my breast care nurse today she says its all about expectation!

[riversidedawn]

Hi Kate, I definitely want sisters lol,!!! and rebeldog im 5 days into 15 rads and determirned to get a matching pair after!!

[rebeldog]

I have only just re-joined the forum and was so pleased to see your post. I have never had any hesitation in wanting my other boob lifting to match the expander. Call me vain but it is all that has kept me going when I look inthe mirror.  But I am getting vibes form my consultant that he wont do it. 

[kate48]

Thanks riversidedawn. I completely understand Droopy and Dolly. It made me laugh out loud. I had a conversation with the surgeon about how my teen daughter had said I just needed sisters not twins but mine felt more like cousins :). I have had an easier road than you though. I was picked up with DCIS in a routine mammogram and consequently my mastectomy did the job. I haven't had to have chemo or radiotherapy. I think that's part of anybody have felt self indulgent about the reconstruction at times as I have been conscious that mine has been a relatively easy journey. Let's hope when your radio is done you will soon get to bbc the end of your reconstruction. You certainly are due an easier ride for the last leg of the journey!
Kx

[riversidedawn]

Kate, well done you for making a decision! I'm not sure what to do because of infection with my original implant. I'm happy enough with Dolly although she's perter and bigger than Droopy!! Need to see what radiotherapy does to her - start Wednesday. I'd like to replace with silicon and have an uplift but let's wait and see. Keep in touch with your progress, guess I'm several months behind you?

[kate48]

Well I got to the stage where I had to make my decision. And finally after a lot of beating myself up for being vain I decided I didn't want 2 boobs that matched in a bra but not in the mirror before my shower every morning. As my wise husband said I have to live with it for the rest of my life so I needed to feel happy with whatever decision I made. So I agreed with my surgeon that as I didn't want my one remaining nipple messed with I would have a small implant in my good boob taking me from a B cup to a C cup and giving it an uplift so both boobs point in the same direction! I have had my final expansions so my reconstructed boob is now bigger than my own boob until I have the operation to swap the expander for a permanent implant and uplift the good boob in the autumn. So I am incarcerating a softie in my good side. Life is just too bizarre for words sometimes but I am glad to have finally made the decision and be getting on with it. The other bonus is no more hospital appts until September!
K

[riversidedawn]

I had mx with immediate implant recon in September. Unfortunately it got infected so removed in December. I had expander put in in may after chemo finished. It was filled up in one sitting 10 days ago as I had my rad planning last Monday! Rads start Wednesday 1st, then will have expander replaced in the future. Like you ladies I do wonder whether to mess with droopy - it would be nice to be even but if it ain't broke don't try to fix it! Watch this space.

[Biddlybee]

Hi ladies, hope you are all ok! Just to let you know that I have had my final expansion last week. I can now wear an ordinary bra with no padding. Wonderful to have cleavage now that the summer has arrived lol. I will see the PS in early August, and that is when she will measure up for my permanent silicone implant, and put me on the waiting list for the op. The nurses think it will be next year. I have to decide whether I want anything done to my good boob. Which is pretty droopy compared to my new one. Fine in a bra, but I wouldn't want to be seen out without a bra! Some days I think well, if they are going to do surgery on one boob, why not the other at the same time, then I think it is best to leave well alone.... Oh decisions decisions. Apparently I would need a lift which would involve taking some tissue out of the good boob and moving the nipple. And probably dropping a cup size. Might just stay with having a droopy good one eh. How's everyone doing? Xx

[Kiki2]

Hi ladies, I had a left breast mx 9 weeks ago with immediate reconstruction using strattice mesh and implant (not an expander one) so everything was done in one operation including the snb(which fortunately was clear) .I am very pleased with the result of the reconstruction, it has healed well with just a scar of about 5cm across the Middle of the new breast and the surgeon was able to save most of the areola so it still looks quite like a nipple even though there is no sensation. Most of the breast is quite numb. It does feel quite alien though and still quite tight and if I do more( eg walk more than a couple of miles) it does still ache. I am hoping this will continue to ease. Under my arm is still quite stiff too and I continue to do physio stretches. I do look quite uneven when not wearing a bra because I'm 50 and the good boob droops but as I am only a B cup this doesn't concern me unduly as it looks fine in a bra. I would be reluctant to mess with the good one in case it reduced the chance of them spotting a problem. ( my DCIS was also picked up at my first mammogram). Good luck with your decisions .

[Kaya51]

Hi biddlybee (by the way I love your name!!).

I'm pleased to hear that you have had your operation and are healing well. My veins are not good either due to the chemo. You previously mentioned "show and tell" - I looked it up and am now booked in to go to one in June. Yes, I am gradually getting more info - a lot of it from all you helpful ladies on this forum. I have been offered different reconstruction techniques which is lucky but at the same time I find it hard to make a decision as to which way to go. The implant route is tempting though because it is the smallest operation. Wishing you all the best for the rest of your recovery and for your expansions.

[kate48]

Hi biddlybee
Good to hear you are doing well. Make the most of all the help and support around you. My expansions have been fine. Non events really in a good way. My first one wasn't until 4 weeks after the op. My surgeon likes to take it slowly. I am back at work now 3 days a week and coping. I do go to bed very early! Take care. K x

[Biddlybee]

Hi Kate and Kaya, a little update - I had my dressings off today and all healing well. Just some steristrips in place now. My first expansion will be in three weeks as the plastic surgeon is away. The wound is still a tiny bit painful so it is probably for the best. I stopped taking painkillers a couple of days ago and the little bit of pain reminds me to take it easy and not overdo things. The nurse said to really take it easy until the implant and strattice is settled and healed. I am lucky that I can take it easy with good support at home. It must be v difficult if there are kids/work etc., as there is a lot of recuperation. Hope the expansions arent too uncomfortable Kate. I am certainly hoping that I will not want to touch my good boob. The whole surgery thing is very draining, and I have useless veins. Took them five attempts to find somewhere for the anaesthetic canula. I am still black and blue! I know I will need more surgery to take the expander out and replace with the silicone implant but am really hoping that both boobs will be similar enough. Hope you can get plenty of info Kaya, and get fit for surgery. xx

[kate48]

Hi Biddlybee

That's great that you have been able to access that support to make your decision. I hope all goes well on Thursday . I have had my second expansion today so it is decision time now on whether I stop now and accept that my breasts are different shapes or have a small implant on the other side that will give me a more matching shape but also will have to make me a little bigger than I currently am. When I made my decision about the type of reconstruction I never wavered and both head and heart pointed to the same decision.  This time my head is saying "why put your good breast through surgery for no medical reason?" And my heart is saying " let both breasts look a similar shape even if they don't feel the same as each other". Just as well my surgeon has the patience of a saint!!! 

Let us know how you are Biddlybee. We'll be wishing you the best recovery. And kaya July will be here in a flash. 

Kate x

[Kaya51]

Hi Biddlybee

Wishing you all the best for your reconstruction on Thursday. I will be very interested to hear how you get on. I am thinking I will go for the expander implant (I believe this is what you are having) and like you mine will be delayed reconstruction but I am not going to see surgeon until July so have a bit of a wait yet. I am pleased to hear that the Keeping Abreast showing really helped you and that you are looking forward to the recon. I will definitely look up the Keeping Abreast charity and see if there are any showings near where I live. Take care and good luck for Thursday. I will be thinking of you on Thursday.   Kaya. x

[Biddlybee]

Thanks Kaya and Kate, sorry haven't been in here for a while. Got my date for recon - this Thursday. For i fo, I went to an evening set up by the charity Keeping Abreast, where volunteers did a private "showing" and explained what they had had done. Very generous of them to share their experiences. Really helped me to look forward to the recon. All of the ladies were v happy with their results, all having had the different types of ops. Will let you know how I get on! xx

[Kaya51]

Hello again Kate. Thank you for your good wishes. Yes I can understand why you couldn't have reconstruction with a long recovery time and am glad you are pleased with your choice. I too was offered different options but do not feel happy about options that use other parts of your body. I feel I do not want to start cutting into other parts of my body that are healthy. I know many women are happy with the result of the stomach flap operations but it is such a large operation and also affects your stomach, and to be honest I just feel I can't face it!  I'm not sure about the LD flap operation either. So I am tempted to try the implant only option and see how it goes as I'm not that bothered about getting a perfect match with my other breast. I know women can have problems with implants but I believe if there are problems you can have them removed. Anyway, as I said before, I was pleased to hear that you have found the process ok. Wishing you the best with the rest of your treatment.

Kaya

[kate48]

Hi Kaya
Thank goodness for that pilot! It is so true that we all make such a variety of decisions. My surgeon was brilliant at setting out all the options and being clear that there was no "right" one. I am self employed so having the shortest period off work was a big driver for me and of all the reconstruction options using implants was the shortest recovery time. I still feel implants was the best decision for me. I hope you find the best decision for you too
Kate

[Kaya51]

Thank you June

[June_BCC]

Hello Kaya51

Just to let you know that SNB is Sentinel Node Biopsy.

Best wishes

June, moderator

[Kaya51]

Hi Kate

Thank you for replying to me and Biddlybee. It is interesting to hear how you have felt about your mx and implant. I understand that no ones experience is exactly the same as someone else's and you would have different experience to us, especially as you had immediate reconstruction. However, I have read so many reports of ladies being unhappy with implants that I was pleased to read about your experience which I find more reassuring and positive. You mention that you think any pains were caused by nerves and the 'snb' - I am not very good on all the abbreviations and am wondering what 'snb' is?  Yes you are right, it does boil down to whether you want to live with a prosthesis under the skin or on top of it!  Like you I was picked up in the pilot screening for women aged 47 to 50, I had lobular cancer and am grateful it was discovered. Wishing you all the best in your decision about what to do with symmetry of your unaffected breast.

Kaya

[kate48]

Hi Biddybee and Kaya
That's a hard question to answer as I don't know how much of the physical and emotional feelings where common to any mx and how much was due to the reconstruction as both happened at the same time. What I can say is that I found the tightness uncomfortable rather than painful. I think pains I felt were due to nerves and the snb. That tightness went by week 5. The reconstructed breast did feel alien, but again I think that is part of the loss that anyone who has an mx has to come to terms with. 6 weeks on it feels less numb, much more comfortable and is becoming part of me. That said it will never feel like a normal breast. In the early weeks I wondered at times if I should have considered not having reconstruction, but I now think in the long run I will be glad. Everyone makes the decision for different reasons and as someone else said in a post that I read it boils down to whether you want to live with a prosthesis under the skin or on top of it.
The only other thing I can say is be prepared that you will have limited use of the arm on that side as you have to be careful not to displace the implant for quite a while. So you can't lift that arm above shoulder height or do anything that exerts it.
Not sure if any of that is of any help but good luck with decision making and ask to see photos of the surgeons work. I found that really helpful in making my decision.
Kate

[Kaya51]

I'm interested in this thread as I am considering having implant only reconstruction. I had mx (left breast only) in April 13 and couldn't have immediate reconstruction for medical reasons. I now have an appointment with the surgeon to discuss reconstruction. I presume I would need to have expander implant. Like Biddlybee I would be very grateful if you could let us know from your experiences what to expect with this kind of reconstruction. I have read quite a few other threads about ladies finding the expansion of expander implants painful and also saying their implants feel alien and uncomfortable. So I am finding it hard to make a decision. I am therefore wondering if any of you are pleased with your decision to have implant reconstruction and how you have found the process.

[Biddlybee]

Good to read about your experiences ladies. I am going to have an expander implant op in the next couple of weeks, delayed recon following mx in Aug 13. Any suggestions for what to expect after surgery would be much appreciated. xx

[kate48]

Hi Naz. That's brilliant to hear. It also suggests that what the Breast Surgeon said is true to your experience. Your no nonsense descriptions are always on the button. I'm really interested to see how your investigations into a tattoo rather than nipple reconstruction go. I am quite tempted although would never have considered any sort of tattoo before this whole process began!
Kate

[NAZ]

Hi Kate

I have a small implant in my good breast ( I had symmetry surgery 2 years ago now). I cannot feel the implant at all, it is like it's not there! However, I do have an implant as part of my LD reconstruction and that i can feel (like a bean bag!). I neeed to have the symmetry surgery or else i would have been severely lop sided and I was not living like that (bad enough living  with a mound of flesh for a breast!), so I am kind of glad i had it done (extra scarring though).

Naz

[kate48]

Thank you both for your replies. Hazel I would talk to your surgeon again if you have more questions. Most women seem to feel numb to some degree post mx and reconstruction. I am recovering some sensation 6 weeks on but it is never going to feel like my old breast as the implant is under muscle rather than tissue. What I am trying to understand is how an implant under breast tissue in the other breast would feel in comparison. Thank you Judith for you experiences.
K

[Hazelr]

I am currently making the decision about mx single or bilateral and had thought I would go with the double as a I would like them to be the same but now not sure as don't want to lose the sensation in my good one. I thought that it would not be the case but maybe I am mistaken? I am a bit confused and having met with the surgeon once I probably need another meeting. Any advise would be appreciated x

[Judithvr6]

Hi Kate48.

Silicon implants are not a one stop, totally problem free procedure.

I had a small one to replace size after a wle years ago so it is in my 'bashed about' boob.
It's been in 8 years and is now playing up and I would like it removed.

I can certainly understand the desire for the best sysmetry (which is why I had an implant) and I was offered 'any size you like... we can enhance both sides to what ever you like' but couldn't entertain the thought of having my good, my 'best' boob operated on.
And silicon, done well, looks good but doesn't feel anything like natural to me or my fella  😉 If you want to keep normal sensations in your good breast tell the surgeon to leave it well alone.

I hope everything goes well.
J

[kate48]

Hi

Today I have my first expansion 6 weeks after my mx with reconstruction following a diagnosis of a large area of DCIS. I was picked up in the pilot screening women from ages 47 to 50 so I am feeling very fortunate as I have avoided the need for further treatment. The expansion was not even vaguely painful and it  has left me feeling only very slightly tight, but nothing like the uncomfortable feelings I had from fluid build up a few weeks ago. 

The surgeon started to broach the subject of the final size and symmetry of my reconstructed breast and my thoughts about the other breast. One option is to put a very small implant in my good breast to match the shapes. I am currently a B cup.so I am not expecting to need many expansions! My main priority is to keep normal sensation in the good breast rather than worrying about symmetry. I am keen to hear

what decisions others have made and what sensation they now have in the Breast unaffected by their mx.