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Deciding to have reconstruction or not

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Deciding to have reconstruction or not

Dear All, 

Finishing chemo in two weeks and surgery will follow 4-6 weeks after with some radiotherapy then, I am wanting some advice about whether to have reconstruction or not. Still waiting on genetic result, but currently it's one breast being removed.  Although I think I will feel bereft to look down and see nothing, flat chest when I wash and have radiotherapy, the thought of an alien body that has no sensation and the intense medical procedures involved too, doesn't appeal either. Although facing the world with two boobs feels better. Big emotional dilemma as don't really want to put my body through big proceedure either. What has helped others with similar emotional make up, decide ? Thanks Kali

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I actually didn’t find it particularly hard to accept my change in appearance. Lots of the leaflets go on about how you might feel the first time you see the wound or whatever but my bathroom has a massive wall length mirror opposite the shower so I couldn’t avoid seeing myself really. I surprised at how long the scar was as the pictures in the leaflets make it look somehow narrower than the width of a breast.

Before my op I had chatted to a friend who had a similar operation and had also decided to stay flat. Maybe some of her thoughts shaped my approach. We are both not particularly girly, tending towards jeans and sweatshirts when possible.

I did have a wobble one day when my husband finally moved back into the bedroom. He had been sleeping in the spare room for quite a while. Firstly while I isolated before and after surgery and then because I wasn’t sleeping well, probably snoring loads through sleeping on my back etc. It was just easier for him to be in another room. When he did move back I was trying to get ready for bed without exposing myself. I thought he wouldn’t like it. Anyway after being really upset and then telling him what the problem was he made it clear that it made no difference to him. Now I just carry on as before.

 

Sorry for rambling. Good luck in whatever you decide.

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I don't know if I can decide. Will meet surgeon tomorrow. Thanks for sharing. 

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Thank you

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Did you find it hard at first? And what was the process of adapting ? 

Thanks Kali 

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Thank you. I will ask the surgeon about that. Thanks for taking the time to inform me. Kali 

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Dear Kali,

I was in the same boat until a week ago when my surgeon changed her mind and offered me a therapeutic mammoplasty, so lump out with, hopefully a clear margin, then breast manipulated together to bring a shape with a small uplift to the breast and nipple moved up.  My lump was on the top part, above the nipple on the left side. Then she did exactly the same on the other side!  Lymph nodes on left armpit removed too.  I have had hardly any pain at all.  I had moderately sized breasts so I didn't mind losing some boob on both sides.  I am so pleased with the result and the recovery period is going very well. Operation took about 1 and a half to 2 hours.  Before my surgeon came up with the TM option I was going to have the flap option as I was unsure about problems with being one-sided, for example, posture and neck strain etc.  I trawled all sorts of sites before deciding on the flap option but, in the end, I thought it was the lesser of two evils.  However, lots of women have chosen a mastectomy and are very happy with their choice.  It really is a personal choice.  I hope this helps you somewhat; I had never heard of a TM until last week!  I wish you all the best of luck in making your choice and really hope that everything goes well for you.  Stay positive, you will come out the other side. Tx

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I had a mastectomy without reconstruction in August. The thought of the ten hour operation and that I would have to wait a few more weeks before it could be scheduled made me decide to just go flat.

 

In theory I could request reconstruction surgery if I wanted it but I don’t think I will. I don’t wear particularly tight fitting or low cut tops and am fairly small breasted. The women I work with say that it is not obvious that I have had surgery (I don’t wear a prosthetic either). My husband has been fine about it. The only person going on about reconstruction is my dad. He seems very bothered by my decision.

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Hi Kali,

I found the first three days very painful. Once I got home, I walked a little further every day, and I was back at work, after four weeks.

By the six week check, I was ready to exercise. I now run twice a week and feel very well. ( The operation was on 13th July).

 I must admit, my stomach still feels tight, even though I have a full range of movement, but that is quite nice. I have lost my little tummy roll! After all, it's a tummy tuck but they don't dispose of the removed tissue!

I have absolutely no regrets, and would definitely choose the same option again.

Best of luck to you

Jane xxx

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I'm in a similar position to you. 

Only you can decide what you feel is best for you. 

I sometimes find writing down my thoughts and feelings helps clear my head. 

It's such a big decision to make.. 

I sometimes feel our initial decision or gut feeling is where we truly want to go. 

Best of luck to you 

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Thank you Evie. Useful to know about the sling option. I wonder if there is any literature on best options for different psychological make ups. I may post s question and yes look at older threads around similar questions.

Thanks K 

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Thank you Jane. How were you fir the first free weeks after the DIEP surgery. I worry that I will feel kind of trapped with so much change to my body , limited mobility discomfort  to tummy , breast recon and pic line as will still have targetted therapies every three weeks too. How was your recovery ? Thanks again. Kali 

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Hi Kali - reconstruction is a very personal decision, and you are doing the right thing by getting as much info as you can to help make the right decision for you. I’ll try to explain my thinking.

I had chemo first, followed by mastectomy and an immediate implant at the same time, and radiotherapy afterwards. I didn’t want to be flat, and I chose implant option as it was a shorter operation and recovery time, and I’m very happy with it. It doesn’t quite match my real one, but I use a partial prosthesis to even things up so you would never know when I’m dressed.

One thing I would say is that plastic surgeons can be reluctant to do implant before radiotherapy as there is a risk of it hardening, but I had an implant on top of the muscle in a Braxon sling which I was told is supposed to reduce that risk so my surgeon was happy to go ahead.

Have you asked your surgeon to show you photos of the various options?

I hope someone will come along who chose the flat option to give you a balanced view, otherwise I’m very happy to answer any questions you may have. You might also look at some previous threads about staying flat and the other reconstruction options. My very best wishes to you, whichever option you decide on. Evie xx

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Dear Kali,

My treatment followed a similar path to yours. In June 2018, I started six rounds of chemo, followed by a single mastectomy in October 2018, and then radiotherapy.

 I found the mastectomy initially daunting, and I really didn't like the look of it, but the breast prosthesis looked amazing, and no-one would ever have known I only had one boob, when clothed.

However, I had a diep reconstruction in July this year, and though I haven't had the symmetry operation and nipple reconstruction yet ( which is a simple operation), I am absolutely thrilled with the results. Even though I am quite slim and they wondered if there was ' enough of me' to provide the reconstruction, the result is great. It feels like part of me, warm, and natural looking, and it will change size like my other breast if eg I lose/ gain weight.

I would say the first few days were very painful and it is definitely a major operation ( eight hours in surgery) but I could not be more thrilled.

I hope it helps to hear about the experiences of others. I wish you well with whatever you decide.

Best wishes

Jane x

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Thank you for replying. Onc nurse said to discuss with the surgeon. Thanks for your advice. I am still getting my head around the different types of reconstruction.

Kali 

 

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Dear Kali, wishing you well with your treatment. A bit decision ahead for you, was wondering if you have a breast cancer nurse at the hospital, they should be able to help you, from what you a feeling, maybe a straight forward reconstruction would be the way forward, however this is easy for me to say.

wishing you lots of luck, keep well. Big hugs Tili x