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Surgery following radiotherapy

5 REPLIES 5
Evie-S
Community Champion

Re: Surgery following radiotherapy and reconstruction options if not enough tissue for diep

Hi @Sierramike - we can either chat on this thread, or if you prefer more private we can chat via the private message system on here. If you go to the top right of the screen, once you are logged in you should find a head/face icon and to the left a pink envelope. If you click on the pink envelope you can write a new private message. Or if you click on my name my profile will come up and you can send me a message that way. Or failing that, I can send you a message and you can reply - you should be notified by email when you get a new private message.

I’m afraid there isn’t a facility to actually chat with regular members, only via messages, but another alternative would be to contact the “Someone Like Me” service on here and you will be put in touch with someone who has been through similar and can actually chat to you. Of course the nurses on here would also be happy to discuss options with you.

If you would like to send a list of questions, I’ll be very happy to answer and discuss with you. I hope that helps, but let me know what would help you most and I’ll happily help you. Evie xx

Sierramike
Member

Re: Surgery following radiotherapy and reconstruction options if not enough tissue for diep

 @Evie-S thank you! I’d  like to take you up on your kind offer of a discussion. Not sure how we do this off the forum but let me know when would be a good time to chat. SM xx 

Evie-S
Community Champion

Re: Surgery following radiotherapy and reconstruction options if not enough tissue for diep

@Sierramike - I had an implant at the same time as my mastectomy and would be happy to discuss this with you if that would help although you did say you weren’t keen on the implant route. I am also a B/C cup and didn’t have enough tissue for Diep. Let me know if I can help at all, but no problem if you have ruled out an implant. All the very best with whatever decision you make. Evie xx

Sierramike
Member

Re: Surgery following radiotherapy and reconstruction options if not enough tissue for diep

 

I have just had my consultation today with the plastics team re surgery and radiotherapy post chemo for ductal cancer. Tomorrow is hopefully my last day of chemo. Yay! 

When we went through the options, it was never radiotherapy first, but surgery then radiotherapy- I didn’t ask why but I guess the breast care specialist nurses online can advise please???


But in terms of reconstruction options post radiotherapy , one offered to me was a temporary implant immediately during mastectomy and then later reconstruction with inner thigh flaps (both sides to get enough tissue )  as the longer term solution, building it up over time . (I’m a B cup but don’t have enough fat tissue in the right places apparently for a DiEp or glute flap). So while I was hoping for a straightforward one step reconstruction, that’s not going to happen. I also will have nipple reconstruction when everything is settled and unevenness corrected as much as possible. 
I don’t think I want an implant as the solution: any contracture will be obvious with my smallish breast cup, and it will have to be redone in 10 years or so anyway.

I also don’t particularly want to go down the route of reducing the unaffected breast: I’m a B cup and want to stick with that and don’t want to operate on the other side unless absolutely necessary. 

I do care about the cosmetic outcome- more than I probably admit to myself.

For personal context: I’m in my late 40s, no kids, currently single but would like to have a long term partner again.

So I was wondering if anyone in (or has been) in a similar position as me where a diep can’t be done because not enough fat / muscle tissue in the lower abdomen? Willing to share thoughts and experience to help me process and decide on options to take? Should I get a second opinion? 
Also where can you get stats on success rates for the different pathways?

 

Thank you and hugs to you all xx 

Evie-S
Community Champion

Re: Surgery following radiotherapy

@VioletLizzie - I do understand and sympathise with the decisions you are trying to make. I just wanted to share my experience in case it helps a little - I had an implant at the same time as my mastectomy, followed by radiotherapy. I was initially told that I couldn’t have an implant reconstruction before radiotherapy, but my plastic surgeon agreed to do a “pre pectoral” implant (one that sits on top of the chest muscle rather than underneath) that sits in a sling (Braxon I think it’s called). Apparently this option has a lower risk of hardening (capsular contracture if you want to google) after radiotherapy. I’m happy to chat more if it helps at all - or hopefully others will come along and share experiences. You might also want to consider searching the forum - the search box is just above this chat, but make sure you change the search button to “forum” rather than just this board. I wish you all the best. It’s definitely worth exploring all options and pushing for what is best for you. Evie xx

VioletLizzie
Member

Surgery following radiotherapy

Hi 

I don't know if anyone can help - due to start Chemo this month, then herceptin+docitaxol.  Consultant then wanted me to have mastectomy followed by radiotherapy.  I want to have reconstructive surgery at the same time - so have pushed to have radiotherapy first then mastectomy and reconstruction  and lymph node clearance early in 2022 (all treatment should have finished by mid December 2021).  I have been met with massive resistance to this plan (they won't know where to target ). My concern is that if have mastectomy first - followed by radiotherapy that the skin tissue will be damaged in order to have reconstructive surgery later on - again told that they won't do reconstructive surgery at the mastectomy op due to radiotherapy and silicon implant ( currently I am veering towards DIEP anyway).  Any thoughts?