Breast reconstruction after mastectomy

I was hoping to get some advise, I have been diagnosed with breast cancer in my right breast and will be having a mastectomy, I have been offered a choice of three different types of reconstruction, an implant, diep flap or LD flap. We don’t get something for nothing so naturally they have their pros and cons. Has anyone had either of these reconstructions? If so what did they think about recovery time and in particular how has the scarring been?

  • Hi ED29

    I have just been diagnosed too in my right breast and am also waiting for surgery. So, I can't offer advice but just wanted to say hello.

    I looked at DIEP flap and thought it seemed wonderful. There are some images online that you can see. It's a major surgery too and a large abdominal scar. I also hadn't realised that the skin from your stomach is also used in the reconstruction.

    I have asked for a double mastectomy and have asked for teardrop implants as I thought the diep route would be too long in surgery and too long of a recovery period. I'm due to have surgery on 7th Jan. How about you?

    Hopefully, we can support eachother.

    Caz

  • Hi Caz,

    I’m sorry to hear about your diagnoses. I had also originally drifted towards the DIEP surgery but like you said the recovery is too long and I have a 9 week old baby and a 10 year old and don’t fancy being of my feet for too long. 

    My surgery is due to take place 30th December, they had offered 23rd December but I don’t want to be in hospital over xmas.  It was originally meant to only be a lumpectomy but they found more cancer in the breast behind the lump after my MRI, so I now have to have a mastectomy. 

    I have until Thursday to make my mind up. I had  asked about a double mastectomy but I was told that they wouldn’t take tissue away that was healthy. I would prefer a double, just because going forward I don’t have to worry about breast cancer coming back again and obviously cosmetically it would look better.

    Did you have to convince them to do the double mastectomy? 

    E.

  • Hi E,

    Yes, I did have to convince them. I changed my surgeon to one that is more amenable and I have got to go for a psych assessment. For me, even though my cancer is low grade, it is invasive and I know I would be too anxious going forward. I've also suffered with very low self esteem and the look of my breasts, along with the desire for symmetry is also very important. As a consequence, everything has been delayed - My surgery was originally set for 20th December but, like you, at least now I can 'enjoy' Christmas. 

    I don't know whether it's worth pushing for a double if you're not comfortable with the decision. The downside is the waiting for the decision. I don't feel that my date or treatment plan is confirmed so I feel very much in limbo. I was diagnosed in 28th November and ever since, it has all been about surgery. It only hit me two days ago, that I have cancer! In the meantime, because of the delay, I've been put on Tamoxifen to block the hormones in the hope that the cancer does not spread further. 

    Did your MRI show clear nodes? I haven't had one, so won't find out until surgery and a biopsy.

     

    Thinking of you x

     

  • I feel just the same, it’s all about the surgery, it takes over the fact that you have this disease in your body and research and stats say you shouldn’t have it but you do and no one can explain why. Each time I go for an appointment it snowballs, the lump was nothing just a pregnancy lump then another appointment it was cancer and the next appointment there is more than just the lump. 

    The MRI showed clear nodes but they are still taking some out but the MRI showed more cancer behind the lump, I have an appointment on Thursday and they will be able to tell me more about the type of cancer etc of the second find. 

    I hope your ok and get your final op date confirmed. Hopefully you can see that as the start of your recovery and getting over this first stage of recovery xx

  • Hi 

    I have right side mastectomy and and implant reconstruction straight away 

    I only have a view on this and can't remember 

    if I was offered anything else 

    the surgeon had photos of work she had done 

    so opted for that 

    dressed you wouldn't know I had it 

    I can almost wear anything and I'm fairly comfortable in a bikini 

    I have a good cleavage 

    it's three years ago now and the scar is barely 

    visable 

    the scar line is under the roundest part of the breast so looking down I can't see it 

    recovery time was good probably 3 months 

    before I could wear a non wired bra 

    and a year before I went back to nice underwired pretty ones but I think I was over cautious 

    I was careful about infection kept the drain in 

    until there was only a little fluid coming off it 

    I did the physio religiously but to be honest I could lift my arm quite easily from about a week 

    I had the sental node and three others removed which were all clear this scar was quite deep 

    they don't tell you how heavy it feels at first 

    it was like having a heavy brick on my chest 

    snd this feeling didn't go for ages 

    I have no feelings in this breast 

    I slept on my back for months on a V pillow and used a neck pillow sort of under the new boob and round my back 

    it was an absolute godsend it was the soft type 

    what ever you decide it's a bumpy ride 

    hope these tips help 

    x

  • Thank you so much for your reply. 

    I hope you don’t mind if I asked you a few questions.

    Did you get any infection with the implant? The consultant has told me that infections are very common.

    Has your implant moved up your chest towards your neck? Again the consultant told me this is very common and one of the reasons that very many people return to get have implants taken out and go for one of the other reconstructions?

    Did you need any other treatment? 

    Many thanks for your reply xx

  • Hi 

    Thanks for replying 

    no I didn't get any infections I started taking zinc 

    and vitamin C tablets as soon as I knew I was having surgery these help with healing 

    also used gentle anti bac soap for all washing 

    the implant hadn't moved but it has a small bubble in it which I had checked out it's a slight crease but it's ok 

    it really isn't a breast it's more a of a mound it's difficult to describe 

    lots of people have a tattooed nipple but I'm happy to leave it 

    I was a 38d and unfortunately they couldn't make the reconstruction that big not enough skin 

    so I use a small balance made by Amoena which just evens it up 

    again they don't tell you about these things

    I did get it free from the breast clinic 

    it's great never moves 

    i had the mastectomy and no other treatment 

    except 6 monthly infusions to strengthen my bone these had no side effects 

    and were preventative rather than treatment 

    as I was triple negative I couldn't have hormone tablets 

    im well up to now 3 years later 

    x

     

  • Hi E,

    I'm seeing my consultant on Wednesday so hopefully we'll both Get Some answers this week x

  • Hi

    I was given the option of an immediate reconstruction, LD flap or DIEP, I couldn't have an implant as I need to have radio therapy.

    After looking at both I opted for the DIEP, and I based my decision on the longer term rather than the recovery time as I felt it would give me a better overall look. I had a skin sparing and nipple sparing reconstruction, unfortunately a biopsy on the back of my nipple showed cancerous cells so I had to go back into surgery and have the bud bit removed. 
    I have a tummy scar,

    new belly button and one scar under my boob which I don't see as it's underneath. I was in theatre for 10 hours, was up walking around the next day and spent a week in hospital. No infections but had to have a skin graft, but it's all healed. I'm pleased that I went for the Diep option. Happy to answer any questions. 
    WL

  • Hi Caz, its so much to get your head round isnt it.  I hope you are getting lots of rest and support. I had an implant at age 18 cos I had a wonky looking chest ( like it had potholes in it) I just recently got dx with invasive ductal carcinoma. It limited surgical options because they couldnt leave it in, so out it came. My anatomy includes dented ribs and missing muscles, so I couldnt face going back to the wonky body I sufferred as a teenager. It took until day of surgery to confirm I wanted immediate reconstruction, with an implant. My surgeon had no idea what he would find when he stepped inside. I am 13 days post op, in pain, but each day it is getting better, the exercises are sore, however they are essential. I cried and screamed when I first looked at myself as the fluid suction thing left me with ripples over my chest, theyare going down now the drain is out, and Im seeing thehospital for possible seroma draining (aspration) on wednesday and praying it wont need doing,. saw breast nurse this afternoon and she dressed some blisters which had come up and were leaking. hope this isnt too  much info but apparently its not unusual after reconstruction,. Hope you have great support off the breast nurses at your hospital, and wishing you  all the best. Top tip- get info, ask for diagrams, ask the breast nurses, and keep on til you feel informed but not overloaded. And rest, sleep and a heart shaped cusion is your new best friend. and I take my pain meds before travelling or doing exercises. its tough, but we can get through  it. gentle hugs, k 

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