Reconstruction advice and info please.....

Hi Pmcd

I had a bilateral mx back in April. I was offered immediate recon but turned it down as I was convinced I didn't want it. However, I'm not so sure now and am seeing a plastic surgeon next Wednesday for a consultation.

I thought everyone with bc was entitled to recon if they want it.

It doesn't have to look false. Your breast or plastic surgeon should be able to advise which type is best for you. My breast surgeon said he wouldn't give me implants as they wouldn't suit my frame and would look false. He did offer LD flap which is from the back but I don't really want that as it would be both sides for me. I have seen one though. A lady at a recon info session stripped off to let me see and it was amazing. It was identical to her other breast. I suppose it depends on how good the surgeon is too.

The ps I'm seeing does diep and if I have recon at all, that will be the one I'll have.

I don't think age is a factor. My mum was 70 at dx and she was offered it but turned it down.

I'd ask for a referral so you can discuss it with the experts. You can always change your mind x

Hiya Pmcd,

No reason why you couldn't start the ball rolling now if after a bit of thought you would like to go for it. A couple of ladies here had their recon over 2 years later.

In a lot of cases they actually prefer you to get rads out of the way before doing reconstructions as the rads can affect the tissue by causing some tightness and possibly a little shrinkage.

There's this Macmillan booklet 'Understanding Breast Reconstruction' (link) you can read and also download for future reference. There is quite a range of different types, some where they use back or tummy tissue you may not be suitable for if you are a bit on the slim side. Be aware it does contain post surgery images but it wouldn't be very informative without them :)

There is also a Mac info page here which  may have different topics about it. If you are a larger lady they may require you to lose a little weight first it depends on the surgeon and annethetist.

There may be several reason why some don't get a recon. Could be they can't face further surgery, were small breasted before and are happy with their look - being uneven can be a pain if you are left with one big boob but they can also reduce the size of number 2 to match the recon breast, as they only usually recon up to a C cup ? as the weight 'pulls' on the stitches and can cause other problems.

I'll butt out now and let others bombard you too  LOL

Good luck gathering all the info and making the right decision for you.  G n' J

Hi Pmcd

I'll try to answer questions in order.  Because you had chemo and rads to do, that's probably why they didn't offer recon at the time.  I'm surprised it wasn't mentioned at all, but we are where we are now.  

There are various types of reconstruction, as George's booklet will show you.  You can also see if the Keeping Abreast Website has information that may help, and this is one time when Dr Google can be helpful - have a look at Google images breast reconstruction.  There are various options there and whilst some haven't been as successful as others, you have a good idea.  I think you need to tell your surgeon that you expect to look good naked, not just in clothes, as I think sometimes they do think that clothed is sufficient.  They will look at your body type and size and previous surgeries and let you know what, if any, types of reconstructions are suitable for you.  Don't fix on one type, because you may find that it isn't suitable for you, but you can have preferences.  

All have pros and cons regarding surgery/recovery/look.  Don't go for implants on the basis that they are they easy option, as they can need replacement over time, and you can get capsular contracture around the implant.  Equally, the operation is quick and recovery is relatively straightforward, but the body can reject them as foreign bodies very occasionally.  I had permanent expander implants and I am happy with them, but it took a while.

If you are a candidate for a DIEP flap reconstruction (using fat and skin from the stomach), this is considered the "gold standard" in recons.  The operation is long, and recovery can take a while, but the results are amazing and lifelike.  Also the Latimus Dorsi flap taking muscle from the back and bringing it to the breast is fairly commonly offered, but is losing favour. The TRAM flap uses the muscles from the stomach but is also losing favour.  This is a possibility where there is insufficient stomach fat, however.

If you are anywhere near a Keeping Abreast Group, it's well worth going along even if it's a bit of a drive, because you get to talk to ladies and see the results of their surgery in the flesh.  

If you want more information, just shout.

Hi Pmcd 

The best way forward is to discuss with a surgeon what recon is best for your body shape and frame. Size does come into it because if you don't have sufficient excess body tissue then an implant might be the favourable option. It will be down to what the surgeon can do with your body to put it frankly. I was advised implants would have been the better option for me based upon my frame and size when I initially sought a Mx. I don't think it was suggested because it was an easier option. 

Have an idea of how you would like your new breasts to look (thing of this as an opportunity) and discuss with a surgeon to see if he can do what you envisage.

All the best x

If anyone wants my stomach fat for reconstruction they are very welcome !!!!!!xxx♡

Lol Ali

Ive had so many offers of donations you wouldn't believe it.

I think I'll have more than enough of my own though.

I'll find out next week. Could be a licence to eat cake. X

pmsl Ali - what are you like  LOL

Hi all, I haven't posted much lately but I've been following this thread with interest because I've just had my appointment to see my oncoplastic surgeon in February to discuss reconstruction. I have more than enough belly fat and just assumed that would be the way forward but was interested to read George's comment that they don't usually like to reconstruct over a C cup. I'm a GG so does this mean a big reduction on that side? Got my first year mammogram next Tuesday and I'm bricking it for some reason so maybe best see how that goes first? Xx

Hi Ali-G, Hope you are doing OK ?

I'm only going by what I have read on here from other ladies recon posts. If anyone has had a larger recon than a C cup could you reply to Ali please ?

It may be worth asking about this when you see the surgeon or better still try to get the info from them sooner so you have an idea on what is involved well beforehand.

G n' J

Xoxo oh thank you everyone.  You've given me good thoughts and also some more good questions to ask when I go. And as usual lots of hope and clear advice.  AliG58, you keep the faith girl... All will be good. Xo. Dream thief thank you for the attachments.  Mistymoley, I going to look out for that group here. Do t think I've heard of it but will be searching now lol. Weeble lol my friends will be all donating bits come the time, and your right the LD flaps does sound to much. Crystlejuju , your right I need to find out what the options are and tell them what I want. I think secretly that's my problem. I've been told by everyone what's going to happen to me over the past year and haven't had to make a decision.... Need to grow a set' and start making decisions again. Xoxoxox