Reconstruction or not after mastectomy

Morning, I had a similar dilemma at the point of my diagnosis,  I had I definite area of IDC but lots of other suspicious calcification and I opted to just go straight to mastectomy. It was absolutely the right decision because they found 5 areas Of IDC  in the pathology post op. 

Personally i really couldn’t have coped waking up without a boob, so I definitely wanted reconstruction but the choices were also very difficult to decide on. I opted to have a temporary implant with s view to diep reconstruction later on.

i was in hospital overnight and went home with a drain which was no problem really. The scar is really neat .

I have to say I really didn’t experience any pain and the implant looks good, it’s healed very well , I was driving after 2 weeks , I’m now 6 weeks down the line and back out exercising and doing everything I did before . So it’s been great really. 

Im waiting to start chemo now which I think will be the more difficult part of my journey. 

Good luck with your decision , if I can help at all please let me know

Claire

Sorry if this is a ridiculous question but during reconstruction do they always remove the nipple?

I’ve decided to go the reconstruction route but I’m having chemo before surgery so no decision has been made yet as to which type. There is a suspicious area in the other breast which they found during MRI scan so obviously the results of that will also be part of the reconstruction decision.

Again it’s everyone’s choice as to what they want but I’ve decided to go for reconstruction, hope your decision won’t be too difficult for you. x

Hi sweetie 

Im in a similar situation I’m so much as I can’t make my mind up. I am needle phobic and hospital phobic and suffer being away from home. So the obvious choice was mastectomy first and reconstruction later. I’m thinking get the cancer gone and whatever treatment may be needed and then get recon after. But I’m also thinking just get it all sorted and over at once! 

But I worry about having the recon if I need radiotherapy as I’ve heard it can distort the skin etc. I’ve been advised against implant and recommended tissue to be used from stomach fat as body won’t reject

but the thought of having no boob (I’m 36e) is freaking me out but so is recovery hospital and needles. 

Heeeeellllllpppppp

Bramble22, I think the decision regarding the nipple depends on the tumour, I had a skin sparing mastectomy but unfortunately because I had widespread DCIS  and the ducts all end up at the nipple it was too risky to keep it so it’s gone, I can have a new one formed at some point but I’m not in a rush. 

Tinkerbell, I had the same dilemma with the potential for radiotherapy / chemo which was why I went for the temporary implant. It goes over the muscle so a much more simple operation with less risk of complications and it meant I kept my skin so I could have a diep when I’m ready.  I didn’t want to risk the diep at the time because of the chance if things went wrong it would delay chemo or if I needed radiotherapy it would spoil the overall result . 

All the decisions are so hard to make, you just want someone to tell you what to do don’t you. 

Im pleased with my decision and actually really pleased with the implant that I’m in no rush at all to get the diep done 

good luck x

Hi Roses123

My story on profile .

So like you say it is so much a personal choice whether to gave reconstruction .

My decision was no reconstruction this was easy for various reasons ..age  being the biggest one .

I am also an F cup so Surgeon is keen to do reduction on other boob for balance he says lol I did ask if he meant I would fall over or walk round in circles .

I had masectomy on 4/7 and chemo started 21/8 .

I had meeting with prosethic lady prior to op so acquired a softy boob 

Went to shops and bought post surgery bra plus expander hooks  for back to cope with swelling

Masectomy op straightforward more discomfort than pain . Nerve block injected during op . And take all pain relief offered .

Scar is very neat .

Exercises are needed afterwards to help regain movement in arm . 

Drain was in for 5days 

I left hospital wearing bra and softy it felt very comfortable.

Yes there is some pain now nerve block wearing off but bearable with some pain relief

recovery was about 6 weeks ..bulk of swelling just seemed to disappear . Softy moving around now having to keep readjusting .lol

Progress to silicone boob 28/8  so much better cant feel weight but stays in position all day no prob. 

Nobody can tell difference and yes I have been known to ask if they can guess which one .

Well that's how it was for me . 

Dont think I'll be opting for reduction in treatment til jan 2021 and frankly happy as I am and can't be bothered 

Hope you make your decision soon and you can move forward to next step 

margaret x

Hi, I’ve not even had this option of implant discussed but from  what you have said it sounds the best option. 

Silly questions coming - is there much scarring? If you decide  to have a diep (what does that stand for) do they remove implant and fill? 

Thanks for your advice 

Hi, yes I think they take the tissue from the stomach and fill the skin if you’ve had a skin sparing mastectomy . My scar isn’t at all as big as I thought it would be , I’d say just about 2 1/2 inches? They glued it and used dissolvable stitches so it’s just a neat line but that’s because my nipple is gone . It’s a pretty good match to my other breast , I was very lucky with my surgeon she was fantastic xx 

Diep - Deep Inferior Epigastric Artery Perforator

Thanks for your replies.  If my personal circumstances were different I might have chosen the diep reconstruction, but I would have to go to a hospital far from home, a longer stay in hospital and a longer recovery, so can't go for that option.

Hi. 

It is a big decision to make , I had mastectomy in June , decided not to have reconstruction, personally just wanted to get rid of the cancer , you get use to not having a boob, it’s not the prettiest sight but I can live with it, prosthesis is very good, and people I know well always say you can’t notice any difference but you have to make the decision on what you want , not easy though

all the best

Rita x

Thanks Rita, I need to decide today I do keep changing my mind it is not easy.  Did you have any other treatment after your mastectomy?