Newbie..therapeutic mammoplasty

Hi I have requested a friend request as I would like to know more about the therapeutic mammoplasty option.

On Christmas Eve I was asked to decide on mastectomy or mammoplasty. I hadnt heard of it and didn’t know it was an option for me until then.

So need a bit help here 

Thanks

Jojodot

Hi and and anyone else who can help.

only realised you had responded to this thread as well so would appreciate any input as to encourage me to have therapeutic mammoplasty as opposed to mastectomy. I was only offered this two days ago and have to make a decision.

I was previously resigned to have a mastectomy and now this is on offer it is quite tempting. Probably though because I had accepted I would be having a mastectomy part of me thinks is it better just to get the breast taken away so there are no further worries. I will be receiving radiotherapy after surgery so need to think about that too.

Any thoughts and experiences gratefully received.

Thanks Jojodot X

Thanks

Horrible timing to have the uncertainty over Christmas! And indeed to have a 'choice' to make - I found that hard.

I agonised over the decision for several weeks. Logically I thought having the breast off felt 'safer'. Plus I initially thought I'd be able to avoid radiotherapy so the mastectomy op (with reconstruction) would be 'the end of the story'.

However my consultant at the Marsden said, that with radio after a TM, the 'long term outcomes' between mastectomy and TM were the same. I can't remember his exact wording so ask your surgeon. 

I also realised that I might still need radio even with a mastectomy, depending what they found. And then I found out that reconstruction (a tummy diep) could require a few more follow up procedures. So a mastectomy stopped looking like a 'done and dusted' option or a 'safer' one - which I'd felt were its main benefits.

My experience of TM has been great. I was big-chested and still am, which made it easier for the surgery. I only went down a cup size, even though I had three tumours in my breast. I opted to have the other breast done to 'symmetrise' at the same time (the other option was to have it done later also on the NHS.) It was a day op which was amazing - about 3 hours.

I reacted badly to the general anaesthetic (groggy and a by nauseous for about a week on and off) but the surgery site/ scarring has healed well and I've not been in much pain at all.  I've been cautious about doing too much (like heavy shopping or lifting boxes) which has been a bit frustrating, but I was out and about 2 weeks after in quite busy places, on public transport etc. 

I'll accept the friend request. What kind of issues are you considering? What questions do you have?

Hi

Thank you for your prompt reply - interesting. I will keep in touch but for now need to get some shut eye if steroids allow. Had my final chemo treatment today so a bit tired.

Thanks again - will get back with some further questions.

Jojodot X

Hi Jojodot,

I had a therapeutic mammoplasty and SNB on my left breast and reduction on my right on 16th Dec. I hadn’t known it was an option and my surgeon didn’t mention mastectomy to me. I was originally going to have a lumpectomy for the tumour but then a second biopsy showed DCIS too far away for two lumpectomies but not close enough for one. 

I had a day of injections, wire guided insertion and surgery but was home by 8pm which I was pleased about. The first few days were pretty uncomfortable especially trying to get into a comfy sleep position but taking paracetamol and ibuprofen was enough for me. I’m now feeling a lot better, am able to sleep and therefore frustrated I can’t do much as I was given a long list of what I can’t do. The therapeutic mammoplasty and reduction is more complex a surgery and therefore more stitches so was told to be really careful or it could delay the healing process. 

I am noticeably smaller but still have big boobs. I think I’m probably 2 or maybe 3 cup sizes smaller, but I’m ok with that, they were pretty large to begin with (G cup). 

I have my surgery follow up appointment on 3rd Jan so will find out my treatment plan then but will definitely have radiotherapy. I was told that the radiotherapy will firm my left breast up a bit therefore make it a bit smaller but if I was unhappy with that I can always go back to see the surgeon after my treatment ends. 

Any questions feel free to ask x

Hi  and

Thank you for your reply. It’s good you are happy with the surgery and you are now feeling a lot better.

Surgery of any kind makes me scared but it’s always a comfort to know others get on ok.

I have had the chemo before surgery. Initially I was told it would be a lumpectomy. Then after mid MRI scan it would be a mastectomy and now as I have had a dramatic positive response the last two cycles I have the option of a therapeutic mammoplasty as like Bearcat there are two areas that are too far away for lumpectomy alone or carry on with original plan of mastectomy.

although TM is a possibility the surgeon however doesn’t think it may end up the neatest effect as I think I am on the borderline size wise as am a D cup and after reading about it last night realise this procedure is often for breast reduction reasons as well as treatment - that’s my understanding anyway. So although the surgeon is prepared to do this op I still feel she recommends a mastectomy. It’s so hard to decide when you don’t really know what’s best. 
I had my last chemo cycle yesterday and managed to speak to a breast care nurse who checked all my notes. So she is now wondering why the surgeon is recommending a mastectomy as at last MDT meeting it was decided to offer me a therapeutic mammoplasty. So next MDT meeting is 9 th January and I will hear back from her then before I make final decision. Planned surgery is on 29th January.

Hence my confusion. Thanks for all your input. I will do more reading about things and will get back to you with any questions.

All good wishes,

Jojodot X

That sound so familiar - I had three tumours across both upper quadrants.  One surgeon (at my first hospital) said he couldn't do a TM - it was about his skill and experience. But the second opinion I got at Marsden, the surgeon thought a TM would be perfectly easy - he'd done them for people with 5+ tumours. But he obviously had experience in doing them and was confident. So I guess you need to make sure your surgeon is confident to do the TM so you can be confident.

Its not clear cut is it! 

Best wishes

Sorry Jojodot for not replying sooner.  I would echo everything and have put about the procedure and afterwards. I am now a year down the line from my surgery and my boobs have softened and settled to a more "natural" shape now all the swelling is gone.  I'm happy I had the procedure and that I was large chested enough to be given the opportunity to keep my breast. 

It's a shame your surgeon has put some doubts in your mind and hopefully your breast nurse will press for a more definitive plan once they speak to the team at MDT meeting in january.  This journey is difficult enough without all these seemingly impossible choices to make about treatment options.  

Whatever procedure you go on to have, very best of luck with it all and we are all here for you to ask questions and support you through it   I found this forum so helpful and reassuring when I was having treatment.

it's great to see you're through the op and doing so well x

Hi , 

Thank you. Yes I have been pleased with how it has gone. I get my surgery results on 3rd Jan and will hopefully find out my treatment plan then. 

Thank you for answering all my questions too, it really helped. This forum has already been a great support to me xx

Hi All,

Its helping me lots too. I've been diagnosed with DCIS but it's been seen as widespread and high grade calcification over 11cm spread and from front to back. They've said a mastectomy and are doing a Sentinel node removal on 8th Jan. Have to go in and have the blue dye inj. on the 7th. Not looking forward to that, never had an op before.

No mention of any other options for surgery so not sure if there are any? I've not been given a date yet but just know it's been listed as urgent and having a DIEP flap reconstruction on the same day.

It worries me how they'll leave the other as is because I'm a G cup on my right, and will be going down to C/D on the other so will look pretty lob sided. How do I get a bra that fits without crushing one side or the other??

Thanks and I'm glad I've found this forum as it helps a lot.

Sam x