Breast reconstruction after mastectomy?

I have had a mastectomy without reconstruction. I decided to go this route as I neither wanted a cold bag of saline nor a massively long operation that operations using your own tissue involves. I also wanted to minimise the possibility of complications and further surgeries. I am super happy with my decision and only bother with a prosthesis on special occasions. Before you decide do some research on the possible complications of implants and reconstruction so you are clear about what each procedure might involve.

Hi

I initially had a lumpectomy so my sentinel nodes were removed in that op, long story but ended up 6 months later with a mastectomy and immediate implant. I knew I didn’t want to be flat, my mum had breast cancer and did go flat but I just remember her with the prosthesis and her being upset at times over the years, I just wanted to not have that constant reminder. The implant op was great, overnight stay, and I was back at work in six weeks (could probably have been earlier but I needed a bit more time off) Unfortunately it never felt right, and I did feel as if I had a bag of cold concrete on my chest, plus it rippled across the top. When I had initially had the mastectomy I was due a Diep surgery, but decided I didn’t want a long operation and recovery at that time. However, I did have the implant changed for a Diep 2 1/2 years later. As Veeayvee has said, you really need to look at the problems that can occur from such surgery, and from all surgery, which I did, and for me everything went extremely well and I was, again, back at work after 6 weeks. It is a longer full recovery, but I am really glad I had it done, I was full of doubts before and hoped it would be the right decision for me, and it was. It also turned out my implant had rotated in the sling so would probably have needed to come out anyway…

All the operations, including just going flat, can have complications, so I would really concentrate on looking a bit further ahead and how you might feel at different times. My boob and foob are the same size and so I don’t need to worry about finding bras to fit etc, it is warm and part of me and feels right. 

The implant didn’t work out for me but there are many women who are happy with theirs, just do what you feel is right for you, not just for now but hopefully for the next 30/40 years ! 

Hope this helps

Jo x

Thanks so much to both of you for replying, it so helpful to hear what other people have decided and experienced. 

I am glad you are both happy with your outcomes and will think about what you have both said when I make my decision. 

Thank you again xx

I have been in exactly the same position as you. I'll be honest and say I did a lot of research on all 3 options and felt before reconstruction that I could "put up" with any of the options offered. However, I chose an implant as this seemed to me to be the least invasive option. I also had not had any surgery at all since tonsils removed at the age of 4. I find the implant OK, but I also had a therapeutic mammoplasty on the other one. The mammoplasty has caused no problems whatsoever. I had a lot of pain after the op with the implant for some reason and also had a haematoma so the whole implant was done again - so to have 2 ops wasn't what I had in mind at the start. I wasn't keen on the fact that you need a spell in ITU for DIEP or the scar or the fact that you could end up with stomach muscles being affected. Even with what I have had, I have been referred for some physio as the exercises, even though I've done them haven't worked to maximum effect. Radiotherapy people could tell this and said so, though I was trying my best with the arm with the implant. Radiotherapy still going ahead though. Going flat ? This didn't really appeal to me, as I wanted more shape and to be more like I was before cancer, but it still figured as No. 3 on my list of options available and if implant had failed for whatever reason I would have happily gone down that route.

Hello, I know how you feel.  I had a left sided mastectomy a few weeks ago and have only yesterday met with my oncologist to start the radiotherapy plan.  Anyway, I have sort of taken a ‘deferral’ on the reconstruction and I had an expander fitted at the same time as the mastectomy.  It will obviously require a second surgery at some point but I can take my time deciding which is the best option for me.  In the beginning it’s all such a rush and a shock that the only thing I knew (apart from getting rid of the cancer) was that a little time and distance might help me to make that decision.  Regarding the DIEP surgery, one of the lesser used options is to make an incision below the pantie line, more like a c section.  But it is not widely done and obviously dependent on the patients ‘anatomy’ and not all surgeons do it - your surgeon will be able to explain the pros and cons.  For me anyway having an expander is sort of a ‘middle ground’ when I didn’t feel like I could make a longer term decision. 

Wishing you all the very best x

Hi Cathers

I had a left mastectomy with immediate silicone implant reconstruction in March.  My options were limited to flat (absolutely no way), expander or implant - DIEP flap or any other options involving own tissue were never on the table (no pun intended) due to the fact I have nowhere to take it from.  As my surgeon bluntly said to me - "you have no gut fat" ... horrible woman, with no tact whatsoever trying to be lighthearted and amusing at the time.

The operation was 5 hours and things didn't go well.  I won't go into too much detail - the planned day surgery turned into a hospital stay of 5 days.

The implant reconstruction is a mess; visible rippling and every inch of fat removed leaving me with a concave indent in the upper region of my chest below the collarbone.  This is purely down to the amateur butchers who were happy to carve me up like a chicken with zero responsibility or accountability for the physical or psychological after effects.  I have 'fired' this team and am transferring to another hospital who will hopefully repair the damage they have done, including the freakish asymmetry I am currently living with.

If there was any piece of advice I could offer you it would be this - please, please research the surgeon/s who will be operating on you.  Ask them for pictures of their work and go through every single risk attached to the surgery.

If anything raises red flags with their reconstruction work, do not allow them anywhere near your body.  

I hope you have a much better time than I did and still do.

xx

So sorry to hear what happened to you, Wake and Bake. My additional suggestion is to have a look at the CQC ratings for the hospital you plan to go to. Everyone is entitled to choose and to change. 

Hi Katherine

Thank you kindly for this - it is The Royal Marsden (rated as outstanding) and I have asked for a specific consultant, so fingers crossed :)

Hi Wake and Bake, I've been at the Marsden too and have (so far) nothing but praise for them.

Hi love

ive aslo decided on a mastectomy without reconstruction. You seem happy with your decision can I ask as I’m worried how did you feel the first time you looked at your chest without the breast. Did y also have radiotherapy?