Mastectomy and reconstruction

Hi

This is just from my experience which was pre-COVID? I had an immediate implant with nipple removed when I had my mastectomy, it was pretty much the same size as my normal boob so in a bra was fine, and to be honest that suited me.I did though ask if I could have further reconstruction at a later date, and so had a diep flap 15 months ago. After both ops there was the option to have some work done to my good boob, but again I am not too bothered about that, personal preference. So you should be offered that and should make a point of asking about further surgery at some point in the future? In terms of your other breast, surgeons are very reluctant to remove healthy breasts, and those who have had this done have had psychological counselling and have to jump through a number of hoops to get it done, so even if you go down this route I think it would be unlikely to be offered at the same time as your original mastectomy. I know there is a real slow down of reconstruction, but some is taking place, so I would most definitely ask if there is somewhere local where you could have reconstruction if you aren’t offered it at your regular place.

I would research the different options and go armed with questions when you meet your surgeon, my diep removed my mum tum and you may be surprised how much fat you do actually have to be able to have a diep flap at a later date.

Good luck

Jo x

Thankyou so much for sharing your experience, it’s really useful to hear how your mastectomy has gone so I can understand what happens. 
xx

Hi

I had mastectomy and immediate reconstruction by DIEP (fat taken from abdominal area) 3 years ago. If they allow you to have immediate reconstruction(either by own tissue or an implant) it is the best way to go as you wake up with a new boob. I do know at the moment with Covid this could be a problem. If you don't have enough fat on tummy area they can take fat from other places such as from bottom or thighs. With an immediate DEIP they do both mastectomy and re-fill via a small hole created from where they have removed your nipple. I'm not sure what they do with delayed reconstruction.

I believe at the moment it's common procedure to remove the nipple but you can have nipple reconstruction and tattooing at a latter date.

They also offer 'fiddling around' at latter date to either new boob or other good boob to gain better shape and/or symmetry. All my 'fiddling around' was all done as day-surgery and it can drag on for quite a while afterwards as they do a little at a time. I had some liposuction and refilling to reconstructed side at the end of November 2020. My operation was delayed from the first week of the first lock-down at the beginning of March 2020 -  I had been on the waiting list since May 2019. But, this was  post-DIEP corrective surgery all cosmetic and not cancer surgery and, to be fair, I was quite amazed to be offered it in November, when we were is second lockdown. No doubt the waiting list is becoming even longer now for this kind of thing. They also like to wait after each operation to see how things settle (about 3 months) before they can see what else needs doing. Certainly my surgeon has been very particular in giving me a good cosmetic outcome and both boobs now droop exactly the same and are pretty identical shape-wise.

I'm afraid I cant give much input re an implant. Ask about the affect of radiotherapy on an implant as there may be a potential issue.

I do know one person who has managed to have their good boob taken and had double mastectomy and reconstruction. However, she had the operation done privately via her medical insurance. She was prepared to pay the extra herself for the surgery to the good side but then her medical insurance agreed to cover it - this was also quite a long time ago. 

Ask loads of questions at your appointment with the surgeon. At my initial consultation with the surgeon I took a great long list of questions and just handed it over to him. He then went through each question individually and explained it all. He said he was quite used to it!!!Hope this has helped. Good luck.XXXxxxx

Hi

I had mastectomy and immediate reconstruction by DIEP with fat taken from abdominal area in December 2020. I had a nipple saving op and delighted with he result, although no sensation in that breast now, it looks great! I was lucky enough to be covered by my husbands private policy and not sure what the current situation in the NHS is at the moment though I believe during the first lockdown they were not doing immediate reconstruction. The method used and where the flesh is sourced is individual but there is a Macmillan Cancer Support booklet called 'Understanding Breast Construction' which goes through all the options/possibilities that you would probably find helpful.

Sorry, that should read 'Understanding Breast Reconstruction'.

Thankyou so much, I will get my list of questions started! 
xx

I will look at this, Thankyou so much for taking the time to reply to my post xx

Hello, I was told that there would be no chance of having reconstruction during covid. I wonder if this is dependent on area? All good luck xx

Hi All,

I had my reconstruction consultation yesterday. I had a list of questions that I didn’t need to physically ask in the end as the plastic surgeon covered them all during her assessment of me! 
I need a mastectomy and have been favouring an implant. Having already undergone chemo, the thought of the DIEP surgery and recovery time doesn’t sit with me mentally at this stage. 
The surgeon specialises in DIEP so was very much favouring that option. I’m very slim and like Pineapple21 have lost additional weight through chemo. No kids though so no breast feeding to consider. I just have enough fat for a DIEP and would need a tissue expander for implant. Also told that an implant will ‘look like an implant’ given my lack of spare skin. I’ve always been more proud of my bottom than my small boobs so as long as they look ok when clothed, how they look when naked doesn’t phase me.

All that aside, the biggest frustration is that although I initially had no lymph involvement a sentinel node biopsy will still be done, but the results unlikely to be known before mastectomy immediate reconstruction. So if I choose implant, and then the node biopsy shows positive, I’m guessing I’ll need radiotherapy and implants are not ideal if radiotherapy is involved as it was explained to me they can harden up & have additional complications.

So the decision to make is... go for DIEP, or choose tissue expander etc and if it all goes tits up (pun intended) likely face another Op anyway to correct it. Or the 3rd option which hasn’t even been mentioned to me would be a delayed reconstruction. I wonder if because my hospital trust is still doing immediate reconstructions (which I do feel grateful for) they just want to get as many done & dusted as possible

So that’s me. Thanks for reading/listening. Feel better for getting my thoughts down & hope Pineapple21 there might be something in my post that frames another question for you to ask at your consultation.

Good luck! xx

Hi jowoomot Just fully read your reply after posting. This is really helpful.  
Thanks for replying to Pineapple21& in turn helping me xx