Very undecided about immediate reconstruction or delayed

I had a consultation this week with my breast surgeon in Leeds and talked about this very issue. Leeds is a centre of excellence in breast cancer. I believe my surgeon to be excellent - and I am highly inquisitive. Her view is that if it is thought that radiotherapy will be indicated, then an expander implant as an interim measure is clinically the best way to proceed for the best outcome. I think this is to do with stretching the skin so can be used at a later date but I’m not 100% sure. It does however appear to be standard practise.

I am having a mastectomy and immediate reconstruction using an implant (not tissue reconstruction) in August. I am choosing not to have a tissue reconstruction as the surgery and recovery is too big for what I feel I want. I have had a complete response to chemo half way through so my surgeon feels confident enough that radiotherapy is unlikely to be indicated.

My understanding is that you are entitled to a second opinion so if you would feel happier with this then yes - go ahead and seek I would say.

Hope this helps a bit.

Jan x

Hi, it is really confusing I agree. 

I had single mastectomy last June, with immediate implant reconstruction. I didn't have enough of own tissues so not another option. 

Surgeon talked about Expander & then further op to replace with implant after radiotherapy. I wanted to avoid as many surgeries/anasethictics as poss & she finally confirmed that I could go straight to implant but there was a risk it may need replacing after radio. Also that it would be slightly smaller than the other side. (I had always been like that anyway)

12 months on & I still have implant. I have some pain & general discomfort but the cosmetic result is good. My surgeon & oncologist tell me the ongoing pains as due to internal scaring from surgery & radio. It is slowly improving but not sure if it will ever 100 %go. (I also had lymph node removal)

Try & talk it through again if you have doubts or questions still. It's so much to deal with 

Best wishes x 

i have recently had consultant with mastectomy and plastic surgeon and have decided to have doible removal and immediate reconstruction using my own tummy as tissue.  It another scary time and lots to think about.  I was told there is a very slight risk of lymphoma if you hse implants.  This is very small so please dont be worried!  I had lymphoma as a teenager so I wanted to avoid this.

i have been sitting having chemo with a lady who had the expander and she showed me the end result and I have to say it looks amazing!  Do you have a clinical nirse specialist you can talk to? 

please excuse spelling mistakes as since I started chemo my eyesight has declined rapidly!

sending lots of love and let us know how you get on.

melissa xxx

Thanks Jan this is very helpful just to speak with someone in similar situation. I wish I had a crystal ball to see if radiotherapy would be needed !! But none of us have that and I’ll have to weigh up the risks . All the best to you xx

Thanks Melissa. I’ll see who else I can speak with. I think being shown a few images isn’t enough really to decide about the expander implant. I want to avoid as much hospital appointments/extra surgeries as I have 3 children under 5! It’s so hard to decide. I also have private healthcare so currently trying to see if I can get private consultation. All the best to you xx

Thanks so much for reply. I’m glad you were pleased with cosmetic result that’s something that really concerns me. I wish I knew whether the expander implant route would be better looking than the delayed reconstruction but it’s impossible to know I guess. I suppose immediate implant would stretch my own skin ready for more work but it’s all the follow ups and extra appointments that worries me, having 3 children under 5! Xx

I completely agree as I want to avoid as mych surgery as possible and my children are al grown up now.  You have your hands full I do feel for tyou.  I too have private health cover and feel I shd use it as have never used before!  I have several more meeting with the surgeons before the op which looks as it maybe end August.  Have they given you a date? Xxx

No date yet as they are waiting my decision. I don’t want to feel rushed into having surgery before I’ve weighed up all my options. I’ve just spoke to breast nurse who has told me there are more plastic surgeons and a bigger breast centre up the road at QE which is another local hospital so I’m going to ask for a consultation there and kind of get 2nd opinion at the same time. If I decide to have simple mastectomy there may be less wait for the reconstruction due to them having more staff. Another option to think about xx

Hi ECD77, I had to make similar choices for my surgery a month ago. I wanted to go the least surgical route and had rejected the recommended expander (made me feel ill thinking about it!) and initially decided on a Braxon implant for immediate reconstruction. I was  Stage 2 and nothing to suggest I'd need radiotherapy even, which mercifully I didn't (after they biopsied the lymph nodes). In the end my husband persuaded me that going flat would give me the least issues ongoing and that he didn't want me to choose any implant for the sake of our relationship. That was huge for me and so I went flat (just one side). For me it was an easier decision than for you I expect because I'm 62, small boobs so not too much difference, grown up kids and supportive husband. I will say though I'm really happy I made that decision as I'm feeling about 95% my old self, arm mobility almost fully restored and raring to go 4 weeks after surgery. I'm assured I can get an implant at any time in the future if I change my mind, but I'm sure I won't. I fancy a tattoo actually. Not quite what you'd asked I realise, so I hope I don't confuse you further, but maybe food for thought? Sending you all best wishes xxx

Helloooooo this was so encouraging! I'm having to decide between going flat or having breast reduction and rebuild and lymph node removal.

I'm in my 60s, hubby, grown up children. I already had an ileostomy 40 years ago and used to my flawsome (awesome flaw) body. Also have small boobs. I want minimal surgery and be able to get up ago asap. 

However if I were younger I would be having it done all at once.