Single mastectomy with implant reconstruction

[MLH52]

Hi. I’m wondering if there is anyone on here who has undergone a single mastectomy with implant reconstruction who would be willing to share their experience post op and beyond? I am due to undergo this procedure, and am particularly keen to know how it is living with one natural breast and one reconstructed with implant. I had been due to have a DIEP flap but have been deemed too high risk for this procedure for various reasons.

[NCD24]

Hi this is my first time commenting I’m new to this site. I have had a single mastectomy with immediate reconstruction and full lymph node removal in July 2020. Operation went well, I had two drains and I was in hospital for 3 days. I had drain into my arm for a week and the other drain under my breast came out after two weeks. I had radiotherapy in September 2020 so my implant has gone quite hard under the skin and at times I am aware of it. I was very lucky with my skin after radiotherapy, it started going a little red towards the end but the doctors said looking at me now you wouldn’t even know I had radiotherapy as it has healed so well. I was lucky as I know this doesn’t happen to everyone. I have been offered more reconstructive surgery for my breast then would change the implant out and do some fat transfer to soften the breast but I don’t want to go through more surgery just now but may do this is the future as my left breast is 2 sizes bigger but it’s not that noticeable in clothes. Not sure what else to say please let me know if you have any specific questions? As happy to answer anything x

[MLH52 in reply to NCD24]

Thanks so much for replying and in so much detail, and I’m very glad to hear your procedure was a success. I too am new to this site.

May I ask why you needed radiotherapy after the mastectomy? I thought this wasn’t necessary if the whole breast was being removed. Perhaps because yours was a more developed stage of cancer? Mine is stage 2. I had a lumpectomy on my other breast for DCIS a few years ago which did require radiotherapy and like you I had very few side effects. But I was told this week I wouldn’t be able to have an implant on that side if I was thinking of going down the bilateral mastectomy route because I had had radiotherapy.

Also, can you tell me how soon after the surgery you were / felt able to resume simple domestic chores? I have 2 kids of 12 and 9 and am wondering how long realistically until I’ll be able to get back to helping them get ready fir school etc. And how long before I can get back to computer based work from home? (I’m self-employed).

Also, I suppose I’m anxious about being lopsided having an implant only on one side. Like you, I’m likely to be a few sizes smaller on the reconstructed breast. How does it feel physically and how have you coped psychologically? I keep reminding myself that this will be a small price to pay to be alive for my kids.

I hope you don’t mind so many questions. Thank you again for taking the time to respond. So much appreciated.

[NCD24 in reply to MLH52]

Hi no problem answering any questions if I can help in anyway. The pathology showed I had residual disease in my breast and lymph nodes so I didn’t have a pathological response to chemo so maybe that’s why I was offered radiotherapy. I am stage 2 also and HER2 positive. I was then offered more chemo to reduce to risk of reoccurrence. I’m in the UK where are you from? Maybe there is different policies for different places, I’m not sure! My radiotherapy was under my arm and also up to my collarbone so didn’t just involve my breast and maybe because I have several lymph nodes affected and 3 tumours over 8cm they offered radiotherapy too. To be honest I didn’t find the mastectomy as difficult as I thought it was going to be, I actually found the lymph node removal harder as it was in my right arm and I’m right handed so I didn’t have full range of movement in my arm (I still don’t) so I needed my husband to help wash my hair and found certain things that involved my arm difficult my chest area was actually okay pain wise. I actually didn’t find the breast surgery too bad, I took pain relief when I was in hospital and I think I took codeine for the first day or two when I was home but then I just took paracetamol after that. The pain in my chest wasn’t too bad at all. I did buy a back rest, think it was from Amazon which propped me up at night and that did help with sleeping. The hospital should give you drain bags too, these are really helpful when moving around. You are tender and need to watch what your doing after a mastectomy, no heavy lifting but on the whole it was actually fine for me like I say the lymph node clearance and not having use of my right arm was the hardest. I was up and about properly after maybe 5 days and before that I was just up and walking about in my hospital room or bedroom. I walked round to my sisters and sat out in the garden with some friends within the first two weeks. I didn’t do any housework though I was just pottering around and going for short walks. It’s hard for me to say about work and housework as I went straight from surgery to radiotherapy then more chemo. I would say after 3 weeks you could manage work from home if your computer based but any housework like hoovering, lifting washing baskets etc I would say 6 weeks even though you might feel okay you need to be careful. I was pottering about and making lunches and tidying up after kids within 2-3 weeks but nothing that involved anything strenuous or lifting. Also I was told I couldn’t drive for 6 weeks so not sure how that would work if your driving your kids to school. I haven’t found the different size breast too much of an issue as I haven’t been back at work yet and I’m wearing loungewear just now but it is something I’m thinking about when I go back to work. If I wear a tshirt round the house with no bra you can see the different in size and also if I was to wear anything tight but it’s not too bad when I wear a cupped tshirt bra. My nurse has given me a website that does mastectomy and lumpectomy bras so one side I would have a sleeve I could slip some padding in to even them up. I haven’t done anything about this yet but will need to before I go back to work in August. My implant is very hard and I am aware of it at times but for me personally I would have found going flat far too difficult so I dont regret my decision and it’s been the best thing for me. Sorry for the long reply I hope some of that helps xx

[Ellymay46]

Hi. I had a single mastectomy with immediate implant in 2015. Had a sentinel nose biopsy at the same time. I was in hospital for 2 nights but that was only me being too scared to go home earlier! I think I could have gone home after one night.

Pain I was taking paracetamol and ibuprofen for about 2 weeks I think. My main pain was at the back of my arm near my shoulder which I think is not common.

I had one drain and that was taken out after about 5 days. I was really worried about it hurting but the most I felt was them removing the sticking plaster over it.

I was really tired and wiped out for about a week and struggled doing my exercises but after that I slowly got back to doing more. My op was 1/5 but I didn’t have any radio or chemo. I went back to the office beginning of July. I struggled with brain fade and would be fine one minute then hit the wall the next.

You won’t be able to lift anything heavy or do housework for as while think it was about 6 weeks. Mine was my left side and I struggled with changing gear when I drove.

In bra you cannot tell but out of bra you can as the natural one is lower and also the implant is round. Depending on the size of your breast mine are small so it’s probably not that noticeable.

I had my nipple removed in the mastectomy. I have since had 2 reconstructions of this and 2 tattoos. I wanted it to look a bit more normal, it does look better. I am contemplating a lift on there other side to make them look more even.

As I didn’t have much fat the implant has a mesh underneath to hold it up and the side of this is quite bumpy. You can feel it. My implant is also under the muscle. At the start I remember feeling like the whole breast was solid and was struggling to push hands together as these were the muscles that you use.

As my muscles have got stronger I can now feel them over the implant and it is a little odd and now my whole breast moves to the side. I think you can have the implant over the muscle but this is more likely to get capsular contracture or rippling of the implant. As I just have the skin over the implant if the muscle wasn’t there they said the implant would be visible. So not sure what that would look like.

I hope this helps a bit. If you want to know anything else just ask. Willing to answer any I can. I did write a diary and if I ever get round to it will get it copies or typed up and then I can send it to anyone who wants to read it. A friend has just had a lumpectomy and she said it really helped her as she felt exactly the same.

Take care and good luck.

Elaine

[MLH52 in reply to Ellymay46]

Thank you so much for sharing. Your situation sounds very similar to mine so this is really helpful. My surgery is on 18 June so I may come back to you if any other questions spring to mind in the meantime. I have to say my consultant was shockingly abrupt and unempathetic when I met him today to discuss the procedure, and made me feel as if I was wasting his valuable time with my questions (although the nurse was lovely and a lot more helpful). It’s left me feeling pretty fragile. Very reassuring to have found this site therefore. Thanks again.

[Ellymay46 in reply to MLH52]

Hello.

I used to take a book with me with my questions. I think they must have got fed up with me as I had lots! So just keep asking what you want don’t worry about upsetting them they are used to it.

One thing I forgot when I came home from hospital I had a pillow in the car to put under the seatbelt to stop it pressing on me. Also couldn’t lay flat in bed so had a few pillows propping me up.

Hope all goes well for you on 18th but just message if you have any questions I will answer as best I can.

Elaine

[Sheppie]

Hi, your question came up on my account. I made a decision at my results appointment to have a straight forward mastectomy and no reconstruction. As an ex-nurse I was aware of side effects. Husband was a little shocked. Surgeon stopped talking and found a date for surgery. I felt that at my age I didn’t’t need my breast and reduce my risk of further risk of breast cancer.The support I had was excellent from all staff. First on the list, back on the ward, comfortable, tea and sandwich lunchtime. Staff checked when I had passed urine and then by 4pm on my way home. Even I was amazed.

Post op. waiting for pain to surface. Didn’t happen. There were breast care nurses to answer any questions that arise, Attended clinic for post care.

Developed some fluid under scar line which was removed twice. Post-op from day one wore sports bra. Had a softee breast with adjustable filling.

Have knitted a couple of “knockers” and use them most days. Obviously

Have real feeling breast but only use it when I go out.

After care... A piece of breast went to Geonomic Health , Redwood City, California USA. Recurrence risk 8%. No need for chemotherapy.

No axilla nodes affected by cancer ,so feel damn lucky. On Tamoxifen and have had 1st follow up Breast scan last October and clear.

I hope all goes well for you in whichever decision you make. Thoughts are with you.

[MLH52 in reply to Sheppie]

Thanks so much for sharing your experience. I hope all continues to go well for you.

[Hidden]

I had a mastectomy left breast with reconstruction expander and then implant in 1996. How I wish I would have had a bilateral mastectomy then.In 1999 I had a right breast lumpectomy, radiation and chemotherapy. That right breast became an odyssey of multiple surgeries during 15 years: mastectomy with implant, revision of implant, and ultimately DIEP right breast. Unfortunately in 2019 I had pneumonia while traveling abroad. Came home and after further testing and treatment it was found that I now had metastatic breast cancer. If only I have had BOTH breasts removed in 1996 I could have avoided this dreaded disease.

Now two years after diagnosis of MBC I’m managing with Ibrance and Faslodex, for the test of my life. Had a CT yesterday and awaiting results now,

If you have a breast cancer diagnosis, PLEASE remove both breasts!

[MLH52 in reply to Hidden]

Thank you for sharing and I wish you strength and luck on your journey. I had left lumpectomy and radiotherapy in 2018, all clear both sides in 2019 and 2020 but this year has shown extensive areas of both DCIS and stage 2 cancer in my right breast hence the mastectomy. I won’t need radiotherapy or chemo. The left side is currently clear. In the UK it would appear that they won’t even consider bilateral mastectomy if one breast is healthy unless you have the brca gene. I did not qualify for brca testing. I did want to explore this option, especially as I have had DCIS in the other breast in the past and worry about recurrence, but my surgeon wouldn’t go there. So I must continue to keep a close eye on it. My only reconstruction option is the implant as I am too high risk for DIEP having Lupus and the ‘sticky blood’ antibody which increases the risk of clotting. So I really hope this implant works...

[Jrocco]

June 2018 I was dx with DCIS. It was stage 2A. I was 46. I had 2 drains for a few weeks. A tissue expander was placed and each week it was filled with Saline until the desired size was reached. I also has 16 rounds of chemo. In January 2019 I had my reconstruction surgery. I’d say it was and still is a “strange” feeling having one fully reconstructed breast. It is numb but I am getting some feeling around the edges. I also did a nipple sparing mastectomy. Luckily my nipple survived so that helped me to accept my new look and scars.

I’d say now I can’t sleep or lay on my belly. I was going for massages and needed a special breast pillow.

January 2021 I was dx with MBC (metastatic breast cancer) but that doesn’t stop me from planning my summer activities. Just keep living! Stay positive. It is possible during this experience and some days will be harder then others. Let love and light be your guide. Let someone else do your online research. There is way too much information out there from non reputable sources.

My scars tell the story of where I have been and I am telling the story of where I’m going.

Best of luck. Reach out if you have questions. I may have left something out.

[OLEM in reply to Jrocco]

How are you doing?

[ElleeB]

Hi I had a single mastectomy left breast 10 years ago with lymph node removal and reconstruction using muscle from back flipped round. I had a nipple constructed from skin grafted from stomach . I was in hospital 5 days and left with two drains . I had a seroma ( fluid swelling) on my back during recovery but it was painless and soon disappeared . I had 6 months of chemo after. Over the years I have had no problems at all. The surgery was done brilliantly and I am delighted with the outcome - now I don’t even think about it or notice the difference between my two breasts - am very proud of scars and my body - they are testimony to my experience - just follow the care instructions, be positive and see yourself as the beautiful person you have always been