Surgery question

Hi all, I saw a specialist today and was given all of the options open to me for my surgery (left breast Mastectomy).

So I can have an expander put in at the same time as surgery which gets inflated slowly over time. They will take skin and muscle from my back... And they will reduce the size of my right breast at the same time to give some balance. Then later they replace the expander with a silicone implant. This 2 stage process is necessary because I will have radiotherapy after the surgery. There are potential complications such as my body rejecting the expander. As I get older the implant is heavier than the fat in my right breast so I may need further surgery later on in life. I will also have to wear a bra all of the time to support and protect the reconstruction.. Or I can have a bilateral mastectomy - so no imbalance, only one surgery, no muscles from my back etc. I must say I am veering towards the bilateral mastectomy. I would love to hear of other people's experiences of both options and thanks to those of you who have already shared yours.

Thanks Bern

15 Replies

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  • Hi bernie, I choose bilateral mastectomy mainly because I wanted to reduce the risk of cancer spreading. As I had this surgery my surgeon said I wouldn't need radiotherapy only chemo as the risks had been greatly reduced.i was pleased be a use radiotherapy can cause the implants to deform in shape.i had implants fitted using skin saving procedure so that they didn't have to remove skin from my back or tummy.however my right breast wound after couple weeks got infected and after many anti biotic and different dressings it is finally fully healed and looks great.i lost my nipples to surgery but don't mind.

    Hope this helps u a bit with ur decision I know it's a hard 1 to make .

    Good luck x

  • Thanks Ciara - they can't use my breast skin because it was cancerous too - not just lumps... I am sorry to hear re your infection but glad it all turned out well. They also seem to be positive I will need radiotherapy hence the expanders. Thanks again for telling me what happened for you - it does help to know it all turned out ok despite infections etc. Xx

  • I had an expander but unfortunately kept developing cellulitis somhad to have it removed ! I had a delay in reconstruction for the same reason. One year after i had reconstruction from my abdomen and my other realigned. It is OK but not sure given the choice i would do it again, it was a bigger operation than I expected. I could not have it from my back as I had had an operation there ! I now look like a patchwork quilt !! My reconstructed breast still sits quite taut them other is sagging a little !! I had to have the aliola retattoed recently which was quite painful ! I went to a presentation by the surgeon on options available with pictures and I found that useful ! Good luck 👍😇

  • Thanks Jules - I must say I did see presentation from the surgeon and was not impressed with the results and pics she showed me - though they looked ok in a bra. Your experience - which I fear might also be mine - is reinforcing my feeling that no reconstruction is the way to go...bernxx

  • They look OK in a bra but I had breast forms in pockets that looked OK too ! I still wear 'chicken wings' to even them out ! I know some who have not had reconstruction and they are happy with it I just felt a bit uneven 😱😱

  • I would definitely go for a bilateral. Get it over and done with. You have enough to go through. Good luck xxx

  • Thanks Pauline I must say I am leaning that way - it feels cleaner and simpler - I am just not sure how I will feel once it is done - I think I will feel free and closer to recovery but wonder how it will feel not to have breasts? Bx

  • I know someone who had reconstruction at the same time but I don't know how unique that was and whether there are certain circumstances that prevent it. It's always worth asking ... what's to lose. Either way, I hope you feel confident once you make your final decision and all goes well. xxx

  • I am in the process of reconstruction. I didn't have it done at the time of my mastectomy I waited until I was given the all clear. I had problems with the scar on my back as, being large, quite a big piece of muscle was taken. This made the wound tight and I didn't realise it wasn't healing as quickly as the front. The tissue expander takes several months to inflate as they only do so much each time and you have to allow time for it to settle. I am just arranging my final op to remove the expander etc.

  • Thanks - hood to know re the back muscle / healing issue by the the time it takes for expander to work bernx

  • Hi

    I had a mastectomy last August. They took the muscle from my back and I had the expander fitted. I have had this expanded gradually while I've had chemo and am hopefully having the implant put in the middle of May. The recovery from the operation was fine and I've got full use on my right arm. The only thing I would say is the expander is a bit uncomfy now that it's been expanded fully. Hope everything goes well for you xx

  • Thanks Sarah I am glad it went well for you and best of luck with the rest of your treatment. Bernxx

  • Hi. Quite a long pathway isn't it? I'm surprised that you haven't been offered a diep or tram flap reconstruction; one using tummy fat and tissue only and the latter involving tummy muscle. I wouldn't underestimate the emotional impact or adjustment to a bilateral mastectomy without any reconstruction and would discuss with a counsellor either way to help you reach your decision.

    Good luck x

  • Hi BernM59 

    I chose a Bilateral lateral mastectomy due to then high percentage of my cancer returning.  However, prior to me knowing the chances of it returning, and knowing I would be having a mastectomy on the left anyway, I had already made this decision. I have chosen to live a flat life. I opted for no reconstruction what so ever. This was something both the nurse and surgeon were rather surprised and tried to insist I see a councillor. I refused. I had made up my mind. I did my research on living without reconstruction etc. For me, I didn't want to go through all that. I  wanted rid of the cancer and that was it. Yes I am as flat as a pancake, happy in the knowledge that the tumors have gone. I'm still on chemo for residual cells and I will be having radiotherapy in about two months. I had surgery on the 5th Jan. I am happy with my choice, I am relaxed. I find it bothers others more that I have no boobs than it does me. I had really done my research though, read profiles of women around the world who had done the same. Yes all this does prepare you but when you first see yourself in the mirror it does look strange. Prior to my surgery, whilst at my first round of chemo, I met and chatted to three women in hospital who I found out live in my surrounding area. All had a single mastectomy and reconstruction, all three were very disappointed about it, (I'm not saying all people are generally disappointed with reconstruction it just so happens these three were) this only strengthened my desire for a bilateral mastectomy. There is some slight discomfort as the muscles knit, and I had to have four needle aspirations for the build up of fluid but that was quite minor. I'm happy, my family support my decision and I'm getting through the rest of my treatment. I wish you well in your decision. It may not be an easy one for you, for me, literally the day I was diagnosed with triple negative breast cancer, I viewed my breasts as my enemies and made a mental decision that they were to go. I am happy with that choice. For me, it was the right choice. Good luck making yours. Lainey66 xx

  • Thanks Lainey - your clarity around the mastectomy influenced me to do the same : I too researched  the options. I met with a fair amount of resistance from the surgeon. I spoke to the cancer society and lived online getting info. 

    I got an appointment with a specialist breast reconstruction surgeon to talk through all my options. She described in detail how reconstruction worked and showed me photos. That was enough to confirm my belief that I would a) get both breasts off ( for symmetry as much as for reducing the chances of recurrence) and b) I would not be getting a reconstruction. So I went back and argued some more and she supported me by speaking with the surgeon. 

     It does look strange - but I am ok with  that. My main issue just now is that it is very painful and I can't wait for that to get better! I am just going on to the hosp now for a review and to get the results of the lab tests following the mastectomy. I read in your blog what happened to you at this stage and am hoping I will be clear and can avoid another bout  of chemo! I reckon I am about 4 weeks behind you with the treatment programme. I am booked for my first radiotherapy consult on 20 April - all going well.

    Good luck Lainey and take good care of yourself. Bern xx

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