Reconstruction after Mastectomy

[KimberlyB40]

Happy Holidays!!! I was wondering if there's anyone who's had a mastectomy with reconstruction and regretted it. I'm 43 MBC and there's a mass in tge same breast they've been watching but I think it's time to have the mastectomy as a preventative measure. Anyone willing to share their experiences?

[FloridaNYgirl]

I was first diagnosed with breast cancer in 2008. I had bilateral mastectomy and reconstruction surgery. I was in remission for 13years until the cancer metastasized to my lungs. As far as the reconstruction. It took some time because I was going through chemo at the time. But I have never regretted it. Wearing clothes with ease and not feeling self conscious was a real boost for me. It's a very personal decision. I am sure you will make the right one for you. Happy Holidays!

[FloridaNYgirl]

I was 53 yr old at the time..

[Onie54]

hi!

I was initially diagnosed in 2003 at the age of 38. As the tumour was large I had a mastectomy followed by chemo and radiation. Roughly 8 months after finishing treatment I chose reconstruction as well as a reduction of my left breast so that it would match my new breast. The surgery was a TRAM flap reconstruction, an implant was not feasible due to radiation treatment.

I have no regrets with having the reconstruction although it was a long road for recovery (min 8 weeks). Feeling good wearing bathing suits and other clothing was great and a confidence booster too.

I’m sure you’ll make the right decision for yourself and i’m sure there are new options out there now too (mine was almost 20 years ago)

Susie

[13plus]

I've got some interesting experiences to share! I was 40 when first dx with Stage 1. It was a tiny lump but it required a mastectomy to remove it due to a combination of it being deep, the location within my breast, and that I have small breasts (34B). I was very physically active and did not want to have my movement impaired at all.

The surgeon talked me into having an implant, even though I was considering going flat on that side. And I guess I was reasonably happy with the results. The fact that I was so used to wearing pretty skimpy clothes, it did help me to dress fairly close to what I was used to wearing. I chose a saline implant (didn't want to risk silicone leakage) which is firmer, so it was not very comfortable to lie on that breast in bed. I never had radiation at that point but I still had to work a lot to regain full movement like I was able to do on the other side.

3 yrs later I got a new lump on the chest wall and they had to do a re-excision (x2!!) , remove the implant and replace it (so they could check everything inside the breast). And then I had radiation as well as more chemo. Again I had to work hard to regain full movement (mostly due to the chest wall excision which made the skin on the side of my body very tight.) But I started hating the implant just because it always annoyed me. A bit like having on a bra that you can never remove.

Then, after a while, I had a very rare occurrence for a saline implant. It developed a slow leak! (Maybe from my son's basketball hitting me in the chest? I'll never know! lol). At this point I was SO over having surgeries I decided to go flat on that side.

So, now I wear a prosthesis piece in my bra. Advantages: I can take my bra off and feel free of foreign bodies. Yay! I can get away with slipping my piece into certain standard bras because it's small. I don't have that permanent "thing in my chest" feeling. I can comfortably lie however I want to in bed. Disadvantages: It does limit which tops I can wear. A lot. Low cut necklines no longer work for me, and that's my biggest frustration. Swimsuits can be a particualar challenge but a rashi sun protection top, or high cut, and patterned fabrics help. Otherwise I have no regrets going 1/2 flat.

Bottom line: I think a lot of the decision depends on all these factors - type of surgery you're contemplating, if treatment includes radiation, how you live your life, what physical activities you do, the clothes you like to wear, the size of your other breast, etc. I also think your skin type plays a big part. I have (or used to have!) fairly tight skin/tissue so I think I was to a certain degree more effected by the rads and surgeries. I have had friends go through similar treatments/surgery and not had their range of motion effected so much. I have another friend who was told by her surgeon that she had very "thin" skin, and the impact of that for her was the implant being more obvious. She ended up doing rounds of complicated fat implants to try to help the look, which is never guaranteed to work. (I imagine that is not such a common problem though).

The bigger/saggier your natural breast is, the harder it would be to match it, shape-wise, with a prosthesis piece. Having said that, even with reconstruction, it is not going to match your natural breast, it will be perkier (and rounder probably). That's why so many find the bilateral more appealing. but then, that's twice as much surgery.

It depends on surgery type too. These days there is the option, depending on your body, to get the fanciest reconstruction which uses belly fat (not the muscle). I had one friend have it done with great results but she was one of the first to get that newer surgery. It was many more hrs under the knife, and requires microsurgery too to move the blood vessels with the fat. I think all other surgeries like flaps and such still move the muscle to create a breast (if you don't opt for an implant), and they take much longer to recover from, and efffect on you physically varies. If you google "going flat" you can find sites where some women have shared their results. The reality is flat, without clothes on, does have the effect of looking slightly concave, not exactly a rounded chest (as in rib cage) that one may imagine.

Sorry for the essay! But I hope some of this helps your decision.

[KimberlyB40 in reply to 13plus]

Thank YOU SO SO MUCH for the full picture! I really appreciate you taking the time to make me think of like ... everything. I'm a small 34b and decided to have a lumpectomy but there's a new benign mass and concerning densities in both so im thinking about doing a double for preventative reasons. I'm not very athletic, amd I hide my body so the implants would just be .. for no reason I guess when I look at it your way...also, the cancer spread to my ribs so when you described the not being able to take the bra off feeling that might send me into like a panick attack So many things you said are super helpful so thank you thank you for taking the time to help me make this decision!!

[13plus in reply to KimberlyB40]

It's a lot to digest so take your time with it. To. be more precise. The 2nd lump was just at the very edge of my "new" breast, 1/2 under, and 1/2 on the outside in a way. They did 2 excisions because the surgeon wasn't happy with the margins the first time around. I actually felt GREAT and free of restrictions after the first excision, but 2nd time they dug deeper and took the upper layer of my pec muscle at that side spot. THAT left everything a little thin for , I guess, safe use of that muscle so they added a layer of (gross) cadaver tissue to hold it together better. It's where I have that foreign tissue that my skin has completely adhered to it, and it to my ribs, so I have no give in that specific location.

Anyway, double flat chest .... the tummy might very look like it is protruding, in relation to a regular bosom chest, just so you are fully aware. But it also means you have the option to have 2 identical pieces stuffed into a bra, or take the bra off when you've had enough. The reason the implant bothered me so much was becasue I have a small frame, and honestly I should have had custom implants to fit my rib cage (was never offered!). That was something I found out after the fact, and I loved my surgeon but ugh! Give me ALL the facts please! So the implant slightly stuck out beyond the ribs (hard to imagine I know) but I often think that's why I developed the lump in the first place because the tissue there was irritated! Reach out if you want to ask anything else

Wishing you the very best for the Holidays!

[Fiercefighter13]

Hi there KimberlyB40! I was first diagnosed stage 1-0 at the end of 2012. I opted to have a double mastectomy and reconstruction all at the same time 3 weeks after diagnosis. I already had implants (vanity!), so a breast surgeon did the mastectomy, my plastic surgeon stepped right in and did the reconstruction with new implants and done. I have never had to think about it again......I was later diagnosed with Metz all over my bones in July of 2019......but my breasts were cancer free! They have been the least of my worries and they healed up quickly so as to move on to treatment. Hope this helps!

[kickaliz]

Kimberly, I so think it is worth it. It makes me feel normal. I ended up doing the 3d nipple tattoo and all my friends are shocked at the unbelievable results. You are so young you won't regret it. I do not think nipple reconstruction is worth it - better to do the 3d nipple tattoo