Mastectomy reconstruction or not?

[waitingfortheendtocome]

I've been told I need a mastectomy as my lumpectomy was not successful. I've got to make a decision on reconstruction or not, if so immediate or not, implant or tummy fat?
Got loads of booklets from the surgeon.
Any advice??

Hi. I had lumpectomy then coz margins weren't clear, second margin op, then third op, then fourth, which worked. After the third op, I decided that
I'd had enough and would have mastectomy so did research. I spoke to a lovely lady who had the tummy tuck thing very successfully but she said that you can't move at all for a while afterwards and recovery time is slower. I have different friend with two recon with implant. She has no feeling across her norks and cannot lie on her front. She looks amazing and as she is small, doesn't need to wear a bra but knows she will need another op. You can go to kind of show and tell sessions run by the ladies. I decided i'd have the diep recon as wanted something made of me or possibly delay recon because I'd had three ops by then. As it was, I was 0.7mm away from the margin so surgeon went for ice cream scooping it out again as a one last chance and glad I did.

Good luck.

I think your previous size is an important factor. I was a AA, an A on a good day and had double MX no recon. A lot of people I work with now have no idea what I went through 3 1/2 years ago and don't register that I am flat as I'm a small person!

But, had I been a DD or something, it might have been different. I don't wear prosthesis, I don't feel the need to. My reason for no recon (age 33 at dx) was that I'd know they were fake, my husband would know, and anybody else - not their business!!!!

Hi, I had implants put in at the same time as my double mastectomy. I had to have them gradually enlarged over the next year to stretch the skin. these implants were quite hard and the valve on one of them was quite irritating (The valve is magnetic and was were they put the saline in- a quick and painless procedure) It was uncomfortable to sleep on my front.
I had the more permanent implants put in a year later which was a one night stay in hospital and they went in through the original scars- they healed well and I don't remember being in too much pain afterwards.
I'm glad i had the implants- i needed to heal quickly and get back to everyday life for my young daughter's sake, (I'm a single parent) and she thought I was going to die. The implants are quite soft and give me an adequate shape when wearing clothes. I don't have to think about how I look as I go out the door each morning etc. I chose not to have nipples constructed as I don't like the look of them from pictures I've seen. The mastectomy was about seven years ago now, and the scars are barely visible.
I rarely think about the fact that I have implants.
Good luck. Feel free to pm me if you want to.

I’m glad you posted this question op .
I had a mastectomy and declined the offer of the reconstruction as it was a big operation ( would be doing a diep) and I was overweight with a bmi of 40.
I hate my body the way it is and have been working hard to lose weight and get my bmi down ( it’s now 33)
I am aiming for 27,
I have already asked my gp to refer me back to the plastic surgeon.
I hope to have another couple of months to lose a lot more weight .
I’ll be hoping for a diep from my tummy which will by that time in desperate need of a tummy tuck.
It will be two years next month when I had my mastectomy. I can hardly bear to look at myself in the mirror.
The op will deffinatly help with the state of my mental health ,the last two years I think I have had depression ( undiagnosed) .
I am now getting excited at the thought of the operation .

I do wonder how I would cope with having one boob! I've finally decided to go with immediate reconstruction. I'm trying to ignore the enormous 8 hour op and 5 week recovery that comes with it!

Good to hear that you've made your decision!
I know the whole thing is terrifying to think about, but try not to think about the 8 hour op. You won't know anything about it, and the pain relief available afterwards is very good. The first few days were obviously the worst. I had my op on the Monday and went home on the Friday (prob a bit early as the ward a virus on it apparently) looking back, I can't believe I was released with only paracetamol as pain relief and stayed on that for about two weeks. It did the job while I was mainly in bed. Once I was moving around more I went back to the doctors and got something stronger. The rate of recovery was quite amazing (i was in my early 50's) and i found myself doing most things after a few weeks. The hardest was reaching upwards to pull a blind down, or close the car boot. When I started driving again I used a cushion wedged between by chest and the seatbelt. Buy yourself a big tub of lovely cream to moisturise the scars. Remember, the scars do fade in time!
Also, get a cleaner for a while.

I got through it by feeling very grateful that I was lucky enough for the cancer to have been found. I took the view (and still do) that I can easily live without my own breasts- an arm or a leg would be much more serious!
Sorry if that sounds a bit glib- it was my way of getting through it. I know that it's much more traumatic for some people.

Do you know when you're going in for the op?

Inn I'm getting my date next week, got my echo on 14th so if results are good, not long after. Agree need to not think about actual op but focus on preparing for a smooth recovery

I had a diep.

I had a delayed one (chemo + rads) and an immediate one (second mastectomy).

The results are incredible on the immediate, no so brilliant on the delayed, but fab if clothed! I had mine done in Norfolk - a bit of a trek from the NE, but Elaine, who did it was a pioneer in the field at the time and i just had the faith in her. My boobs have gotton bigger when i put weight on, then smaller when i lost it. They feel completely and totally original, though the delayed one does have some bad scarring, so could not go topless 😊

As for recovery, my God, i thought i was dying when i wike from the Op, but within 2 weeks, absolutely fine. I have never regretted it, but never bother having nipple tattooing, which I do regret in retrospect.

Anyone considering a diep, happy to give the gory details 😁

Gloria yes I've heard that if you don't have immediate recon, it can be a tricky, long drawn out process to get the op, I'm over the operative 30 BMI, but it's ok to operate now as it's urgent!
I'm a non smoker and the surgeon said they would've expected me to give up smoking first though.
Not all hospitals offer immediate recon, like a postcode lottery possibly? Another positive that I should see this as being fortunate I'm being given the option.

Sorry for typos, have not slept for 39 hours and it is showing!

Tooold did you have your tummy fat & skin used?
When I heard you self administer your pain relief straight from surgery I thought god it must be bad!!
Yeah I'm happy to hear anything you wish to share. My BCN is an ex post recon nurse and didn't hold back on the reality of op and recovery!

Flying did I read right that you had 3 lumpectomies then a final mastectomy?

Waiting-The waiting for the op is awful!
Yes, I had a moment of panic as i woke up from surgery as the pain flooded in. But it was only very very brief- I think a few seconds- and someone is there with you in the recovery room as you wake up. The pain relief is very immediate and bloody marvellous! Having control of the pain relief puts you in control and is very reassuring.
The worst is then behind you, and you can focus on recovering.The first few days are hard, but doable. The difference each day in recovering was incredible. Do let us know how you get on or whether you have any other questions before that we can help you with

Yes, i had tummy fat and skin used. I had to put weight on, not too much, but enough for them to harvest! The skin was only used on the delayed recon though, the immediate needed only fat. The surgeon was brilliant in twisting the skin to make nipples too, but obviously they needed colouring in to make them more realistic!

To sum up, i have a scar, below the bikini line, hip to hip. There is scarring to the delayed recon, but not the immediate. There is a colour difference on the delayed recon side - my belly was considerably paler than my cleavage, and that has never changed, never tanned.

The op itself, i was in hdu for a couple of days following the op, but that was standard at the time. When i woke up properly, i did not feel horrendous, so had a sneaky peek at the new boobage. In my blurry state i got so upset because i think i was expecting to see Madonna like cones and everything was so flat - to put this into context, my first bra post surgery was a 32C, a huge step up from my pre cancer size of 32a.
Following my inspection, i decided to turn onto my side a bit. BIG mistake, the pain was immense.
I had drains coming out of everywhere and a morphine pump, self administered which i made good use of, until i projectile vomited so profusely, it hit the wall at the bottom of my bed!
But that was day 1. And day by day, things got better and better. The boobs were no bother, it was the abdominal surgery that caused the pain. After a week I was allowed out. DH and I stayed in a holiday cottage in the area for a week before having a final check up and going home. During that week i had short walks, pottered about, but could not do an awful lot.
Came home and i would say that within a month of getting home (so roughly 6 weeks post op), I was just about back to 'normal'.

It was worth the pain, i have never regretted the procedure, i only wish both could have been done immediately, but I have been brutally honest about the pain, because it was something I had never expected.

I nope I have not put anyone off 🙄

@Toooldtobearsed
You haven’t put me off .
I think the more info that there is ,the better .
I have no idea about the pain .and how bad it will be .
I only have the mastectomy ( and a reduction in my good breast ) to go by ,and there was actually no pain at all from that op ,I had paracetamol in hospital and was Home the next day and apart from struggling to get comfy for sleep ,had no real pain issues .
I am a bit concerned about the length of time the op takes ,but I think it’s a little bit shorter than the immediate reconstruction .i was told 10 +hours for that .
I’m hoping the delayed one will be a bit shorter.

@waitingfortheendtocome
I don’t anticipate any issues with getting the op .
My hospital is quite well advanced in their care of breast cancer patients .
Immediate and delayed reconstructions are the norm there .
I am glad you have decided to go ahead and do it ,my biggest regret is not having it done straight away .
Even though my bmi was high .they would have done it but I was afraid of the risks then .
But on the up side,I was very overweight then ,and I don’t know how the tummy tuck would have worked out when I am now losing the weight .
Can they do a tummy tuck twice🤔

Would love to know how you get on ,an update on this thread maybe 👍

I'm not put off, just more aware of what I'm going to be going through

Waiting. No, i didn't have a mastectomy in the end. Some in the hospital wanted me to, But the (female) consultant said to give it just one more go at margin clearance. It was only ever the one margin that wasn't quite clear enough. As it turned out, there was no cancer cells found at all in the fourth op so actually the third op had worked. I would have been gutted if I'd lost my nork and had recon for nothing. Four ops - one per month, has taken its toll and my nork isn't in such a lovely shape after the first two ops but hey ho. I did, however, have to consider mastectomy and recon as an option. They told me that one woman had seven goes at margin clearance. Couldn't have done that.