Lumpectomy with oncoplasty (bilateral reduction mammaplasty)
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I was very happy I did this. They looked good and I was thrilled to reduce after many years of not liking my hangy boobs. When I asked about the procedure my surg was very happy to set it up. Referred me to ps who did that surgery and my then required bmx, te placement and exchange. I would highly recommend the oncoplasty to anyone getting an lx and wants a reduction. It is covered by law by insurance.
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I had one after my lumpectomy, about 5 days after, to be sure margins were clean.
Never looked back. Still may have to do rads, but the oncoplasty was the best thing I ever did for myself.
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yep the nerve pings felt rythmic...like drummers communicating... It was very strange.
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hi
Just saw the breast surgeon today and was very surprised when he talked about another option for BCT involving lumpectomy plus bilateral mammoplasty. Had never heard of it but he talked about cosmetic advantages along with better radiation outcomes
Has anyone had recent experience with this as noticed this thread is a few years old now
Any advice on this option both positive and negative would be appreciated
My breasts are pendulous these days but not huge, though not A or B cup either
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This is exactly what I needed to read right now. This is route I decided to go
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I just left the plastic surgeons office this afternoon and this is the route that I have decided to go. I have very large breasts and am in the initial stages of my diagnosis. This is my first post and it's nice to know others are here. I'm still navigating though things.
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Doesn't look like this thread has been active in the past few years (except for lately)....I'm in the same boat as you ladies. Surgery 3/1.
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I'll just leave these links here. I have heard Dr Silverstein lecture on this topic many times.
https://www.ncbi.nlm.nih.gov/pubmed/24847860
http://www.onclive.com/conference-coverage/mbcc-20...
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I had a bilateral reduction when I had my lumpectomy in August 2015 and have been very happy with the results. I had very little discomfort and only missed six days of work. I could have gone back earlier but my plastic surgeon wouldn't sign off on my leave until after my one week post-op appointment. It was my understanding that radiation would be easier with less breast tissue. Very happy with my smaller breasts. Went from G to C. Wish I had done it 20 years ago
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Hi,
I realize this might not be the right forum for this. If not, please redirect me. I don't know if anyone is might see this who is having LX/SNB and then Reduction vs. simultaneous LX/SNB with Reduction. If not, does anyone know of a forum where there might be others having these two procedures sequentially?
Question/ Advice: I'm going to have breast reduction to try to minimize risks of radiation SE from my very, very large, pendular breasts.I've had LX with SNB. Will need more time off but do not want to say that I need "reduction," because it will evoke a sense that it is totally optional and cosmetic, as well as "elective" vs. "medically necessary" to try to reduce risks of radiation problems. Not good time of year to take off a week or possibly two. Any advice about phrasing this for co-workers and even for some family, who would not understand??
If I were having the procedures together, I would just say, I am having surgery for breast cancer. I think I will do that now, but it is very hard because very well-meaning people who are very supportive, will ask a lot of questions and might assume that the second surgery means very bad news.
Thanks so much!!
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My sister had this procedure in November 2016. It did not work out for her in the sense that the original tumor was larger than originally thought and they did not get clean margins, and the tissue from the breast without the tumor had small areas of DCIS. She also had cancer in one lymph node on the side with the tumor. As a result she has undergone chemo and will be having a double mastectomy this month.
That being said, had she not had these unexpected issues she would have been happy with the choice as she likes her new breasts and the surgery itself went smoothly.
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I saw 2 BS and both insisted I have a Mx and would not attempt a Lx. The tumor was large (4.5cm) but so were my breasts (E+ cups) and I figured the tumor had lots of room to grow. the first BS said the size of my breast had nothing to do with it and the 2nd said I needed neo chemo to shrink the tumor first to make the surgery 'easier' for her. ???
I found a surgeon who said he can do a Lx via co2 laser with oncoplasty. I have a 6" scar across the top of my breast with a slight indent, for me no biggie. The PS wanted to revise the scar but I had enough surgery and have since covered the scar with a tattoo vine of chili peppers.
I had rads and 6 mos. later had a reduction on the other side. A matching set! I am really pleased with the results of the oncoplasty. A 10x10cm chunk removed and if not for the scar it looks really natural.
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Since this topic has been revived, I'll share that I'm in a similar situation to Blooming; that is, lumpectomies and SNB followed by bilateral reduction. In my case, there's been a lengthy delay. I initially was going to have bilateral mastectomy, but chickened out late in the game after seeing the plastic surgeon's photo gallery plus I was very concerned about the pain that many experienced with tissue expanders. Consequently, I didn't discuss the option of a reduction in conjunction with the oncological procedure.
Due to age & a 100 pound weight loss, my F / G cup breasts hang down to my waist. Since it's occurring many months after the lumpectomies, it's not considered reconstruction and insurance approval was a lengthy process, despite calling to confirm that the PS's report noted that radiation was being delayed.
I developed a nasty infection when my SNB seroma was drained so infection is a worry. I live alone with two large dogs so self-care might prove challenging. I've been buxom since the 9th grade (a 32 D or DD at 112 pounds) so am concerned that my resulting breasts will be too small. In order for insurance to pay their share for the surgery, over 600 grams must be removed during the procedure. I have a large, droopy stomach and want significant protrusion so tunic tops will drape gracefully over my problem areas. Given that I still would like to lose another 50 to 60 pounds, my preference would be for an uplifted D cup, but the PS doubts she can do that and meet the insurance company's requirements. I may end up much smaller than desired, but that's the trade-off I must accept since I can't pay for the procedure myself.
Since she's seen unpredictable changes in size related to radiation, this surgeon aims for symmetry. I hope I won't experience significant shrinkage or swelling that will leave me unbalanced.
Lyn
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Lyn,
I'm sorry your still dealing with BC tx's a year after surgery. Radiation did not shrink my breast and I noticed no ill effects. However, a good part of my Lx included the skin. and it was perky compared to my droopy, large 'good' breast. I know what you mean wanting your bust to be protruding over your tummy. MY tummy is catching up with my new bust size so I wear tunics and baggy dresses and it hides my tummy (who am I fooling). The first time I unveiled my reduced boob It was a shock and I called the PS complaining that she took too much. Now I love my cute little C-D.
Maybe you should shop around for a PS who will give you your D's. If you have a lot of breast tissue left a D cup should be doable. Maybe with implants. Too late for oncoplasty but since you had lx's on both breasts insurance should cover the reductions???
My reduction was covered but it was for balance. I hope you can find someone who will work with you. Keep trying.
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I just had a lumpectomy, ALND and reduction/lift almost two weeks ago. I had chemo first (stage IV from the get go at 41) and my 3:00 & 9:00 tumors shrunk significantly, BS did good, clean margins. The PS did good too, they're high and tight but I cried when I saw that my DD's were now reduceda full C maybe, I won't know for sure until my axillary drain is out and I can go shopping. I too have some ab workouts to do now I try to focus on the fact that I was lucky to have this option at all.
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Thanks for the reply, Chef. I had two lumpectomies, but both were on the same breast. DCIS was found in the tumor margin requiring a second procedure.
Reduction surgery was Tuesday and I'm pleased that I already got my drains out today. The post-surgical breasts are very perky, but I know they'll settle in the months to come. A C-cup would be perfect if I were thinner. I'm looking forward to not having my nipples at my waist and some relief for my neck, shoulders and back will be welcome. I hope that, like you, I don't have shrinkage from radiation.
Lyn
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Thank you for the most helpful and informative post.
I am going to have oncoplasty when I have my IDC removed. It is 4mm in size, with another 3mm area 6mm posterior. I have been thinking about having the left side done and leaving the right side alone. The PS agreed that this was a good idea due to the fact that I need radiation, and the left side is already smaller than the right side, which means that the PS can't just leave my left side larger. After having a day to think about it, I am wondering if I should have the right side done at the same time, as I will likely never have the time to take off work to get the right side done in the future. I will be using up all of my leave to have the BC surgery.
I had a second opinion with a BC surgeon, and when I left the appointment I felt much more informed. My 1st dr. performed a lumpectomy last year (left side) and discovered ADH. She is a terrible communicator, but a great surgeon. I would love to use the 2nd opinion dr, but he does work with a PS who can perform oncoplasty. He feels that the PS I went to is the best in the area. He feels that I have a great team. It is just the I don't feel like this breast cancer surgeon gives me all thlae information that I need to make an informed decision.
I am definitely going to go back and read through the rest of the posts in this threads, as I think the information you shared will help me to prepare for my surgery.
I do have huge concerns about how sore my arms and chest will be after surgery. I have a job that regards a lot of repetitive upper body movement, lifting books, pushing loaded book carts, moving books from one cart to another. My PS said that I would be limited to lifting 10lbs for 6 weeks.
Thanks again for your helpful posts!
Mrsmcg
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Hi, Mrsmcg,
I'm glad you found this old thread and resurrected it - I'm scheduled for surgery 3/20. Going to have a partial mastectomy in my left breast with immediate reconstruction plus reduction and lift in the right breast. I'm meeting with my PS Tuesday for the first time. This thread has been so informative - I have so many questions for the PS. I am just so happy I can have it all done at once - it is very difficult for me to take time off from work.
My biggest concern is lymphodema, so I saw a PT and got some helpful hints. She says flushing the lymph nodes is important, so she has me drinking 32 ounces of water before lunch and 32 more before dinner. It hasn't been as hard as it sounds.
I'm feeling pretty optimistic this morning, but that changes from day to day.... I have been on a clinical trial with neoadjuvant endocrine therapy, but I might need chemo after surgery depending on the pathology. I'm very anxious about my pathology results (I soooo dread the thought of chemo.) So I'm trying to focus on preparing for surgery and letting go of worrying about the pathology.
When is your surgery?
Thanks, Linda
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Linda,
I found it helpful to find some questions you want to ask. Print them out and take them with you. My PS loved that I was prepared with questions. I have been very stressed about making my decision on whether or not to have the oncoplasty done on both sides. I am having oncoplastic (oncoplasty) on the left breast that was diagnosed with IDC. I have the option to have the same procedure done to the right side. I am having a very difficult time making a decision in this regard. This has been causing me a lot of stress. I want to make this decision and feel at peace with it.
I am also experience having problem with taking time off work. My work can be physical, as I am not sure how much I am going to be able to do post surgery.
I hadn't heard that suggestion about drinking plenty of water. That's a great tip. One of my dr. gave me a booklet on Lymphedema. I need to sit down and read it.
Linda, I pray that you will not need to have chemo!! Best wishes to you on your surgery on 3/20. I do not have a surgery date scheduled yet. I am waiting for my genetic test results to come back. I have a history of BC in my family.
My boobs are a size 38D. I have Ptosis (droopy) breasts. I know that this procedure would help with that, but I'm not huge on the cosmetic reasons for doing the procedure to the unaffected side. I can live without my boobs being completely equal. That said, my left breast is already smaller than the right side. I also had a lumpectomy last year.
Any feedback would be GREATLY appreciated. Trying to come to a decision is really stressing me out!!
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Mrsmcg and Linda,
I just had this procedure 4 months ago and hope that maybe my experience will help you as you go through this same process. I found this website and message board very helpful when I was diagnosed in August and trying to make decisions about surgery etc. Though I referenced this board regularly, this is my first time posting.
A little background, I was diagnosed with IDC on the right side in August. Genetic tests all came back negative. I was hormone positive and HER-. I was a 34 DD (maybe a little larger, but that was the bra size I was wearing) on a fairly petite frame. With very dense breast tissue, my breasts were very heavy and sagging. My right side was probably a cup size smaller than the left side (though I didn't really notice it until my diagnosis when I was paying more attention in the mirror after biopsies etc.) After genetic tests came back negative, my Oncologist suggested a lumpectomy with sentinel node biopsy followed by radiation. Because the right side was already smaller and would be even more so after the lumpectomy, I started thinking about having the reduction and lift at the same time - I believe it is termed Oncoplasty by reduction method for symmetry. I too was trying to decide whether to do it at the same time or wait until after radiation to do it. I can only speak to my personal experience and my thought process.....somewhere I had read that sometimes after radiation treatment you have a more difficult time healing. I also read that sometimes radiation can shrink the breast size. I hate needles and IVs and the effects of anesthesia so I started thinking about doing the reduction and lift at the same time as the lumpectomy/sentinel node biopsy on both sides so that I would only have to go through one surgery and one recovery. My oncologist had a plastic surgeon that she works with that she referred my to for a consult. The plastic surgeon thought that doing it all at the same time was the way to go. She left my right side a tiny bit larger than my left side to account for any radiation shrinkage that I may have. I am extremely happy that I decided to do both sides at the same time prior to radiation. Initially, the incision from the sentinel node biopsy (which is closer to the arm pit) bothered me more than the other incisions. Because that area pulls when you raise your arms etc. I was just more aware of it. Also, I had numbness in my arm pit and some tingling and numbness in my upper arm because of the nerves affected from the SNB. Not a lot of pain, just weird numbness and tingling mostly. I think personally, I would have been more uncomfortable if I had left the left side alone and only done the lumpectomy etc. on the right side. The heaviness of my breasts and the size difference I feel would have made my recovery more difficult. Of course, that is just my personal experience. Also, I am all about checking things off of my list and just moving through the process. I kept telling my friends and family that this was just a little bump in the road and I would be through it soon!
If you decide to go this route, and you also need radiation, know that you may have to spend a couple of extra weeks healing from the oncoplasty before you can start radiation. My oncologist and plastic surgeon said that typically after lumpectomy, radiation starts 4 weeks later. Because of the oncoplasty, I had to wait 6 weeks post surgery to start radiation. My cancer was small and not aggressive and was not in the lymph nodes so my team of doctors all felt fine with waiting a couple of extra weeks to start radiation. Fortunately I did not need chemotherapy. I finished radiation the end of December and now have to take Tamoxifen for 5 years and hopefully all is good.
Please feel free to message me if you have any additional questions. I will be happy to share my list of which items I found very helpful after surgery etc. I did a lot of research on post op bras etc. Sometimes it is hard to find comfortable ones.
Best of luck to you both as you navigate your process!
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Hi Folks,
Thanks to Nyama for starting this thread in May 2013 and for those who recently rekindled the thread. I'm sending good wishes to Mrsmcg and Linda2119, who posted that you are considering or already scheduled for reduction oncoplasty soon.
I had partial mastectomy (lumpectomy) with SNB March 31, 2017 and bilateral reduction mammaplasty with lift in mid-May, 2017. When I was trying to get info about reduction oncoplasty, I had difficulty finding others who'd had it. I was pleased to find this forum and very pleased that someone reached out to me via private message and offered valuable info and encouragement. By the way, when I prepared my bco.org profile, I didn't find reduction mammaplasty among the treatments listed in the dropdown. I don't know if it's been added to the choices since then, but it would be helpful.
In my case, there were reasons that it wasn't a good idea to combine the lumpectomy and reduction, but that is a valuable approach for many. I am very, very happy that I had the reduction. It's given me peace of mind for several reasons. (1) I am sure that my radiation was "easier" on my body because the reduction removed so much dense breast tissue. (I was a 42 G-J) The remaining breasts were still large, but I understand it was easier to direct the radiation and possibly less was needed. (2) I found it much easier to protect my skin during radiation because it was easier to try to lift and separate the breast from the skin underneath. There was far less irritation under my breasts. I was able to support my breasts by wearing bras without underwire, which was important for healing from reduction and for undergoing radiation. I can't imagine having been to "keep skin from skin" without the reduction.
(3) Also, a lot of tissue was removed from both breasts. In the left breast (with BC), analysis of tissue removed from reduction showed other types of growths that were not cancer, but were not totally "typical." At lumpectomy, Invasive Ductal Carcinoma (IDC) was removed and found they'd also removed some DCIS as well as intraductal pappilloma (which had also been detected on biopsies.) Pathology on the extensive tissue removed on reduction showed atypical lobular hyperplasia, more intraductal papilloma, usual ductal hyperplasia, proliferative fibrocystic changes, calcified fibroadenoma and fibroadenomatoid nodules. None triggered the need for more extensive surgery and I **realize** these are not as insidious as IDC, but I gained peace of mind knowing that those growths were no longer in my breast. The right side did not show any of these atypical growths. (4) The reduction also made The reduction also brought quick relief from neck and shoulder pain from having very heavy breasts over many years.
I did not find it hard to recover from the bilateral reduction. I needed an extra week off from work for the reduction than for the lumpectomy, but I was not in a lot of pain and did not need heavy-duty painkillers after the very first two days. I'd also been worried that people would pry and ask why I needed a second surgery and I did not want to tell people it was for a reduction, since many people assume it's cosmetic and would be dismissive. I found a way to navigate that and just said the doctors said I need a second surgery for the cancer treatment. That is accurate and all people needed to know. I was concerned about finding the right bras, especially since my breasts were still big! Immediately after reduction, I needed a surgical bra for a while - perhaps 2 weeks. The first weeks, I also needed to buy gauze for added comfort and in case of some bleeding. After the surgical bra, I experimented by ordering things online. I'd been warned that the cup size(s) change as swelling subsides so it did not make sense to invest in expensive bras until things settled down. Also, I found it helpful to remove the underwires from my pre-surgery bras and wear those. Once radiation started, I looked for 100% cotton bras and found some that were very helpful. I was also advised to look for bras without seams in the cup. Cotton camisoles were also very helpful for radiation. Because I wear a pus size, I was worried that nothing would fit, but I got wonderful recommendations of others on this forum and discovered things that worked.
I don't know if any of this would be helpful for those exploring or preparing for oncoplasty and radiation. Like JosieF, I'd be happy to answer any questions via pm or to share info about things that helped after surgery or bras that helped after surgery and during radiation. I appreciate the help that I received and want to "pay it forward" if I can.
Sending good wishes to all.
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I just had this procedure about three weeks ago on 1/19, a Friday. I returned to work on the following Wednesday; I am just being conscious of not lifting anything too heavy. My pain is little, but noticeable, three weeks out. I still have redness, swelling and the itchiness began about 1 week ago. I had what amounted to a quadrectomy, or 200g of tissue removed from each breast, with a lift. I went from a D to a C cup. My PS has told me that I am probably eligible for enlarging my breasts with fat (from tummy tuck) down the road, if I wish but, as we all know, I have much bigger fish to fry right now.
In my post-op period, I have been able to work and go to Dr. appointments. I have begun PT to hopefully ward off Lymphedema. I did the simulation for radiation. I even had cataract surgery! I'm off to the dentist later today, as well as oncologist and port flush.
My one concern is the redness; I'll question my Onc about this later today. I had some antibiotics in the house so I took some this weekend. I know it's not good to take antibiotics without knowing cause but, again, I've got bigger fish to fry:)
I'll keep my eye on this thread and add to it when I am able.
Eve
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Blooming,
Thanks for posting your experience with radiation therapy and how you think the reduction helped to lessen your issues with treatment. All of your points are very good! I too feel that my reduction helped my radiation treatment be more comfortable. I was able to do the 4 week course of radiation rather than the 6 weeks. That means you get the same dosage of radiation but in a shorter time period. That also means that, as my radiation oncologist had explained to me, most of the skin symptoms appear at the end of the treatment or shortly after treatments are finished. When I finished my radiation, I was instructed to not wear a bra if possible for a couple of weeks....instead I just wore a camisole or cotton tank top and dressed in layers. Since it was December/January I was wearing heavier clothes anyway. I was perfectly comfortable without a bra since I didn't have to deal with the heaviness and droopiness of my pre-surgery breasts. I am happy to share my experience if anyone else has questions related to radiation therapy as well.
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Hello, everyone - Thanks so much, Josie, blooming and lightseeker for sharing your experiences. It is so encouraging.
My first appointment with my PS is tomorrow. I have the usual list of questions, but if anyone has anything outside of the normal that the wish they had asked or known, please share.
With my DDD droopy breasts, it is so hard to imaging wearing no bra! Bras have been such an ordeal my entire adult life. This reduction/lift is the only upside of this experience (and one that I thought of and hoped for immediately upon diagnosis, if I must be honest.)
I'm very interested in any advice you all have - I'm reading and rereading all your posts. I feel like I am finally reading relevant posts to my situation.
For those of you who have had radiation after surgery, did the radiation shrink your breast?
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Hello,
I am contemplating a lumpectomy followed by the bilateral reduction. I'm wondering if any knows whether, in addition to the benefits of this procedure discussed in this post, whether a breast reduction also reduces one's chances of recurrence or of a new breast cancer? It seems like: less tissue, less chance of recurrence/new breast cancer, but I don't know if that's just wishful thinking.
Thank you
Barbara
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Hi,
In terms of Linda2119's question, I don't know if I have any questions beyond the norm. However, I wish I'd known more about what to expect while recovering. My PS had a list of discharge instructions on the website and I found other such lists. My instinct is that unless a physician has gone through this or observed a loved one go through this, that physician doesn't have a tangible sense of some of the things to expect. Certain things might seem obvious to a surgeon, but if a person hasn't dealt with this before, it's hard to anticipate.
I had a really positive experience but I found that folks in these forums who'd had mastectomies or reconstruction were very helpful with suggestions. I think the part that wasn't clear: what to expect in terms of wound care, amount of blood, what types of gauze would help, etc. Folks in the forums suggested specific types of gauze or specific shapes. (It was hard for me to anticipate what would stay on!! The first day back to work, I had to do a conference presentation and found myself worrying that my gauze might slip out or something!!) Someone with experience and know-how could market things! I think there are some items! It might help to compile some list of the types of things that help us. I found craftsfolks who market items such as quilted seat belt covers for folks following breast surgery or during radiation (or even for those having abdominal surgery). These are very helpful.
In the recovery room after reduction, I had a surgical bra. I did not have drains. The recovery room nurse, who happened to be a woman, noticed that I didn't have a back up, and scrounged up something. She figured I might need it. When I got home, I found that my bra was drenched in blood. I called the PS and learned that no, this was an amount I could anticipate. I wish I'd bought extra gauze before the surgery and I wish I'd gotten a sense of what to expect the first 24 - 48 hours.
I want to emphasize that these things were mild. I really had a good experience. These are only things I wish I'd known to ask about!
In terms of Barbara1120's question, my instinct is that having reduction helps the outcome. I read the scientific literature almost a year ago, so I don't recall the specifics. I suspect that we could find some evidence from the surgeons who are at the forefront of this.
Sending good wishes to all.
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Just met with the plastic surgeon. He answered all of my questions. Says no drains, surgical bra for 5-7 days (bummer).
The big takeaway is that it doesn't seem like I have any say in the ultimate size - the breast surgeon does her thing, he reconstructs that one then does the other one to match. Also, no guarantee about nipple sensation - likely none in the breast cancer side, he tries to keep nerves intact in the other side, but could end up with nothing. Bummer.
Everything else was very encouraging. He gave a list of reasons why doing this at the time of lumpectomy is a better route (not that I had any doubt in that regard.) Re radiation - his opinion is that it only shrinks the breast in less than 10% of the patients, and it is typically when the breast has a lot of fat tissue. He did not seem to think I was at risk of that happening. He showed pictures of a patient who had similar breast size and appearance as mine - the final result was very pleasing.
Now I have to wait until March - ugh!
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Yikes! My PS didn't mention anything about having extra gauze. He didn't give me any details about wound care either. Of course, at the time I saw him I was undecided as to whether or not I wanted to do just the effected side or both. I have since decided to do both. I have sent him some questions through Mycharts, and now he is suggesting the I see him again in the next couple of weeks so that he can answer my questions.
Blooming - do you have a list of items that you found useful to have on hand post surgery, or anything that I can do to prior to surgery to help make recovery go smoother?
I have been looking getting a seat belt cover. Do you have one that you would recommend?
My cancer dr told me that I didn't need a post surgery bra. I had to talk her into writing me a prescription for one. I am supposed to have a fitting tomorrow. My PS said that there is a 50-50 chance that I will a drain(s). I have read that a lot of folks end up having a surgical bra put on post surgery. I am now questioning whether or not to use the prescription, or to wait until after my breasts have healed.
Still waiting for my surgery date. I thought my dr. was going to put me on her schedule, but they are waiting for the genetic testing to come back. My dr's nurse told me that she would get me on the schedule, but make sure that it was set up for a time when we would have the bloodwork results back, but I have not received any other details. I saw on my MyCharts list that my dr has put in a request for NM lymphatics and lymph gland imaging. Not sure what that's for, if it is the pre-op of putting in the wire locator or the imaging for the sentinel node.
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Hi Folks,
Linda2119 and Mrsmcg, glad you've both seen your PS.
I'll be happy to go through my files and prepare a list of things that I hope would be helpful. I'll be able to do that during the weekend.
I should clarify that I did not get a prescription for a surgical bra that needs a fitting and a prescription for insurance reimbursement. After the bilateral reduction, I woke up to find I was in a very basic post surgical bra with Velcro closure in the front. I saw that same type of bra listed online for about $50, which is much less than a surgical bra that needs fitting. I can look that up.
I've needed different types of bras at different stages of healing after the reduction. For a period of time after reduction, I was instructed to wear a bra 24/7 but it was NOT have underwire. When I started radiation (almost 8 weeks after reduction), again I was not to wear underwire. I was told it was very important to have a cotton bra and to try to make sure that the cups did not have seams (which would irritate the breast).
The PS has a post surgical instruction list posted online, as do other PS. I haven't seen these lists suggest buying gauze or cotton bandages. That was something I learned from the bco.org forums!
I realize it is hard to try to make decisions about these surgeries. It's especially hard when you're waiting for test results. I remember it was this time last year that I was rushing to get genetic tests and multiple external biopsies to try to get a handle on what was going on and what type of surgery, etc. would be needed. It isn't an easy time. Thursday, I'll be going to my first mammogram since surgery.
I'm sending good wishes to all.
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As blooming stated, I too have needed different types of bras for different stages of healing. My surgery was a little over 4 months ago.....I was told not to wear underwire for 6 months. I was also told not to go shopping for a fitted bra (band size and cup size) for 6 months. I have just been buying soft bras that come in small, medium, large sizes so far.
Someone asked about extra gauze....when my plastic surgeon took me out of the post op bra she actually put narrow maxi pads in the crease under my breasts inside of my bra. Worked great to keep the bra from rubbing on the crease incisions and to soak up any oozing. I also used nursing pads over my nipples for a short period of time when the stitches were sticking to my bra a little bit. This helped me but I didn't need them for long.
A surprise benefit from my radiation....my scars on the side treated with radiation are much thinner and softer than the non radiated side.
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