Any Michigan Ladies?
Comments
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Madison. Why did he suggest a lat. flap versus auto fat transfer?0 -
Hi Stix, In order for me to get an implant on the radiated side I have to have a flap. I don't have enough fat for a TRAM or DIEP. He said he can do fat transfer to fill in spots if needed.
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Madison- Have you gotten second opinions if you have enough fat?
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I don't think I need a second opinion. Dr. Momoh came highly recommended to me by my doctors. I'm a college student in my early twenties (23) and was in really good shape before chemo. Even though I have a few lbs. to lose now, I still have minimal stomach fat compared to what you would need for one breast, much less two of them.
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Tree - I can totally understand being torn about neo-adjuvant. Who's your MO? Mine is Dr. Beekman. She recommended the chemo regimen TC, but after some research and consulting an onc friend at Sloan Kettering, I decided I wanted to do the more aggressive regimen of ACT + Carbo. I spoke with Dr. Beekman and she was good with the ACT, but didn't okay the Carbo until later. I would say if you want to do neo-adjuvant, keep pushing and tell your onc that's what you're most comfortable with.
Madison - I saw Dr. Pierce for an opinion on rads. She was amazing! Sounds like you have a great team!
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Madison-One of the girls had several opinions in Michigan and THEY all said they could not do fat transfer.
They went to NOLA and the fat transfer was successful. It is important to get more than one opionion and know if there are any limitations in your activity after the surgery. I have implants and NOBODY told me I would be unable to perform pushups afterwards. There usually is always some physical limitations/drawbacks to every surgery- Make sure your surgeon talks about this
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Stix, I'm good with a flap and implant. It is a proven good result. When you have radiated skin you are more limited for reconstruction. I only posted to see if anyone else has gone to Dr Momoh. I have no desire to go to NOLA for reconstruction. Fat grafting is not perfect either nor is it what I'm looking for. I'm sure there will be limitations after surgery. I will just be happy to be alive and have nice breasts!
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I'm the NOLA girl that Stix mentioned. I was about 5'6" and 120 pounds with very little fat. They did do an amazing job of reconstructing two breast for me (as I had bilateral breast cancer) using my stomach and hips. UM couldn't do that for me. That said - I am now back at U of M for round two. Two years later my cancer is back in the left breast - yes, it can happen after a mastectomy - particularly (I'm just finding out now) because they didn't get clear margins in my left breast and had to go back in. U of M thinks that NOLA still missed some and that this is that same cancer coming back - as opposed to a brand new cancer. Dr. Sabel did my lumpectomy this time - he is fabulous. My first chemo was yesterday (didn't need chemo last time) and by the time I'm done with radiation I'm not sure what damage will have been done to my flap but I've heard it won't be good.
Regarding neo-adjuvant chemo... U of M will do whatever you are most comfortable with. I had consulted with MD Anderson and they wanted to do neo-adjuvant plus really heavy chemo. I preferred to do surgery first and UM was perfectly fine with that. They are also doing a less intense chemo. Unfortunately, tlhey did find that 1 of 3 lymph nodes was positive for cancer so that area will all be radiated too.
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Thanks for sharing your information Klanders- so that others can benefit from this. I am sorry that one of your 3 lymph nodes came back positive. Keep us posted. Do you know who will be doing your reconstruction? I have a consult with mohmoh soon
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Hi Stix, too soon to think about recon. I still have a seroma so looking at my breast now I have a new scar but no volume loss. Once that seroma goes away I'll have a better idea of what "fill" I might need. And it's hard to say what radiation will do to me. NOLA wants to see me 4-5 months after radiation. But I don't feel a huge urge to go to all the expense of NOLA again since I'm dealing with a different type of situation where I'll probably only need a little fat grafting. Time will tell... although we have such a high deductible that whatever I do really needs to happen by Dec. 31 and that might be pushing things a bit. I consulted last time with Dr. Wilkins and Dr. Momah at UM. Both seemed great.
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Hi Klanders,
Thank you for sharing your experience in NOLA. I am so sorry that you had a reoccurrence. You will get great care at U of M. I am not able to get reconstruction until one year after radiation at the earliest because of the risk of reoccurence with IBC. I am 23 and really dont even know much about reconstruction. When I met with Dr. Momoh (very kind and compassionate) he recommended a LAT flap and an implant with fat grafting if needed. I am trying to finish my engineering degree at U of M so it would be easiest for me to have it done there. Fingers crossed hoping for next May.
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Madison, I'm sorry you are dealing with all of this especially at such a young age. U of M has an excellent reputation and is a leader in cancer care. Your number 1 priority is getting rid of cancer and they will make sure that happens for you. Because reconstruction will be delayed, you have a year to research YOUR best options.You have admitted that you don't know much about reconstruction, so you owe it to yourself to learn as much as you can! These message boards are a good start. Please DO NOT limit yourself to just one Dr. or one hospitals opinion. There are many options out there for thin women, and they don't all include using muscle like the lat flap does. Implants seem like the easiest route, but don't work for everyone. There is even a chance that you could decide not to reconstruct at all. Picking a Dr. or hospital that is convenient has it's merits, but the smartest thing you can do is to get several opinions and then make your choice according to what sounds right to YOU after you have as much information as you can get.
Please consider everyone's experience. My research and experience tells me that if you do a lat flap, implant, and fat grafting, you will need to have the implant exchanged every 10 years for safety...that's about 5 or so more surgeries over time. What do you think will happen to the flap after they cut through it a few times? The muscle that they removed from your back (weakening that area) could be ruined. How about all of the fat grafting that they are putting in over the implant? Do you think that will survive during the exchange of the implant? Please look deeper into these surgeries before you make your decision. Traveling for a surgery sounds daunting, but logistically it's not as bad as it sounds especially if you are not doing immediate reconstruction. You would have time to plan for it and maybe do it during the summer of 2016 or after graduation. Just research, and ask questions...not just to the doctors, but to all of the knowledgeable women on these boards. Take people's experiences with a grain of salt, but listen and process the information so that you can make the best decision for you!
One step at a time...kick cancer's ass first!!
Tami0 -
Madison,
I'm so sorry you are having to deal with this at such a young age! My daughter is a civil engineering student at UM (she'll be a junior next year) and I can't even begin to imagine how hard it would be for her to keep up with her classes and deal with cancer at the same time. You seem so strong, but from personal experience, even we "strong ladies" can develop cracks occasionally in the facade. I will be praying for you as you walk this path.
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Hi Klanders,
Unfortunately I could not keep up with school, I had to withdraw for a year. I try to stay positive and have faith but trust me I do have bad days like I'm sure everyone does. My friends find it difficult to understand what I am going through since they have not gone through it themselves (understandable). I am trying to get on with my life as a "normal" 23 year old but that is difficult since I have not had reconstruction yet. They are starting me on a clinical trial for Olaparib/Placebo this month for one year so hopefully I can get reconstruction once I am done with that. I am registered for fall classes and have three semesters left, looking forward to finishing my degree. Thank you for the prayers I will pray for you as well!
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Madison, I'm a graduate student in allied health. I just submitted my medical leave on Wednesday. It is a hard decision but we need to be able to focus (by finishing the medical treatments) to enjoy the learning process.
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I have to say with recent 2nd opinion consults that I sure did appreciate dr. Studdingers bedside manner. I would recommend her. I am a tough complicated case- so I have been getting several 2nd and 3rd opinions on what to do.
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After much thought, I am going to get a few more opinions. I was recommended to see Dr. Meininger, Dr.Andrea Van Pelt and another doctor out of U of M. I would appreciate any other suggestions for Michigan plastic surgeons? Thank you so much!
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I'm so glad to hear that Madison!
I used Dr. Studinger in Novi at Providence hospital...she specializes in DIEP flap, but also does implants. I was not a candidate for DIEP because of previous abdominal surgeries, so I did implants with her. Unfortunately they failed due to infection. Before I decided to go with SGAP surgery in Charleston, I consulted with Dr. Meinninger in Troy and was set to have him have another try at implants, but his office called me back to cancel the surgery because they thought they participated with my insurance, but didn't. I saw some pictures that another member sent me of her reconstruction that was done by him and it was one of the best implant reconstructions I have seen. She was very happy too. As far as I know he does not do DIEP. I also met with Dr. Shubert in West Bloomfield. He was very nice, but the approach he wanted to take to my situation didn't make sense to me. I have a client that used him for her lat flap surgery and she is happy, but said she wouldn't recommend that type of flap surgery to anyone who lives an active lifestyle because her movement is impeded. I have no experience with U of M doctors at all.
I hope this info helps, and again I'm so glad to hear that you are taking advantage of the time you have before surgery to investigate all of your options!
Tami0 -
My PS is Dr Barry in Saginaw. He specializes in implants only. Had my exchange 4 weeks ago to 410 anatomical sand I have been very pleased. I am having a complication now on my cancer side. The radiated breast is not healing well and I am having incision draining. Hoping that it doesn't get worse, the opening closes and I can keep the implant.No fault of the PS, he has been great. At time of bmx I had TE put in as we did not expect lymph node involvement. Had I expected at that time that radiation was in my future I would have more seriously explored DIEP. However, at the time, I wanted the shortest recovery possible. I am also older than many of you young ladies. I was diagnosed at 51. My heart goes out to you with the hard choices you have to make.
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I have consulted with several PS. My rundown:
Implants:
Dr. MEININGER, Somerset Plastic Surgery. He only does implant reconstruction now. He stopped doing flaps last year. I liked him and I really liked his staff. He took his time talking to us. I've chosen DIEP but Dr. M will do my TE if I go with Dr. Momoh.
DIEP
Dr. Chaiyasate, Beaumont. I really liked him and his staff. I didn't love his resume that DIEP results are really going to vary based on several factors. He is currently booking into February 2016 for DIEP.
Dr. STUDINGER, Providence Park. I did not like her. She was far too casual with me and seemed reluctant to answer questions. She made me feel like she d I dint have time for me. She also told me that DIEP is a "fun and quick" surgery. What the?
Dr. Momoh, U of M. I liked him, though he does seem a little reluctant to do delayed DIEP on someone who is going to a different hospital (I'm at Beaumont). He suggested immediate DIEP recon which sounded tempting at first.
I am currently deciding between Chaiyasate and Momoh.
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I felt as though dr. Mohmoh did not care what I thought about the outcome of the reconstruction. I did not care for his bedside manner at all.
Dr. Studdinger I loved! But, I had trouble getting clear cut numbers of how many of different types of surgeries she does.
Dr. Meininger is a good PS. However, I did not have luck with him. He talks w. you long, but if you research and ask questions imo it seemed like he did not like that versus someone who is passive
Dr. Sherbert I see know- he is kind and considerate. He has a good bedside manner. He has improved my cosmetic outcome some- yet not completely
I am a hard case to solve.
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I decided to go with Dr. Chaiyasate at Beaumont.
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jlstacey... what made you decide on chaiyacete? I remember you mentioning that you were questioning if u liked his on the pictures you saw. AND anyone.... who used dr. Hammond? Someone did i just cant remember who. I need a second opinion... plus I plan to go to nola
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Stix - Dr. Hammond is my doc
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hi i thought it was you.
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jlstacey How are you doing? I also have 2 school-aged kids (10 and 14 y/o) and am wondering if September makes your life easier too.
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Hi ladies, I haven't posted here in a while, but I think it's time I see a new PS. I'm having constant pressure in my breast to the point I can no longer wear a bra without it driving me crazy. I just had a clear MRI, so it's probably scar tissue or the way my implant has settled. I'm scared another surgery will create more scar tissue and I'll end up regretting leaving well enough alone. But at the very least I'd like to talk about my options and, without question, would like some aggressive fat grafting. I've got lots of rippling and major indenting above each breast. The indenting prevents me from being able to wear any normal type of bathing suit or top that gapes a little when I bend over.
I've been with Dr. Izenberg at St. Joe's from the beginning, and he's a nice man, but he thinks I went too small and keeps recommending larger implants. The size is about the only aspect I'm happy with at this point, so that's just not an option. When I tell him this, I get the sense he feels like there's nothing more he can do.
Did anyone here have extensive fat grafting and happy with the results? If so, with who?
Anyone here go smaller than your original size and happy with your results? If so, with who?
Thanks so much!
Stix - sorry to hear you're having to go to NOLA, but I hope they're able to fix things once and for all.
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I was told to do gentle massages to prevent scar forming and contracture (something like holding the implant and move it up-down as well as left-right). I think unfortunately we do use more surgery to remove scar tissues. That's what my current PS at St Joe's said about a salient "fold" in my chest skin, created by some scar adhesion.
My first PS at Beaumont 5 years ago told me that fat grafting didn't work because it would get absorbed by the body or simply hardened. But that was 5 years ago and people on the forum do get the procedure. You should do a search (using the search function). He did a good job, according to every healthcare provider I encountered afterwards, (I went from 32 A/B to full
but I still get wrinkles and dimples if I'm not standing upright. So I wonder if there is a limitation if the size is not "hefty enough." It does get better with time for me with a little natural fat.I hope someone with the experiences will answer soon!
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Treelilac... pm me who your surgeon was at Beaumont. Ty
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