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Implants after radiation or go flat

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storylife
storylife Member Posts: 9
edited September 2022 in Breast Reconstruction

I am about to have UMx soon. I met with my plastic surgeon. Once my PS heard that I need radiation, he started to talk me out of implants. I have small breasts to begin with, so if I do implant, I will need to augment the other side too. My PS worries that if I have capsular contracture - then I will end up with asymmetry implants and discomfort, not to mention all the operations. According to him, my better option will be go flat or DIEP. I don't think I will do DIEP - feel it is a lot of work to reconstruct a small breast.

I need to make the decision if I put TE in with mx. My BS suggested me put TE in anyways to keep my options open in case I still want implants. My PS however said that if I put a TE in now, I wont know how "go flat" will look like. Anybody with similar experience? Or do you have suggestions on how should I make decision?

Comments

  • parakeetsrule
    parakeetsrule Member Posts: 605
    edited September 2022
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    I agree with your PS. It would be better to get a good flat closure and then see how you like being flat. It saves you a lot of extra pain, recovery, and endless stream of surgeries. Make sure they don't leave you with loose or extra skin if you want a good flat result! You can look at this website for photos both for yourself and to show your surgeons, if that's what you want: https://www.flatclosurenow.org

    The best part about going flat is that it's not permanent. Like your PS says, putting in TE now won't let you experience or see what being flat is like. You do NOT have to do them now. If you go flat and hate it, you can always do TE and implants later.

    Going from boobs to no boobs when you are small is easier than it is for women with larger breasts. I only had one removed but unless I'm wearing more tight-fitted clothing nobody can really even tell. And if you want to look like you have breasts, it's easy to throw a prosthetic on and go! I also think having one remaining breast makes wearing prosthetics easier. I'm glad I kept mine for that reason and others, but many women prefer being completely flat. If you don't get many responses here and you want more, let me know and I can direct you to several flat facebook groups where you'll get tons of responses from women in similar situations!

    One final thought....sadly, it is common for surgeons to disregard a patient's wishes when it comes to this, and for them to not do a good flat closure when they disagree with what the patient wants. Women wake up from surgery with loose hanging skin because the surgeon decided to leave it "in case you change your mind". So I would use extreme caution with your BS and possibly choose another one who supports your decision.

  • wondering44
    wondering44 Member Posts: 260
    edited September 2022
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    I had radiation on top of existing implants. Well, capsular contracture reared its ugly head not long after I completed radiation. Boy, I didn't like the look at all. I was challenged leaving the house with crooked breasts.

    I recently had the implants removed during a skin-sparing BMX with TEs placement. I had to wait for no less than six months to do it due to the radiation treatments. It looks much better now than a pair with capsular contracture on one side. While, I'm not a fan of having smaller breasts right now, I look forward to the finish line.

    DIEP was recommended to me instead of TEs due to radiation. I opted out because I wanted my breast size back. It was explained that if I didn't heal correctly after the BMX due to rads I'd have to remove the TEs and remove the entire breast. It was a big risk. So far I have healed nicely and plan to move forward with implants later in the year.

    It sounds like your PS is on target with recommendations.

    I second rah's advice on using extreme caution with your current BS. Perhaps your PS can refer you to a different BS for a second opinion.


  • miriandra
    miriandra Member Posts: 2,071
    edited September 2022
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    Hi StoryLife! I hope you get the end results you want, regardless of how you get there.

    But if you do decide to go flat, know that there is a rapidly growing community of fabulous flatties and uniboobs to support you on your path. Many are working to increase visibility of UMX and DMX, and advocate for aesthetic flat closure (AFC) as a legitimate option for surgery. As Wondering mentioned, you absolutely want a surgeon who is willing to commit to your decision for your body, and has the skills to do a good, clean job. Too many women who wanted flat closures woke up to loose skin, dog-ears, and ragged scarring because the surgeon wasn't on board. Be safe, and all the best!

  • storylife
    storylife Member Posts: 9
    edited September 2022
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    Thank you all! I don't mind being flat, but I don't want a dent on my chest. Can aesthetic flat closure avoid dents? Does breast surgeon perform aesthetic flat closure, or a plastic surgeon?


  • maggiehopley
    maggiehopley Member Posts: 111
    edited September 2022
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    I am 10 days post BMX with flat closure. I did not have a plastic surgeon, just my breast surgeon. I have indentations near the armpit, which I believe is where he removed the "tail" of the breast, but the front of my chest is not concave or indented. It's not "flat as a board" either, but has a tiny bit of shape to it, sort of like a male pec or breast buds on a young girl. It's not saggy or lumpy, just a gentle shape. I know that as I heal the shape might change a little, and I have enough skin that I don't have any tightness across my chest as I move. I was expecting "flat as a board" but I actually really like this.

  • storylife
    storylife Member Posts: 9
    edited September 2022
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    Hi Maggie, thank you so much for sharing your experience. Super helpful! Hope you have a speedy recovery!

  • parakeetsrule
    parakeetsrule Member Posts: 605
    edited September 2022
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    Whether you are concave (a dent) is mostly about your body shape. It's not something controlled by the surgeon, unfortunately. I'm a little concave and I had no idea it was even a thing or that people worried about it until several years ago! It hasn't been an issue at all.

    The surgery can be done by either a breast surgeon or a plastic surgeon. It depends more on the individual surgeon's experience than their title.
  • storylife
    storylife Member Posts: 9
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    Hello everyone, thanks for all your input. I want to provide an update: I decided to go flat in the end. My chest is flat, but relatively smooth. My skin healed well after radiation. It is a little tight, but I do not feel the tightness. I recently went back to see the PS, and he thinks I made the right choice given my body type. I am just glad that I can focus on my treatment without worrying about reconstruction procedures. Thanks all for your support!