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Reconstruction?

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I am 56 years old, and I am going to have a mastectomy on my left breast soon, but I am considering going flat. I just want to get the surgery done, recover, get through any cancer treatments, and see how I feel. I don't want to have to worry about a longer surgery time, multiple surgeries and/or complications. Is there anyone out there who made this same decision and has come to terms with having one breast? I want to try out a prothesis and go from there. Any advice? Insights? Thank you!

Comments

  • lw422
    lw422 Member Posts: 1,411
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    Each of us is different when it comes to deciding what surgery to have. I am 3 years out from a single mastectomy and I'm ready to schedule a consultation for a prophylactic mastectomy on the "good" side. I recently went through a scare and had a stereotactic biopsy on a suspicious area of my remaining breast and I am tired of worrying about it, and tired of having mammograms on that side.

    Also, I HATE having one "DD" breast. Nothing fits right, I hate the prosthesis, bras are a nightmare,… just aggravating. I am grateful to be alive but sometimes the crap cancer leaves us to deal with is just overwhelming. Going flat and never wearing a bra again sounds heavenly to me. Good luck with whatever you choose.

  • alexandra86
    alexandra86 Member Posts: 7
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    Thank you for responding! I was only diagnosed 11 days ago, and I am overwhelmed by everything! Every summer I have a new hobby, and I didn't expect hat this summer, it would be breast cancer! Anyway, next week, I meet with the surgeon, and it sounds like they want a decision on whether or not I want to do reconstruction. Still my intuition tells me to wait on reconstruction…

  • lw422
    lw422 Member Posts: 1,411
    edited July 5
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    Oh my goodness, bless you. You are in those early days of being bombarded and overwhelmed. It will get better as you settle in with a treatment plan. My cancer is/was IBC (inflammatory), so I was not given the option of a double Mx because of the "IBC Standard of Care." (IBC patients have to wait on any additional surgery or reconstruction.) I wanted both of them GONE but had to wait.

    Many people do fine with a single breast so it's hard to say what your outcome will be. Seems to me that smaller breasted women do better with a "uniboob" because they aren't as lop-sided. You may be wise to have the cancerous side removed and see how you do with it. You always have the option of having the prophylactic Mx later if you decide to.

    Edit to add: It just occurred to me that your surgeon will want to know if you are considering reconstruction because that will determine how much skin they will leave during surgery. People who choose to go flat usually opt for the "aesthetic flat closure" which leaves the chest smoother with no excess skin or "dog ears."

  • girlnamedmaria
    girlnamedmaria Member Posts: 3
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    Hi! Thanks for starting this thread. I came today to ask something similar. I’m a month past a bilateral mastectomy with tissue expanders, and I’m still undecided as far as reconstruction options are concerned. (I’m also still awaiting my oncotype score so I don’t know yet how further treatment will delay reconstruction, and I’ve gotten two saline injections into my expanders so far.) I’d love to hear from other women as to how they decided to go with implants/autologous reconstruction/no reconstruction. I definitely sympathize with the difficulty of the decision — for me it’s been the hardest decision b/c it’s just up to me! As to treatment decisions, I can follow my doctors’ recommendations, but it seems like there’s no real pointing in one direction or another for reconstruction. I’ve tried pro/con lists, but I would love to hear from women who have shared their “why’s” for choosing a reconstruction option over another, and how they feel after their surgeries. I’d be interested if anyone feels like sharing!

    I’m currently leaning towards implants myself to be able to move on and be done (for the moment), and I am a bit spooked by the intensity of DIEP flap surgeries, though I handled my mastectomy surgery pretty well (fine with anesthesia, no pain or nausea). That said, I’m 40, and I don’t love the idea of having to switch out my implants after so many years (God willing). Perhaps I should go for the flaps while I’m younger and have the support to be able to handle the recovery now.

  • dimples90
    dimples90 Member Posts: 16
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    girlnamedmaria,

    I agree with you in that reconstruction decisions are difficult. Unfortunately, my reconstruction path was 3 years long.
    I had implants, Lat Flap and finally DIEP surgery.
    The main thing (in my opinion) to consider is the effects of radiation on your skin. Implant reconstruction becomes more difficult after radiation.
    I don’t know if radiation is in your treatment plan.
    Implants are easier surgery than DIEP. However, like you said, implants may need replacements later.

    I had DIEP surgery when I was 57. It was a long surgery and more difficult recovery than implants but I have no regrets! Love the softness and warmth of my breasts.
    The main thing that you really need to consider with DIEP is the experience of your plastic surgeon. Ask for photos. Just make sure to do your homework in that dept. It’s very important to make sure your PS has a lot of experience doing DIEP. You might consider traveling if you can’t find a PS in your area.

    You can always get implants now and opt for DIEP later if you are not satisfied.
    Good luck!

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,072
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    The main thing to consider (other than health limitations) with ANY reconstructive surgeon is to see photos. Whether DIEP, implants, lat flap, tram flap, etc., you should definitely check out their work. Best of luck with your decision.

  • tb90
    tb90 Member Posts: 284
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    Hi Alexandra86: This is such a personal decision, but you asked for others experiences. I was your age 11 years ago and had a mastectomy. Like you, I just wanted to get the surgery over and recover and get back to “normal” as fast as I could. I never considered reconstruction for a minute. I am very active and was rowing a canoe six months later. I have never regretted my decision and do use a prosthetic. I am in Canada and we get fitted for bras and prosthetics by a specialist and qualify for new ones every year. I think having a great surgeon and proper fittings really helps with aesthetics and comfort. This is strictly my experience and not a recommendation for you or anyone else. Good for you for exploring all your options. All the best with whatever decision you make!

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,072
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    As a great illustration of how different we can be on out thoughts on reconstruction, I never imagined not having recon! Granted, I knew next to nothing about the various options so I knew I would decide after speaking with the plastic surgeon. My objective was for recon to make me look as much as possible like my native breasts. I also knew that I wanted to simply put on my bra and carry on as usual. I was also a bit squeamish about other parts of my body being used for surgical sites so I was already leaning away from those types of recon. As it turned out, my ps (very experienced in DIEP and other flap surgeries) felt I was too thin to those types of surgeries. I’m kind of scrawny 🤷🏻‍♀️. Based on pre-surgical assessments, it seemed likely that I would be able to have a skin sparing mastectomy so he offered one step implants, no TE’s! He did caution that he would bring TE’s into the OR in case he didn’t like the way the permanent implants looked. He went with the one steps and once I was healed, everything felt as close to “normal “ as possible given the circumstances. 13 years later and I know it was the right decision for me.
    I think if you can articulate what you want to feel like or how you want to relate to your body after surgery, this might help. It also helps to have a good understanding of what each choice entails.
    All the best as you go through this process.

  • abigailj
    abigailj Member Posts: 104
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    I didn’t think my body would tolerate anything that wasn’t autologous so went with immediate DIEP recon. My BS and PS both said you get Bette aesthetic results if the DIEP is done as a single surgery with the BMX. I never considered not having recon. Yes, it was anlong surgery and recovery was tough for me (was a 62 year old former smoker so had wound healing complications) but very happy I made that choice 4 years ago. As others have said if you opt for any recon make sure your PS had lots of experience in doing whatever recon you choose and shows you pix as well. Wishing you good healing!

  • laughinggull
    laughinggull Member Posts: 517
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    Hi,

    Very personal decision for sure. I also wanted to be done as soon as possible, avoid years of surgeries, and keep things simple. I was also very accepting of having lost one breast.

    Then, on second thought, after having a better idea of what I would look like with one breast only, I knew I would prefer to have the option of wearing some kind of prosthesis, rather than not. Then, when I looked closer at the prosthesis thing, dealing with that felt to me, personally, given my lifestyle, royally inconvenient. I was (and still am) working, have to dress up a bit for work, and I am very active and a swimmer. Needing special bras for the prosthesis, having to put in on and take it off several times a day -I would rather not deal with that. I thought of an implant as the closest thing to having a prosthesis that is permanent, that you dont need to put it on and take if off, and that works with any bra. That's what I did, and I never regretted the decision (later down the road, I needed a second mastectomy, so another implant); my breasts look obviously fake (when I am naked and/or with light clothes) but I look more or less normal when dressed or in a swimsuit, and not under close scrutiny. One month to the day after the mastectomy, I was back in the swimming pool and could swim all four strokes. I swam with the tissue expanders, and I swam with my implants one month after I got them. Besides running, biking and weight lifting. I am super happy with my decision, in peace with not having breasts, and also very thankful to not have to deal with special equipment when I need to dress up, and I am glad I can walk around the pool deck in a swimsuit looking more or less like the rest of my swim teammates.

    Best of luck with your decision,

    LaughingGull

  • ann5631
    ann5631 Member Posts: 1
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    I am 58 and had my mastectomy on my left breast at the end of Jan. I opted for no reconstruction. I did not want to go through more surgeries and more recovery, because I opted for no reconstruction, my recovery after the mastectomy was fairly easy and quick. I have been very happy with my decision, but I also know that I could choose to have recon done at a later date.
    My custom prosthesis looks great. You are able to wear regular bras with your prosthesis - they don’t need to be special bras. I wear both. No matter what type of bras you choose to wear- it’s some trial and error to find ones you love. The person who worked with me for the prosthesis and bras was amazing. Very helpful and caring. She had so many helpful tips ans recommendations.

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,072
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    I know that people talk about multiple surgeries but for those who have skin sparing mastectomies and don’t want to increase their size, one step implants can be an option. My understanding is that you have to be a good candidate for this and your surgeon needs to be experienced in this type of recon. I had a bmx with one step implants, no TE’s. Literally one and done. 13 years later and it’s all good.

  • alexandra86
    alexandra86 Member Posts: 7
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    Thanks for everyone for the responses. I meet with the surgeon to make a plan tomorrow morning, and I am still undecided. This is not easy! I wish my health and life wasn't literally on the table! Then, it might be easier to make a decision. I had no idea that there were so many choices. Again, I am still leaning towards no reconstruction, at least for now. It just feels like me. I will let you know what my surgeon has to say. Thank you for all your support!

  • moderators
    moderators Posts: 8,287
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    Hello @ann5631, and welcome to the community! Thank you so much for sharing your experience and tips about prostheses and bras. We're super glad to hear that your recovery after surgery was smooth and that you’re happy with your decision. Feel free to share more about your story or ask any questions you might have. We’re all here to support each other!

    Best wishes,

    From the Mods

  • girlnamedmaria
    girlnamedmaria Member Posts: 3
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    Agreed! Thank you @alexandra86 for posting your question and sharing your thoughts! I’m so appreciative of all the folks who responded for sharing their experiences and thought processes here!