Reconstruction options

dtseibert

My wife has finished six months of chemo and immunotherapy and scheduled for a mastectomy at the end of the month, to be followed by up to six weeks radiation.

We have discussed reconstruction with both the primary surgeon and a plastic surgeon. Quite frankly, these have been good discussions, but we still feel confused as to best practice for my wife's condition.

Her oncologist's personal perspective is not to do an implant now (though the plastic surgeon said it was the way to go). We are feeling that it's wise to go treatment step by step and to get through radiation first. We know about the tissue expander, but have conflicting comments from our research.

What we want to hear from other experiences if not having a tissue expander placed during the mastectomy precludes a later reconstruction? Anyone have experience with this approach?

PS, my wife was diagnosed with stage 3 triple negative BC. After the chemo/immunotherapy process, there has been significant reduction in tumors, but as we were always told, the surgery and radiation were going to be part of the necessary treatment.

If anyone could share their experience and advise, we would be very appreciative.

exbrnxgrl

dtseibert,

Let me say that I’m sorry for what brings you here. Reconstruction choices are personal and there are pro and cons to different approaches. Additionally, there are no guarantees as to outcomes. You can read anecdotes, retrospective data, etc. but none of those things are predictive of how your wife will do.
I did not have the type of recon your wife is considering. I had one step implants, no TE’s, but this is not as common a procedure. Best of luck to your wife with whatever decision she makes.

ratherbesailing

dtseibert -

Sorry you and your wife are going through this, the options can be overwhelming.

I had a tissue expander placed during mastectomy, followed by radiation, and DIEP surgery seven months later. The idea was that the tissue expander would stretch my skin enough to enable a better cosmetic outcome, with the breast/chest skin aesthetically matching. In the end, though, my radiated skin was too fragile and the plastic surgeon used my abdominal skin instead to place over the new breast mound. As a result, I have an elliptical patch of skin covering my breast that is somewhat lighter than the surrounding chest skin (I was not a bikini girl in my youth!) It is not perfect, but evident only without clothes.

I am guessing - and only guessing! - that this is why your oncologist is saying don't bother with the TE. And everyone's skin - and experience - will be different. So please take this only for what it is, an anecdote. But I'm hoping it might help you drill down to find more clarity from your providers.