Reconstruction Decisions
I was just diagnosed with Invasive Ductal Carcinoma. Two masses in my left breast. One being less than a centimeter from my left nipple. I can accept that I will need a mastectomy in my left breast, but I'm having a hard time accepting that I will lose the nipple. Does anyone have experience with reconstruction of their nipples? I'm also trying to decide if I should just go ahead and have the right breast removed (which is perfectly fine BTW) just for symmetry. I'm so grateful I found this group.
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Hi @borednika -
Welcome to the forum! We're sorry you have had to join our 'club', but glad that you have found us.
Regarding nipples. I have been dxd with bc twice….first in my right breast and nearly 20 years later ( a new cancer) in my left. Each time I had a mastectomy. The 1st time saving the nipple wasn't really being done by anyone. The 2nd time, like you it was too close to the nipple so no choice to keep it. The procedure to create the nipple is the last thing (usually), once you are done with reconstruction. It is a pretty simple procedure where they pull up a piece of skin and create a nipple. You then can have it tattooed with an areola or actually some people do something creative. Also, there is an option not to create the nipple with skin, but do a 3D tattoo. I have no experience with that. The first areola years ago was done by my PS. It faded within just a couple of years to the point of disappearing. My 2nd time it was done by an esthetician who was recommended by my PS. Much has changed and I am very happy with the result. She also did my first one to match. It may need touching up in a few years, but it's much better than the first time.
Regarding removing the other breast. It's a really tough decision that only you can make. I did not do it and was happy to keep my other breast for nearly 20 years. The PS did a reduction to that breast to make it match. I don't regret that decision even though maybe I would have avoided a 2nd dx. No one knows that. Something to consider is that if you are planning on doing a DIEP flap, that can only be done once, so if you are later dxd in the other breast you will need to do a different type of reconstruction. In my case, I had a TRAM flap the first time (earlier version of the DIEP). So, I did a LAT Flap (with no implant) the 2nd time. If you are planning on doing implants, a good PS can likely make it match the other breast pretty well. After all, even people who have never had bc don't always have breasts that match well. 😊
Regardless of the decisions you make, know that once you make them, they are the RIGHT decisions for you! No 2nd guessing. Follow your gut.
Take care. We are here for you to help you on this journey.
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Agree you have to decide what is best for you. I tried lump and then had to more to take more before they it had to go. Did one side though since other side was ok since wanted it to be one side that was 'me before cancer. I chose implant and nipple sparing for me since could do that but know for those who lost theirs they did do tattoos there as well for them so they looked realistic. He offered to do a lift and reduction on the other side to make them match but did not care that point. I was glad for my decision. Know others who had surgery at the same time with more risk for recurrence who chose to take them both off for their own piece of mind. Some stayed flat as well and did no reconstruction. Best wishes and know the decision is not an easy one to make. You have to be at peace with what is best for your own health and piece of mind.
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