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Topic: Breast Reconstruction Experience

Forum: Breast Reconstruction —

Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: May 26, 2021 09:42AM - edited May 26, 2021 09:31PM by Aram

Aram wrote:

Hi everyone,

I need to decide whether I want breast reconstruction or not. So far I have been leaning heavily toward going flat because I don't want to have foreign objects in my body, but more importantly I don't want to have multiple surgeries. I am not a candidate for DIEP. But these days I am kind of questioning my objections. I am coming to terms with the foreign object part. But I am still concerned about how much maintenance there is after construction. how often did you need to go into surgeries for them? What was your overall experience with reconstruction? Will you choose to do the same given the chance?

Thank you.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/10/2021 AC + T (Taxol) Targeted Therapy 6/2/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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May 26, 2021 07:20PM Yuuki wrote:

Hi Aram,

I had silicone implants for 16 years until I had a local recurrence followed by radiation that caused painful capsular contracture on the radiated side, so I had the implants out and replaced with autologous tissue (DIEP procedure). I have been generally fine overall with both.

You say you're not a candidate for DIEP, but don't mention why. At the time of my first diagnosis I probably wasn't either (it was a rare new procedure then, TRAM being more common, but I didn't have a lot of spare tissue to work with in either case). However, things can change a lot between initial reconstruction and the time you would need a replacement set of implants: you might become a better candidate for autologous tissue surgery, or new surgical techniques may come along that make the procedure more possible or palatable - so it may be on the table for you at another, later time. I was a better candidate for the autologous tissue by the time I would have needed an exchange.

If you do need an implant exchange later, I am told it's a pretty straightforward procedure.

As to the maintenance and the feel, the implants were fine up until I had the radiation-induced complications. On my chest, I wasn't terribly conscious of having a foreign object in my body - in fact, there wasn't a lot of feeling there at all. To the hand, they felt a bit firmer than the real thing, a bit flatter up front, and not as warm, though none of this troubled me. The surprise bonus was the bra was built-in and I could simply wear a cami (or even nothing at all) under my clothes and no one was the wiser. I did put on around 10-15 pounds during the intervening 16 years and pregnancies, and it was nice to have something up top to balance out a bit of belly pooch.

Would I do it over again? Yes, even knowing I would end up with the DIEP down the line (I am also very happy with that, though I can't get away without the bra any more). For me, being able to wear most clothing without alterations would have been a bonus to "going flat" - dresses, jackets, and blouses are usually designed with a bit of something built into the assumptions. But your mileage may vary.

Hope this is helpful! Best of luck to you,

Yuuki

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May 26, 2021 07:56PM exbrnxgrl wrote:

Aram,

Although it’s good to hear the experiences of others it’s not useful as a way of predicting how you might do. I did not have enough tissue on my stomach for DIEP and was not crazy about the idea of two surgical sites healing at the same time.

I have a skin sparing bmx with one step implants, no TE’s. I have had no further surgeries and that was almost 10 years ago! At the time, of course, I had no way of knowing that my one and done surgery would be successful so was fully aware of the fact that additional surgery might be needed. My ps had a lot of experience with one steps and I tend to heal quickly and without complications. Yes, I would do it again if the same good outcome could be guaranteed but the problem is that there are no guarantees. All the best with your decision.

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole) Hormonal Therapy Aromasin (exemestane)
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May 26, 2021 08:04PM bcincolorado wrote:

You can meet with the PS and they can give you all the options available. You have to decide what is best for you.

I had a one sided mx done on my cancer side and he said he could reduce and "lift" so I would match at the same time. I personally chose not to do that. Am I lop=sided? YES! Do I care? NO!!! I wanted one side to be "me" totally if I could that was marred by surgery as long as I could. My choice. With a fitted padded bra no one can tell.

Dx 8/2009, IDC, Left, 5cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 1/6/2010 Lumpectomy: Left; Lymph node removal: Left Hormonal Therapy 1/14/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/29/2016 Femara (letrozole)
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May 26, 2021 08:11PM Monarchandthemilkweed wrote:

I just had a bilateral skin sparing masectomy with tissue expanders. I too was hesitant about implants. I’m a very natural person meaning I don’t wear make up, I don’t color my hair etc. the thought of having “fake boobs” upset me. I never desired any cosmetic surgery. I was not a candidate for any of the flap type procedures. So I decided to go with implants and if i hate them we can always come up with a second plan as my plastic surgeon says. I had considered aesthetic flat as well as I am very active and was concerned implants would make lifting weights difficult. I also have anxiety about drs and appointments etc. and have been blessed to only have been in the hospital when I had my babies My only surgeries were c sections

well I am two weeks post surgery and my tissue expanders were placed and filled a little. Probably I am an A cup. I used to be a C. Depending on my weight sometimes a D. I have to tell you in looser shirts I appear flat. In fitted shirts I look better ans you can see I have breasts. At this point a lot of my cute summer clothes don’t really fit. Ive made a lot of my clothes and it saddens me to know I made these dresses and tops to fit my natural breasts perfectly. I wonder if they will fit again. I really don’t like appearing flat. This surprised me. It’s so hard to know how you will feel in any of these situations. I am healing very well from surgery ans looking forward to my fills.

Good luck in your decision. It’s hard. I know.

Sarah, Chek2 positive Dx 3/11/2021, IDC, Left, <1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/9/2021 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 6/27/2021 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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May 26, 2021 09:46PM - edited May 27, 2021 09:33AM by Aram

Yuuki, thank you for your reply. It is good to know that you disn't have any issues for 16 years. As for DIEP, the PS mentioned something about me being very thin. At the time I was sure I will be going flat so I didn't ask any questions.

exbrnxgrl, thanks. That is one of my concerns that there are no guarantees but seeing women on this community I am more and more leaning toward the fact that it seems complications are not that common and from different threads I have gathered mostly womem are happy with their implants.

bcincolord, I have seen my PS back in February, less than a week after I was diagnosed. At the time I was very shocked, and I was sure I just want to be done with my breasts by "going flat" so I didn't ask many questions. Since then, I have changed my SO, and he mentioned it might be good to think about it again.

Monarchandthemilkweed, it is like you have written some of my reasons. In the same way I have had a very natural look, very little makeup, etc so it seemed like not me when I thought about implants. But now I am questioning that assumption. It is good to hear you are healing well :)


Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/10/2021 AC + T (Taxol) Targeted Therapy 6/2/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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May 26, 2021 10:51PM trinigirl50 wrote:

I had double mastectomy, straight to tissue expanders and then chemo and radiation and then exchange to implants. Unfortunately my radiated breast tightened and lifted so I have lopsided breasts. I am too thin for diep or any other surgery involving my own tissue.

I have pain mainly due to the removal of my lymph nodes and my breasts are certainly not real looking. In fact, I don't like them very much BUT at the very beginning after my surgery, the fact that I had a shape still (the expanders were not completely flat) made me feel more normal and less as if I had been mutilated. And I definitely would do it again. I prefer lopsided, numb fake breasts to flat scarred chest. I don't wear makeup and waltzed around with my bald head quite happily during chemo but in fact I was surprised at how much it mattered that I was not flat as a board.

I think that it's better to have them in because you can always remove them if you decide to go flat later. I didn't have any particular complications apart from during chemo (the chemo hated my expanders and they swelled up and skin turned purple much to the amazement of my surgeon and oncologist - and me!) but it passed with a round of antibiotics and didn't change anything in the grand scheme of things.

Anyway, I am glad I have implants six years later because now I am in menopause and my hips have widened so it's nice to have breasts to balance them out. Lol.

Good luck.


trinigirl50 Dx 3/7/2015, ILC, Left, 6cm+, Stage IIIC, Grade 2, 20/24 nodes, ER+/PR-, HER2- Surgery 3/7/2015 Lymph node removal: Underarm/Axillary; Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 4/13/2015 AC + T (Taxotere) Hormonal Therapy 9/14/2015 Arimidex (anastrozole), Femara (letrozole) Radiation Therapy 10/1/2015 Whole-breast: Breast, Lymph nodes
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May 27, 2021 08:37AM SummerAngel wrote:

I was too thin for DIEP as well so I went with implants. My surgeries are listed in my signature, and I haven't had any complications or a need for any more. I wasn't thrilled with the idea of implants, either, but I'm very happy with them. Emotionally it helped to feel like I still had breasts after my surgery, even if they weren't real.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/27/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/3/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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May 27, 2021 11:16AM - edited May 27, 2021 11:22AM by naps

I had a skin sparing UMX with TE placement for an eventual planned lat flap. Was not a candidate for implants alone or DIEP (and probably wouldn't have wanted those things anyway). I got all the fills, but in the end just didn't think it was worth proceeding with recon. My skin was very thin, and I ended up really wanting to avoid future lengthy surgery/recovery, implant exchanges, surgery on the other side, etc. I also was concerned about the risk of pain syndromes, which are not uncommon. After three years, I went flat on one side, and I have been very happy with this decision and much more comfortable. I am about a B and have found a prosthetic to work well under clothing. It's a cost/benefit analysis, different for everyone, and I was someone who just didn't care very much (or enough to warrant the costs) about having the appearance of a breast with my shirt off (and neither did my DH). Best of luck making this very personal decision.


Dx 3/2016, ILC, Left, Stage IIIA, Grade 2, ER-/PR-, HER2+ Surgery 8/10/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Left Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy Breast, Lymph nodes, Chest wall Targeted Therapy Herceptin (trastuzumab) Targeted Therapy Perjeta (pertuzumab) Chemotherapy AC Immunotherapy
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May 27, 2021 12:06PM Yuuki wrote:

Hi Aram,

I forgot to mention (though you will see the issue on these boards if you search on it) that my only option with the implants was sub-pectoral, meaning they went behind the muscle as opposed to lying on top of it. I am told this can make a difference in the feel. I was comfortable with the sub-pectoral positioning, but it seems people have had a positive experience with pre-pectoral implants. Like every other choice we make, I am sure it has its benefits and drawbacks. But I wanted you to know that it may have affected my experience of implant reconstruction and you will no doubt want to hear from others who did it the other way.

Yuuki

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May 28, 2021 02:41PM Aram wrote:

Thank you everyone.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2+ (IHC) Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2+ (IHC) Chemotherapy 3/10/2021 AC + T (Taxol) Targeted Therapy 6/2/2021 Herceptin (trastuzumab) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Surgery 10/6/2021 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right)
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May 31, 2021 10:19PM karen1956 wrote:

I've had these implants for 13 years - two fixes prior but the second was mostly I didn't like the size - been happy with these - no maintenance at all Mentor Silicone mid profile

Karen in Denver, Dx 02/03/2006, ILC, stage IIIa, ER/PR+, HER2-,
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Jun 1, 2021 10:40AM OnTarget wrote:

I had a BMX and went for implants. I've had a number of surgeries:

1) BMX, TE's placed

2) Exchange surgery

3) Revision

4) Infection and explant of 1 implant

5) New TE placed

6) Replacement for leaking TE


I will have to have a 7th to have the Exchange surgery.

Now all that being said, I could have stopped at #2, but I was not happy with my implant shape because my tissue capsules were too tight and making them look flatter.

I'm not unhappy with the experience, and I was flat on 1 side for 6 months after the infection, and I didn't care for it. I didn't mind walking around without a prosthetic, but I just hated the way it looked (flat/concave) for the long term.

I would absolutely do it again. My fake boobs aren't perfect, but I like the one well enough, and if they match I'll be content.

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 2/15/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Surgery 3/30/2020 Reconstruction (right) Surgery 11/6/2020 Reconstruction (right): Tissue expander placement Surgery 6/1/2021 Reconstruction (right): Tissue expander placement
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Oct 18, 2021 09:55PM Maryjogee wrote:

OnTarget, I appreciate your post and feel Im in a similar boat. I was 10wks bilateral implant post-op, doing great and had a tiny fissure in my left incision, hit by a big infection, bug still unidentified and culture continues (I am currently 3 wks post emergency explant). Just finished 18 days IV antibiotics and contemplating next step. Ive had 5 surgeries in 12 months, a couple not breast-related. Think I will go for a 6 mo hiatus, ordered or not. Im concerned about another infection but am going to try again. I really liked my implants. What was your bug and what protocols (antibiotic, etc) will you follow for your exchange? Many thanks!

Dx 8/2017, LCIS, Both breasts, 1cm Dx 8/2020, LCIS, Right, 1cm Surgery 4/13/2021 Mastectomy: Left, Right Surgery

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