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Sep 27, 2007 04:01PM
I had a double mastectomy at 29 - I wanted it at 26 but was told I was "too young". Mine isn't for genetic, I have other risk factors. I had a skin-sparing mastectomy with implant reconstruction and kept my nipples. This means they kept all my skin, just scooped out the breast tissue behind it (I still have 3mm of breast tissue just behind the skin so still a tiny risk), lifted up my chest wall and put the implants underneath and then stitched me back up again. Because I'm small-busted, I was able to have fixed volume silicone implants straight away with no need for expansion. This means I don't have to have another operation to exchange the expander implants to permanent ones. My incisions are in a different place from most prophylatic cases because I was having tumours removed.
I know some women decide to have their nipples removed - by keeping them, you have a slightly higher risk of bc than if you have them removed and there is also a risk of the blood supply dying during the op so you lose them anyway. There is a much lower risk of this in younger women, particularly if you're fit and active and don't smoke. Basically, the surgeon scoops all the tissue away from the back of the nipple before replacing it. You're left with the veins and blood supply still attached but no tissue. Some surgeons like to cut around the nipple, mine left mine attached to the rest of the skin flap while he removed the tissue. If you lose a nipple or your surgeon recommends you have them removed, there are techniques to reconstruct it. This involves making little incisions and twisting the tissue round to form a point, then tattooing (under a local anaesthetic) to make them "nipple coloured".
In terms of activity, I started on basic physiotherapy 3 days after the operation - I was in hospital for a week. By about 10 days post-op, I could pretty much raise my arms right above my head. I wasn't allowed to carry anything or lift for 6 weeks post op but once that was over, I was given the all-clear to do what I liked, which included swimming (but I haven't been yet!) :)
Choosing implant only means you don't risk disability, which you can get particularly with LD recons. This was particularly important to me as it seems to be for you. Although I am still quite tired from the operation and I don't quite have my full strength back, there isn't really anything that I can't do.
Few things to consider: you "new" breasts will look different from you old ones. My implants don't move at all - they're just there, almost stuck onto my chest. The implants are a lot wider than my natural breasts - although they look very similar in clothing, I'm finding it difficult to get bras in my new size. You loose sensation on your breasts and your nipples - mine still react randomly to cold but are mostly numb. You won't end up with "Hollywood Boobs"!
However, I suspect that you are already aware of these things and, like me, have decided that life is far more important than having cosmetically perfect "natural-looking" breasts. Good luck and feel free to ask if there's anything else you want to know :)
Incidentally, there is a young woman called Jackie Mac who was on a show called Dr 90210 - she had a prophylatic mastectomy at 18 so it's not impossible... the younger you are, the easier it is to recover from operations and the better quality your skin is so it makes for faster healing.