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Topic: Mastectomy with simultaneous Reconstruction

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Jun 18, 2020 09:20PM

blessed2bHis wrote:

Considering implant reconstruction during mastectomy... please share share pros and cons. Thank you!

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Page 1 of 1 (9 results)

Posts 1 - 9 (9 total)

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Jun 19, 2020 06:01AM ajminn3 wrote:

I had a BMX with direct to implants and so far have been really happy with it. I wanted the minimal amount of surgeries possible due to having small children and an active job. My recovery was easy and I generally like the look of my breasts. I went smaller (from DD to B), which I like. The downside is that I will eventually have to get the implants replaced. Also, I just started radiation and am curious how that might effect my implant on one side (didn’t realize one sentinel node was involved going into BMX which put me on the chemo/radiation plan)

Dx 12/2019, DCIS, Left, 6cm+, Stage 0, Grade 2 Dx 1/2020, IDC, Left, <1cm, Stage IIA, 1/3 nodes, ER+/PR+, HER2+ Hormonal Therapy Aromasin (exemestane), Zoladex (goserelin) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Jun 19, 2020 08:44AM bcincolorado wrote:

I had a one-side mx done with immediate tissue expander put in place to avoid an additional surgery later.

I could have opted to "reduce and lift" my non-surgical side to match but chose personally to leave it as "me" so I am totally lop-sided.

I was already almost 50 and long married and grown kids. If I had to do again, I honestly do not know if I would have done it at all. Many women remain flat too.

Most of the time I prefer to not even wear a bra now at all because not comfortable for me and use a "cover jacket" for nipple coverage since I had skin sparing and nipple sparing and have those on both sides.

Most people who do expanders done and implants as reconstruction begin when they safely can. You should talk honestly with your breast surgeon and your oncologist about treatment before you can decide what is best for you.

Best wishes for your surgery.

Dx 8/2009, IDC, Left, 5cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 1/7/2010 Lumpectomy: Left; Lymph node removal: Left Hormonal Therapy 1/15/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/30/2016 Femara (letrozole)
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Jun 19, 2020 12:08PM exbrnxgrl wrote:

Are you considering TE placement during your Mx or did you mean one step implants ? One step implants are less common and generally only done if your Mx is skin sparing. I had the one step procedure almost 9 years ago and have been quite pleased. My plastic surgeon had a lot of experience with the procedure. If that’s what you’re interested in make sure to find a plastic surgeon with experience. Wishing you the best.

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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Jun 21, 2020 08:48PM pegasus68 wrote:

I had nipple-sparing PBMX with direct-to-implant (pre-pec) one-step procedure about 6 months ago. I just wanted to have one surgery and be done with it. One potential complication with this procedure is nipple/tissue necrosis - I did have some issues with necrosis and had to use nitroglycerin cream but was fortunate that in the end everything healed up beautifully. So far I'm pretty happy with my outcome, although I do have some rippling for which I might have fat grafting done at some point.

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Jun 23, 2020 10:22PM DiveCat wrote:

I did a one step (PBMX, nipple sparing, direct to implant, subpectoral, Alloderm slings) in 2014. It was still not that common outside of certain areas then, but I was a good candidate and my PS was comfortable with it. No issues and smooth recovery though it did mean I lived through that weird tightness with implants “all at once” before they settled rather than adjust with expanders. I stayed same size (30E/32DD). I did switch to 410s a year or so later, and back to rounds again last fall, but not due to issues with going direct. My nipples survived just fine, etc


My sister tried to do one step nipple sparing pre-pectoral late last fall - very experienced surgeon, but during surgery they can concerns about blood flow to nipples/breasts so did left her flat for 3-4 weeks before she went back in to place implants. Just something to be aware of - choose a surgeon who will do what is best for your tissues at the time of surgery.

Hereditary High Risk, Uninformed BRCA Negative Surgery 4/23/2014 Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 3/11/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/13/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 5/27/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Jun 24, 2020 03:48AM - edited Jun 24, 2020 03:48AM by Moderators

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Jun 24, 2020 06:03PM KarenJohnson wrote:

I would not recommend it. So many of us have to have ex-plants because of problems with pain, etc. If I could do it all over again I would do DIEP (which I have coming up) or just go flat. There are no good options, but I think implants are the worst option. Toxic and painful.


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Jun 24, 2020 06:31PM MBPooch wrote:

Had a great experience with my BMX with direct to implant. My plastic surgeon was very experienced in the procedure and that piece was super important to me. I liked the idea of having both surgeries done at the same time with one recovery. It will be 3 years in Nov and they look and feel great! I had a little scare last week with some soreness on one side but got MRI results back today and everything looked perfect, phew! Attributing it to some extra hard workouts. Do what you feel is best for you! I was 45 at the time of diagnosis and haven't regretted my decision for a second.

Dx 10/16/2017, DCIS/Paget's, Left, 1cm, Grade 3, 0/3 nodes, ER+/PR+ Surgery 11/29/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jun 24, 2020 07:03PM exbrnxgrl wrote:

I agree with finding an experienced ps if you consider one step implants. Mine are almost 9 years old and I haven’t had a single issue with them and I pretty much look the same as before my bmx.

I’d also like to point out that regardless of what type of recon one chooses, most folks who are happy with their outcome tend to stop posting. People tend to post more when having problems or when they’re unhappy about something.

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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