What makes you have a reconstruction?

au0rei

I had a mastectomy done and didn't choose implant or reconstruction as I had wanted to get into surgery quickly before Xmas. I didn't want to see a plastic surgeon as it was so close to Xmas and was fortunate my breast surgeon was operating near Xmas.

i see that some of you or maybe most of you had a reconstruction done, implant put in or tissue stretcher? 

I would love to hear why you choose to do that and if there's any benefits medically, besides esthetically. That might help me make some decisions in the near future.

Thanks. xxx

primek

I had a bilateral tissue sparing mastectomy and immediate reconstruction done with tissue expanders. I originally was interested in a flap reconstruction but after discussion with my surgeon and decision of a bilateral an implant reconstruction was a lesser surgery, could be done by my breast surgeon and not only by a plastic surgeon and could be done in 20 days. Any other choice would have meant a delay whilst new referral to plastic surgeon and surgery wait. For me having it done at the beginning was very important. Aesthetically it can be a better outcome if planned from the beginning (but not necessarily) and it didn't mean having to cope with 2 prosthesis whilst I awaited surgery. Whilst I had private surgery I chose public as I felt the gap expense too high. In my mind I always thought if really unhappy with my implant reconstructions I could still revisit a flap reconstruction at a later date. I am thus far very happy with the outcome. The changeover surgery was very minor so the need for replacement at 10 to 20 years doesn't concern me. 

Hopes_and_Dreams

Hi @au0rei, when I was diagnosed with an 13mm IDC on 20/07/16 it came out of the blue.  In that post diagnosis whirlwind everything moved so quickly!  Before I saw my surgeon I just assumed I would have a lumpectomy.  I don't know why, common sense should have told me that wasn't going to work! I'm not big breasted (just a little B cup) and a lumpectomy wouldn't have left too much of me behind if I wanted good clear margins. 
I didn't have enough flesh on me to do a flap reconstruction so that wasn't an option either.
So with those 2 ruled out, my surgeon explained that he could do a nipple sparing mastectomy with an immediate silicone implant. 
I actually thought about going up a cup size but that would have meant additional surgery on both breasts and at that time I just wanted it all over with.  My surgeon warned me that if during surgery it looked like I may need further treatment he wouldn't do the implant.
Fortunately, my cancer was grade1, stage 1 with clear lymph nodes.
It was the right decision for me. Cosmetically, my breasts are a near perfect match and I'm comfortable with how I feel.  8 months later I'm numb and blue spotted from the sentinal node dye but this is now my new normal!
wishing you all the best with your decision.
Jane xx

mum2jj

Hi @au0rei ,
It's a hard question. I just knew I wanted a reconstruction, yes for aesthetics, but also for practical reasons.  I have back problems and I found this was exacerbated with only one breast.  I also live in the tropics and found the prosthesis vert hot to wear in summer.  I also couldn't wear the clothes I liked as my mastectomy bras and prosthesis were often visible through them.  They sound like little things but they were important to me. I was very small breasted and as I wasn't suitable for implants due to radiation damage to my skin I opted for a TRAM flap (tissue transfer surgery).  My new breasts are also small and not quite as nice as my old ones, however they are growing on me.

It's interesting that  you say some or most of us have reconstruction.  It is a really personal thing and in Australia reconstruction rates are actually quite low compared to the rest of the world, lower than 10% in some states. These rates may change now the Australian Government Cancer Australia released a statement on best practice in breast cancer where they say it is "Not appropriate to perform a mastectomy without first discussing with the patient the options of immediate or delayed breast reconstruction."  I

Everyone has different reasons and many choose not to reconstruct, there is no right or wrong, just what is right for you.

If down the track you do choose reconstruction or would like to connect with others feel free to join the choosing breast reconstruction group
Paula

Glemmis

Hi @au0rei, I originally had lumpectomy & then mastectomy. I wasn't offered reconstruction at the same time as I was having lymph node clearance & it was quite urgent. This was August last year. All being well in July I am having the other breast removed & double reconstruction purely for aesthetic reasons. I hate wearing a prosthesis & hate looking at the scar everyday, just want to feel a bit normal. 

melclarity

Hi @au0rei

Certainly a good question! I'm currently recovering from a left breast Mastectomy/Diep Flap reconstruction. My Surgery came 14 months post Chemo, so mine is preventative after a recurrence. I actually couldn't have an implant done as I had done radiation back in 2011 and as a result too of 2 major lumpectomies and a massive scar I did lose a huge disc of skin at the front of the breast. My Plastic Surgeon recommended the Diep Flap as his preferred option and said with an implant Id have to do a changeover in about 10yrs. Having said that I didn't have a choice, but I have to say I'm really happy with the feel of new breast filled with my tummy fat haha!!! its so natural looking and feeling. It was a tough surgery 7hrs doing both plus the tummy surgery but I was glad it was done all in one hit as I couldn't have done the tissue expander etc., Certainly look at all the different stories on Breast Reconstruction for all sorts of reconstruction, the stories from all the ladies are so great and gives you a great insight into their experiences. Hugs Melinda xo

rowdy

Hi I had mastectomy with immediate reconstruction Tramflap with a lift on the other side for me, for me it was a decision I made as I didn't want to wake up with one breast. A very long surgery and recovery time but well worth it as I'm really happy with the result. Thee is never a wrong or a right it is a choice for you to make. Good luck 

au0rei

melclarity said:

Hi @au0rei

Certainly a good question! I'm currently recovering from a left breast Mastectomy/Diep Flap reconstruction. My Surgery came 14 months post Chemo, so mine is preventative after a recurrence. I actually couldn't have an implant done as I had done radiation back in 2011 and as a result too of 2 major lumpectomies and a massive scar I did lose a huge disc of skin at the front of the breast. My Plastic Surgeon recommended the Diep Flap as his preferred option and said with an implant Id have to do a changeover in about 10yrs. Having said that I didn't have a choice, but I have to say I'm really happy with the feel of new breast filled with my tummy fat haha!!! its so natural looking and feeling. It was a tough surgery 7hrs doing both plus the tummy surgery but I was glad it was done all in one hit as I couldn't have done the tissue expander etc., Certainly look at all the different stories on Breast Reconstruction for all sorts of reconstruction, the stories from all the ladies are so great and gives you a great insight into their experiences. Hugs Melinda xo

Hi Mel, what do you mean when you said 'surgery came 14 months post Chemo, so mine is preventative after a recurrence'? Does doing reconstruction and having implant help with recurrence? Sorry I did not quite catch that.

I am very skinny only 48kg now after losing 3kg recently (stress of treatment and tests and diet change) and hardly any tummy fat :splus my breast is small and the mastectomy site...hmmm looks all flat and tight now... i wonder if i ever can have a construction or implant done lol. I might opt to get the right side removed and wear bigger prostheses all my life :Dmy hubby doesn't mint at all. xx

melclarity

@au0rei

So, in 2011 I had Breast Cancer, lumpectomy, radiation and tamoxifen for 4yrs. 2015 I had a recurrence in my scar tissue from the lumpectomy even though I had very wide clear margins and tamoxifen. I had another major lumpectomy as I'm big breasted and my Surgeon said I had no advantage of a mastectomy over lumpectomy. I couldn't do radiation again as you can only do it once, so my only option with 2.5cm tumor Stage 2 Grade 3 aggressive, ER+ only was Chemo so I completed that in December 2015. The day I finished my Oncologist said..now go away and get better 'Oh by the way I want you to think about a mastectomy now as you've had a recurrence already, so twice in the same breast'. This was out of left field. So they said no hurry I was all clear, but they wanted the mastectomy to ensure I didn't have a 2nd recurrence. So that's why it was like 14 months post chemo by the time I did this surgery and of course all pathology was clear. So it was to not gamble again. Hope that makes sense? Hugs M x

AnnaB

I initially had bilateral mastectomies and right auxiliary node clearance over 4 years ago - cancer in both breasts. Followed by chemo and chest wall radiation just on the right side. I swore I would never go near another operating theatre so I wasn't considering reconstruction at all.  2 years ago I was chatting with my radiation oncologist trying to get some guidance on managing my post radiation fibrosis which required constant exercising. Although no studies available to support the theory she said that tissue reconstruction moves non radiated skin and fat to the radiated area and may reduce symptoms of skin tightness etc.  I did decide to undergo bilateral tram flap reconstruction and am very happy. The constant tightness on my right side is so much better. It is a big surgery, I waited for 18 months on a public list  which meant no out of pocket costs, other than lost income for time off work, which for me was worth the wait.

Good to be reminded that for some of us reconstruction isn't just about aesthetics!

Reclaim your curves is a great resource too

All the best Anne

Jane221

Hi @au0rei, I knew I wanted reconstruction once I was told I would lose my breast, but due to a lengthy treatment regime and concerns about what was to happen, parked the idea until I had recovered. I had my reconstruction 2yrs after my mastectomy and during this time lived with the scarred, concave space left after my surgery. I was devastated by how my body looked and although I used a prosthesis during that time, it often fell forward, exposing my chest and I was limited by the types of clothing I could wear. I didn't feel comfortable or happy in my own skin. My relationship with my husband suffered and my confidence plummeted.

The emotional / mental benefits of having reconstruction were enormous for me and was a turning point in my recovery. I think if I had to live indefinitely with just one breast, I may well have descended into a deep depression. Reconstruction hasn't given me a perfect new breast but it did give me some control over the nightmare of my cancer ordeal.

It also had a number of physical benefits including; 1) rebalancing my spine (which is affected by scoliosis anyway) by putting weight back on to the chest. Through the 2yrs without a breast my balance had suffered badly, 2) the DIEP reconstruction which moved my own tissue onto my chest to make a breast has helped to soften the radiation damage (as suggested by @AnnaB ).  

I know that some people around me questioned why I would go through with such major surgery after undergoing treatment but for me it wasn't a question of aesthetics, it was a question of trying to achieve a sense of peace with my body after all I'd been through and to regain a little "normality" so that I could move on. 

primek

@Jane221 Thankyou for your story.

 I agree about the benefits to general health but  I often feel because I chose reconstruction I am being judged for not wanting to tough it out with having scars (well I still have those). Campaigns for bc now show women without reconstruction, which is great, but you almost feel that you haven't suffered the same as you chose a different path. I don't know that I am explaining this well. I often show women my reconstruction not to boast but to show it is possible. Such small numbers of Australian women have reconstruction. ..but so many who don't do suffer physically and psychologically due to the physical trauma caused from the treatment that hopefully saves our lives. 

I attended an YWCA encore program where there were a number of younger women present. A passing comment by the person running it stung me..."I never felt the need to or could see the necessity of having a reconstruction." Hmmm. Unfortunately I can't incorporate her tone here adequately.  Whilst I happily support all women's choices ...I don't  feel you should be made to feel that you are "vain" or "shallow" because you chose the path....or that you suffered less. (hell the surgery is even worse for reconstruction)  I've always prided myself in accepting who I am...I wear little make up, have allowed myself to go grey (which skyrocketed with chemo) and don't spend much money on clothing, cosmetics or even shampoo.

Nobody would suggest if you lost a nose or an ear if they could reconstruct that you shouldn't. The function doesn't really return with those reconstructions either but for psychological reasons it is considered very important. So why are not breasts thought of in the same way?

Just food for thought.

I  hope all women are given the choice to reconstruct or not.  I also hope all women are supported with their decisions either way and also are informed if they are unhappy with their choice it can be reconsidered later, regardless of age.

Afraser

Hear, hear. I didn't want a reconstruction and have never regretted that decision but the notion that anyone, particularly anyone who has lost a breast themselves, would think someone else is vain or shallow for wanting reconstruction is appalling. Be just as daft to say that everyone who doesn't have one is a cowardly wuss who doesn't care about their appearance! Scars we all have, those with reconstruction often have more and some of the worst scars don't show physically at all. Every woman should have the right to choose. And all choices are legitimate.

melclarity

Gee that's odd!! I honestly have never ever looked at reconstruction as being vain, I know for me it had nothing to do with it. Having 1 boob I wouldn't have been able to live with psychologically. It certainly isn't an easy way out either, I know I've lived with massive scars from surgeries and now well its even worse due to reconstruction. The scars don't bother me in the slightest, I don't even care about if they fade, I've never looked at the care of them strangely. I have friends who haven't reconstructed, its such a personal choice, but I certainly wouldn't take it as it meaning because I chose reconstruction that I wasn't toughing it out, that it is tougher to just have a mastectomy and leave it. I honestly have never ever thought about it like that at all ever. I would have just taken that ladies comment of 'not feeling the need to' as a personal choice for her. 

LOL I do wear makeup not a lot and I do colour my hair, but I'm a real girly girl and I enjoy these things, its personal, doesn't make me vain LOL. 

Certainly interesting Kath, I guess everyones perceptions of things. x

primek

@melclarity ...most women colour their hair, lol. I'm actually too lazy for most of those things, but I like what others do. As I said it was the tone, and inclusion of the word "necessity"  ..not just the comment that suggested she meant otherwise.

melclarity

Aaah I see, I guess it's interesting isn't it how we are all different. Each to their own I say, we are all united under the same horrible umbrella aren't we? I actually don't think about it at all, I like hearing other peoples decisions, theyre all so diverse.