Implant Question

Mjames

Hi Ladies,
I'm wondering if I could get some advice please- 
I am nearly finished my chemo and need to make a decision about surgery. I am eligible for a lumpectomy and was going down that path until recently. I am now thinking of having a skin and nipple saving double mastectomy. I'm 40 and although my doctors are telling me that a lumpectomy is the way to go I just don't know if I can cope with the constant worry and tests in the future. I do tend to have lumpy breasts and they are a DD size. 

I spoke to a breast surgeon yesterday who said they could do a skin and nipple saving surgery with immediate implants which sounds good but I will need to stay around the same size. One thing she mentioned was as I am of a fairly small frame ( short & 50kg) the implants may feel really heavy as opposed to my real breast. 

It's such a big decision, if anyone has any advice I would be grateful. 

iserbrown

Hi  I can't advise you one way or the other with regard to your ultimate surgery, it is what you and your medical team feel is the most appropriate.

Mjames said:

I spoke to a breast surgeon yesterday who said they could do a skin and nipple saving surgery with immediate implants which sounds good but I will need to stay around the same size. One thing she mentioned was as I am of a fairly small frame ( short & 50kg) the implants may feel really heavy as opposed to my real breast. 

It's such a big decision, if anyone has any advice I would be grateful. 

What I can tell you is that the comment about the implants may feel really heavy as opposed to your real breast - that is what I have found.  Good luck and take care

Ann-Marie

@Mjamesi I just wanted to jump in and let you know that we have a private group which you may like to join - Choosing breast reconstruction

Hopes_and_Dreams

Hi @Mjames, I had a single nipple sparing mastectomy just over 12 months ago.  I guess the main difference between us is that I am only a small B cup and perhaps because of this I haven't noticed any extra heaviness from the implant.  The implant feels well supported by a mesh sling and sits under my pec muscle.  You will find other stories and photos in Choosing Breast Reconstruction.  Wishing you good luck with your decision.  
I also wanted to welcome you to this forum.  None of us ever wanted to be here, but it is a great place for support and information.  There will always be some who understands how you are feeling.   Take care,  Jane xx

primek

Well mine are about 2 cups down. But the weight of the 2 is less than 1 of my old boobs. The best thing is you don't have to houist tgem up into the bra...they just sit there
.

LouiseTurner

Hi @Mjames, this is a biggy. Making the decision is have a mastectomy over a lumpectomy is a huge step to take if not medically necessary. I understand psychologically it might seem the way to go, but living with reconstructed breasts has its own list of physiological and psychological adjustments to make. Having the option of choosing is good and bad at the same time.

4 years ago at 41 I chose immediate bilat mastectomy and recon over single side lumpectomy and radiation. I miss my breasts everyday. In hindsight I can see I could have made different decisions and perhaps still had one breast with sensation.

My advice now, when asked, is to go slow, deal with the cancer and the cancer side and be thoroughly informed because there is no way back. I know that's really hard.

All the best, ultimately the right decision is the decision you make. Hopefully we can chat again in the BR group.

Xx

Zoffiel

DD is a big implant, even if you are small framed. Some ladies opt for a smaller implant then get the other breast reduced. That means more surgery. It's probably worth getting your surgeon to run through all the possible options with you--which isn't likely to make the decision making process easier, sorry.

 I can totally understand your concerns regarding the lumpectomy, sometimes we do need to listen to our 'inner voice' particularly if you suspect it is going to yap on for years about something that worries you.

I had implant reconstructions and now regret that move because my body doesn't like the intrusion and constantly encapsulates them. This is not a common reaction and the majority of women have no problems.

primek

Also it is worth noting, nipple sparing mastectomy means the nipple is kept but all sensation is lost.

Mjames

Thanks everyone,
@LouiseTurner you are right it is a massive decision and I'm annoyed at myself as I've had 5 months of chemo to consider it but was going with the lumpectomy and have just recently turned my mind to masectomy. I now need to decide fairly soon as they will operate in about 4 weeks. 
It's interesting as my medical team have said that a masectomy is not required and chance of recurrence in the breast is low, however I keep hearing about people getting a new cancer in the other breast or same one sometimes 15 years later. My medical team also said they deal with the facts and don't take into account the emotional side of ongoing fear of recurrence and I need to work out can I live with being called back for biopsies in the future etc. What I find difficult is to imagine myself In the future when I'm not as consumed by breast cancer and how I would cope with monitoring my breast etc. 

Unicornkisses

@Mjames I had the same choice.
I had DD/E breasts.
My initial reaction was mastectomy, but after my first scans and biopsy I was convinced that it wasn't necessary and went with lumpectomy and bilateral reduction at the same time.
My reduced breast is a great size (C) and I have full nipple sensation, though it took a while to be less sensitive enough to touch.
However, the pathology after lumpectomy was much worse than the scans showed and I ended up with the decision again of whether to remove both or just one as I had to have a mastectomy on the affected breast.
I had an MRI to make the decision and it came back that the other breast was clear so I opted to leave it on, as reassurances from Oncologist and Surgeon suggested it was not a big risk.
I can always have it off later if I decide I cannot live with the uncertainty of the mammograms and Ultrasounds as my previous ones have not been correct.
I can't afford to have constant MRIs.
I am now pleased I did leave it on, having one natural breast is for me better than having none, and I did not think I would feel that way.
Sometimes you don't know how you will feel until you get there, so take the decisions slowly, and if in doubt perhaps leave it for another day.

I have put my name down for DIEP flap reconstruction on the public list and will have a 12-18 month wait. This gives me time to adjust to the mastectomy and decide if I want to go ahead with a big operation.
I cannot have implants as I am having a lot of radiation and my surgeon was against the idea.

Be prepared that the decision may be different after surgery, you may have to go back for more, so keep this in mind when making your decisions.
I really hope you don't but having to have a mastectomy later may mean that you would have made different decisions if you had known.

Good luck with making a decision you feel comfortable with, Jennie

June1952

Hi @Mjames
Don't be annoyed with yourself - your focus has been on the chemo and what the medical team originally said.  At least you have had time and did not make the decision way back when then regret it. @LouiseTurner has made a good point above.
As most other ladies will no doubt tell you, be guided by your medical team.
I won't say to do the lumpectomy as if you are concerned about it coming back you will probably stress about it and that won't help at all.
Mastectomy is not the end of the story as you will still need to be monitored.
Weigh up all the opinions from ladies on this site, talk to whoever you think will understand and help, then listen again to your medicos.  Ask them lots of questions and don't be afraid of your decision, it is your body and your life going forward.
Whatever your decision, good luck.
Summer  :-)