Choosing Implant or Prosthesis

Lallaby

Hi Everyone
I was diagnosed with BC in November and have just finished 8 Dose Dense Chemo Treatments. I got though that OK without any real serious side effects but the tumour didn't shrink as much as expected. A nipple sparing mastectomy is scheduled for after Easter.
My Dilemma is what to do after the mastectomy.  I may be able to have immediate reconstruction with an implant, depending on what is found during the operation, (radiation still may be needed) but I am not sure I want to go through the hassle of having an implant, possible follow up surgery and associated risks of implants. Is there anyone who wishes to share their experience with an implant and also anyone who can share their experience with a breast prosthesis. Choosing no reconstruction sounds like the easiest option with the quickest recover and no additional risks but I don't know how practical (or annoying ) a prosthesis is. I am only a 14B bra size . Looking forward to some feedback. Thanks!

iserbrown

@SoldierCrab
@primek

Can any of you offer advice please

primek

You are ideal for a breast implant if you want reconstruction. If you join the  reconstruction group you can discuss the various different options. Being a B cup you could go possibly go directly to implant with a dermal sling. So one surgery. Changeover surgery (10 plus years) is very short. I had tissue expanders in first and 3/4 filled until after chemo. One fill then changeover after. I stayed  in hospital 48 hours for protective antibiotics. I only required panadol for pain management once returned to ward. The initial surgery is painful, but everyone copes differently. All surgery has infection risks whether straight mastectomy or reconstruction. 

I personally didn't want the hassle of a prosthesis (or 2 in my case) I like to swim. So yes...a bit of hassle with surgery but once healed up you are pretty right for many years. With a posthesis you may need new ones every couple of years.  You need special bras and special swimsuits etc and it can be expensive.
Many women do this and are perfectly happy. 

The breast reconstruction group also has photo stories to give you an idea of possible cosmetic outcome. I would have loved to have saved my nipples but it wasn't possible. 

@socoda went directly to implant with  great results. 

primek

http://onlinenetwork.bcna.org.au/group/1-choosing-breast-reconstruction

Link to the group. 

Afraser

Hi 
I have a prosthesis. I was never very keen on reconstruction and I had a persistent seroma that took 12 months and surgery to fix, which made me feel hesitant about further surgery. I am quite large breasted so going without anything would be very noticeable. I find a prosthesis easy. Unlike @primek, I am only an occasional, holiday swimmer and I just use a synthetic pad in my swimsuit. The prosthesis lasts about 2 years, and I get it fully rebated every 2 years.  A properly fitted prosthesis has the right weight and shape. Some women living in the north report that they find them hot- I live in Melbourne and have no difficulty even in hot weather (we do have that too!). I also don't have a problem with how I look - I have a large scar and it's a bit 'untidy' - my surgeon left enough to assist a reconstruction if I wanted one and that also gives me a bit of cleavage, which is good!  It's me, I am fine with the way it is, it doesn't concern my partner either and after I had stripped off in a shared shower in Iceland before getting in a hot tub, I don't think I'd think twice about doing that again! No-one batted an eyelid. It's a really personal thing - to reconstruct or not - and it's what's right for the individual that matters. Best wishes,

socoda

Hi @Lallaby, I had a skin and nipple sparing mastectomy and went straight to implant. I also had a sentinel node biopsy and my surgeon used the same incision to do that too!! I was in hospital for 6 days and left with two drains hanging out my side. First removed 5 days after leaving hospital and the second 8 weeks later!! Only reason it was in so long was because the fluid levels wouldn't drop - turns out it was the drain itself causing irritation. Would I do it again - you betcha!!!!! I am incredibly happy with my implant. It is a D cup - I had been a C cup prior but my surgeon sheepishly told me on the day of surgery that she'd mismeasured me and I was going up a size. No drama's there. I have posted photos in the choosing reconstruction site. If you have any questions that I can help you with please don't hesitate to ask. All the best with your decision. Xx Cath

Sister

Going further to what @afraser said - wouldn't it be a nice world if no-one batted an eyelid.  I still don't know if I'm going to go down the reconstruction path.  My body is being battered enough.

Afraser

I think the shared hot bath culture in Iceland and Japan leads to a much more realistic understanding of the human body - saggy bits, fat bits, old bits, missing bits, seen it all before!! 

kmakm

Totally agree @AFraser. We're all so private here. Throw in the air-brushing of almost every media image we see, it's no wonder people get self-esteem issues about their bodies.

Deanne

I initially thought that I would do reconstruction but my pathway was mastectomy - chemo - radiotherapy - hormone therapy. By the time I got through all that I had been living with one breast for long enough to feel that I was ok with just a prosthesis.

 I was a 14D at the beginning of the whole process but ended up a 12C in the remaining breast by the time I lost 9kg after treatment finished. Something else to consider as implants do not change with body weight changes.

I know I always have the option to do reconstruction but almost 5 years after my mastectomy I am content with things just the way they are. I swim a lot in summer and find that the swimming prosthesis is just fine with a good mastectomy swimsuit. I actually also use the swimming prosthesis in a sports bra most of the time. It suits my lifestyle and is very comfortable. I don’t know whether I will bother getting another ‘proper’ prosthesis as I so rarely use the one I have now.

Lots of options, it’s just a matter of working out the best one for you.
xxx

Lallaby

Thank you all so much for your wonderful replies! Every time I think I have made a decision I find myself almost immediately wondering if it is the right one for me 

KatyJoy

I had a double mastectomy with immediate implant recon. Cancer was in the left but I chose to have the right removed also due to family history and the fact that my breasts were very dense so my cancer was difficult to find. We knew it was likely that I would need radiotherapy so my surgeon didn’t want to do a flap (my own tissue recon) initially even though I would have been a good candidate if I didn’t need radiotherapy. My surgery was 1 year ago and I have some capsular contracture on the left due to the radiotherapy. It’s not too bad and under clothes you can’t tell. It feels a bit tight but not painfull. The plan is to have a double diep recon in a few years when I’m ready, and that will hopefully be my final surgery. Like you I had chemo before my surgery. Good luck and best wishes to you

onemargie

Hi there @Lallaby I was diagnosed may 2016 with triple negative bc and I’m thinking you might be the same with your dose dense chemo as that’s what I had as well. 4 rounds of AC two weeks apart and 2 weeks of paclitaxol 2 weeks apart. I chose to have the left boob off with the 3cm tumor in it so I didn’t have to have chemo and rads and then took the other one off as a prophylaxis and no regrets from me either. I was only a 14b too At first I definately didn’t want a recon as I didn’t want more surgery but wish I had the immediate recon done now had I known the wait in qld was so long and I’ve been on the qld waiting list for nearly 2 years and haven’t seen a surgeon at the royal Brisbane yet but have seen dr green who does private public and intermediate  for an opinion and he is awesome so I’ll do intermediate with him once I get my holidays up at my new job and the money together for it (sigh)

He has said saline expanders one night in hospital, topped up every  2 weeks, then at the 10 to 12 week mark saline implants, again overnight surgery only for the changeover and he doesn’t think I’ll need a drain in at all so fingers crossed and after the expanders 1 to 2 weeks off work and after the change over only a few days so I’m really happy with that. 

I changed my mind as I hate the prosthetics they are so hot heavy and sweaty for me here in qld. I actually gave them away and just use the crocheted knockers now in my cheapy Kmart sports bras and my proper mastectomy bra Which is fine for now but I have some issues with some of the clothes I like and can’t wear as they don’t suit the bras I have and I was a matron of honor st my girlfriends wedding last year and I spent the whole day adjusting the bloody prosthetics and it was a pain in the arse. 

So so it’s a yes from me and like @Afraser and @Deanne says it’s a very personal thing and they are  quite happy with the prosthetics and I am looking forward to my new set of porn star titties(joking) but a little something up there would be nice too. So each to there own love. You’ll know what’s best for you. Margie xxx 

Tennille

I had a mastectomy at 35 and reconstruction wasnt an option as I was pregnant. I have never had any interest in reconstruction to this day. I am a 14c and I am very comfortable going to the shops without my prosthetic if I dont want to wear it. Im not bothered if people stare but most of the time I havent noticed if they do or not. I do wear a prosthetic if I am going out and I am so used to it now as its just a part of my normal dress routine. It will take some time to find one you are comfortable with though and clothes shopping can be a bit of a pain but I wear bras with lace panelling so I can have more options.

Captaingrumpypants

Thanks for your insights @Deanne and @Tennille I'm a one-boober because the need for radiotherapy made me unsuitable for immediate reconstruction. I've had chemo and just finished radiotherapy and at this stage I can't imagine volunteering for any more surgery. Losing the breast hasn't phased me too much (it was crappy and cancerfied - good riddance!) but I'm still not quite used to being one sided yet. Glad to hear it becomes so normal.

Captaingrumpypants

Hey, thanks for the link @primek I'm a newbie and couldn't figure out how to find the groups everyone keeps taking about. What a fantastic resource.