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kayyzee's avatar
kayyzee
Member
14 years ago

2nd Stage Reconstruction with fat transfer

Hi all,

this is my first posting. I was diagnosed with lobular carcinoma, grade 2, in January this year.  ER+/PR+, 2 nodes removed. I have been having mammograms plus ultrasound for 20 years, due to dense breasts.  Have had several cysts aspirated and one lumpectomy (in the non-cancerous breast).  Was not due for another scan until June this year.  Found the cancer myself.  Opted for bi-lateral mastectomy and DIEP flap reconstruction.  My oncologist suggested we send my pathology to the United States for an Oncotype DX test.  I was fortunate enough to receive a result score of 14, which puts me in the category that recommends I do not have chemotherapy, as I would only gain about a 2% advantage.  So I decided on no chemo and am only taking Femara.  I have also found out that I have Osteoporosis, so I was given an infusion of Aclasta.  This is done once a year, for three years.  Last week, I had the second stage of breast reconstruction, with fat transfer.  Had stitches out today and I am really happy with the result.  I now have nipples!  Still have to wear the compression suit for another week - for the areas where the fat was taken from.  Hopefully, this will be the last of the operations.  I want to get back to playing with my grandchildren.   Prior to this happening, I was a very fit 60year old.  I want to move on now.  

10 Replies

  • Hi Chris,

    My lumpectomy was done about 18 years ago and it was found to be benign.  Since then, I have had numerous cysts aspirated.  Once when I was having an ultrasound, the sonographer referred to my breasts as 'cyst city' , because they were so dense.  It was always a challenge for me when checking my breasts myself.  To be honest, the length of the surgery did not really enter my mind.  I just wanted to have the surgery, remove the breasts and hopefully, give myself a better chance.  Naturally, when the surgery progressed past the original estimated time, my husband said he was really pacing up and down!  Regarding the contrast dye, I did not have any reactions.  My main problem is that I cannot tolerate heavy duty painkillers.  I had dreadful hallucinations and was really nauseous.  So much so, that I requested no painkillers, other than panadol. With the surgery, I chose DIEP, as I did not want to lose any tummy muscle function , whereas with TRAM, it is my understanding that some muscles are affected.    In some respects, I think I was fortunate, in that I really didn't have much time to think about it.  It was a case of needing to get it done asap.  

    All the best.  Regards, Kay

  • Chris,

    I too had a cavity, my surgeon took fat from my "bum"" and filled it in that way.

  • Chris,

    I too had a cavity, my surgeon took fat from my "bum"" and filled it in that way.

  • Thanks for sharing your story Kay.It really helps lots of women on this site to get an honest  picture of what's involved for DIEP reconstruction.It sure doesn't look like a walk in the park!

                                           Tonya xx

  • Hi Kay,

    Thanks for the detailed report, I really do appreciate it. All of this should make my decision easier, but I'm such a procrastinator, and hate to make a decision, incase it is the wrong decision. I know I drive everyone around the bend, including myself. Can I assume that this is your second breast cancer, as you mentioned a previous lumpectomy? I'm also glad to hear you could have a bilateral DIEP when obviuosly a small person with a flat tummy. I have lots of tummy fat, so was a bit surprised that he said I would end up smaller than my current size B. I've had 4 pregnancies and have always had a tummy', but still a size 12.. Were you scared at the thought of such a long surgery? My fears stem from the fact that as a nurse you know what can go wrong. I have never had an issue with a general anaesthetic, but I've never been under longer than an hour or two. I'm also abit concerned about the need for a CT angiogram to mark out where the best blood vessels are. I had an allergic reaction to a constrast I had 30 years ago. I know they have changed the properties of these injections now, but for me it is still a risk. I'm in Sydney, and I have been to see a surgeon here, Dr Pennington from RPA who specialises in the DIEP. He is so nice and really has a wonderful bedside manner. If I decide to go with the DIEP I would be happy to put my trust in him. I have also seen first hand some of his finished products and they look good, very good. I didn't have to wait very long to get to see him either, only a few weeks. On the other hand, I've seen some excellent implants done by another surgeon who works at the SAN, and they were most impressive as well. He doesn't do the DIEP, only a TRAM, and I don't want to lose my tummy muscles.

    So glad your DIEP and nipple reconstruction has gone well.

    Chris

  • Hi Tonya,

    My surgeon is Mr. Howard Webster, Arc Plastic Surgery, Hawthorn.  www.arcplasticsurgery.com.au

    I cannot speak highly enough of him.  I think he is absolutely brilliant.  I am so happy with my second stage results.  Tomorrow, I am going into Myer Melbourne, to see the specialist bra fitter and buy myself a nice, new bra!  

    From the very beginning, he puts you at ease with his gentle manner.  He visited me every day in hospital and his aftercare is faultless.  

    Please ask any questions.  I'm happy to reply.

    All the best.

    Regards, Kayxx

  • Hi Chris

    It's a bit of a merry go round, isn't it?  Hope you are going okay.

    I was diagnosed at the end of January this year and was fortunate that my general surgeon was able to get me an appointment, the very next week, with  Mr.Howard Webster, Arc Plastic Surgery, Hawthorn.  www.arcplasticsurgery.com.au.  It was an absolute whirlwind.  I chose to have both breasts removed, because I had already had a lumpectomy in the non-cancerous breast (many years ago)  and it was a bit smaller than the cancerous breast. I figured that way, I would least have a chance of having a better, more balanced result with the reconstruction.  Also, it would stop me from stressing about whether the cancer would return in the other breast!  I chose to have the DIEP surgery, because I wanted a more natural look.  Last week, I spoke to a lady at the Think Pink Living Centre in St.Kilda Road, Melbourne, and she is having her implants removed, due to discomfort and she is going to have the DIEP surgery.  My surgery took approximately 12 hours, as it was discovered, during surgery, that I have very small blood vessels.  There was a lot of microsurgery involved.   I too, did not have much tummy fat (prior to surgery, I weighed 54kg) and had a very flat stomach.  Howard was able to harvest enough fat to give me a reasonable looking cleavage, but there was not much fat to put in the lower area of each breast.  In clothing, you would not have known that I had had surgery.  I was in ICU for about 24hours, then moved up to the ward for another six days.  Howard visited every day, which is very reassuring.   You have several drainage tubes as well as a catheter.  It is a painful recovery (I have had two caesars - this is worse than that).  The first two to three days are the worst, then you slowly start to sit up and eventually, I was carrying my drainage tubes (in a pillowcase!!) and walking around the passageways.  Each day, one more tube was removed.  Once I came home, it was a case of little walks at first, then slowly increasing the distance.  It took me about three months, to feel fit again. I went back to doing my exercises and swimming, with no problems.  Two and a half weeks ago, I had my second stage reconstruction.  This is a day procedure, done at Mr.Webster's private clinic - Linley Clinic, Hawthorn.  He took small amounts of fat from my thighs and injected it into my breasts.   He also reconstructed my nipples.  I now have reasonable looking breasts and it is a case of wait and see, for about three months.  Hopefully, most of the fat will remain.  I used to be a 10D, but now I will probably be a 10C.  After this operation, you wear a compression suit (waist to knees).  Recovery time is about two weeks.  One week post-op, stitches are removed.  Two weeks post-op, you can stop wearing the compression suit and get back to normal routine.  

    I don't know if you are in Melbourne.  I also recommended Howard Webster to another friend. She had gone through radiation and a partial mastectomy, several years ago.   She could not get an appointment with Howard for about three months (this was in March this year).  She did, however, consult with another surgeon at Arc - a female doctor.  She went ahead with her surgery and is extremely happy.

    I hope I have covered everything in this message.  If there is anything else you need to ask, please don't hesitate to contact me.  It's the main reason I put my message up in the first place, so that I could share my experience and help others.

    All the best.  

    Kay xx

  • Hi Chris,I've got a bit of a cavity and puckering so can't wear anything even slightly low.Kayyzee can I ask which plastic surgeon did your reconstruction.I'm in Sydney .I'm not ready to have any more surgery yet but it is something to think about.Sounds like it all went well for you and you can now get your life back.

                                           Tonya xx

  • Hi Chris,I've got a bit of a cavity and puckering so can't wear anything even slightly low.Kayyzee can I ask which plastic surgeon did your reconstruction.I'm in Sydney .I'm not ready to have any more surgery yet but it is something to think about.Sounds like it all went well for you and you can now get your life back.

                                           Tonya xx

  • Hi Ladies,

    I'm interested to know how you were after your surgery? I'm doing the rounds of plastic surgeons at present trying to work out what is the best reconstruction for me. I had a mastectomy on December 22nd last year, 3 weeks after having a lumpectomy. At the time when I knew I needed more surgery, a mastectomy seemed the best bet as it gave me better reconstruction options if I didn't need to have radiotherapy. This surgery was too rushed to be able to get a plastic surgeon at the same time just before Christmas. I decided to give myself time to recover from chemo and think about my options. I'm also trying to decide if I should have a prophylactic mastectomy as well. My BC was grade 3 and 21mm long, and didn't show up on 2 mammograms 3 months apart. the ultrasound found a small 4mm cyst, that showed DIC. This is what they were looking for when I had my first lumpectomy. I know I will be followed up well, but as I will always question a mammogram, I'm seriously considering removing the other breast at reconstruction and then not worrying about a new BC. The 2 options that would work best for me are, tissue expanders / implants, or the DIEP. I'm concerned that the TRAM would leave too much muscle weakness. I saw a great surgeon on Friday who specialises in the DIEP, but he seemed surprised that I would want to do both breasts. The surgery could take 10 - 12 hours for both breasts and I don't have enough tummy fat for 2 the size I am now, which is only B cup. From all my research, the TRAM or DIEP give the best results, but I'm put off by the lengthy surgery. How long were you under for, and how long did it take you to recover?

    Any suggestions or advice from anyone would be greatly appreciated. I'm 53 this month, and still want to look normal in clothing. I find my bra and prosthesis tend to slide abit and my mastectomy cavity becomes visible.

     

    Chris xx