Too many choices

Hi @Spillsy - I can't add much to the excellent advice above - just to research, research, research!

@kmakm - has hit the nail on the head about recon being your first consideration as that will determine a lot.

I had a nipple sacrificing, skin sparing double mastectomy in April. I didn't know at the time of the surgery what my treatment plan would be, but simply because of the size of my cancer I was informed that radiation would more than likely be part of my treatment and it's radiation that determines the success of different types of reconstruction. 

I consulted both a radiation oncologist and plastic surgeon before my breast surgery and that was invaluable.

The plastic surgeon told me that he would do a great reconstruction for me but that he did not want his 'work' radiated because it would compromise the result and then we would both be unhappy. He would not do an immediate reconstruction but suggested expanders for a later reconstruction well after radiation was over. I was disappointed because I wanted an immediate reconstruction. 

So then I went to have an appointment with the radiation oncologist who explained to me why I was likely to need radiation and also the effect that radiation can have on reconstruction - both implants and autologous (which uses your own tissue eg DIEP flap). She was absolutely amazing and when I left her rooms I was 100% comfortable that my plastic surgeon was right. This was enormously comforting for me and although it wasn't what I originally wanted, I went in to my surgery feeling absolutely confident that I was doing the right thing.  

Now I'm doing chemo and will do radiation after that - I have air expanders in. I'll have to wait until at least 6 months after radiation if I want an autologous recon or at least 12 months if I choose implants - that's because there's a greater risk of issues after radiation with implants than autologous. 

It's such a minefield out there so really do as much research and consult as many professionals as you can.

All the best with everything! 

xxxxx

The way I see it first you need to decide if you want a reconstruction. There's a really useful tool at the Breconda web page. I found this helped clarify things for me.

https://breconda.bcna.org.au

If you think a breast reconstruction is something that you might want to do, you should definitely join the Choosing Breast Reconstruction group. There are photos of all different types of procedures there, as well as people who are able to answer many of the questions you might have. I found this closed group to be absolutely invaluable. I am less than three months post my own recon and the women there are still helping me. Tap on 'Groups', select the recon one and apply to join.

Once you know if you want to reconstruct or not, you need to tell your breast surgeon. If it's a yes, you need to choose between private or public. If it's public, ask about waiting lists.

You'll be referred to a plastic surgeon who will be able to talk you through what type of reconstruction is suitable for you.

Whatever you decide, ask your surgeons what the pros and cons of each of your choices are, what are stats and risk factors. Many of them are happy to answer emails, which can give you time to organise your thoughts.

Some other questions to ask yourself might be what suits your lifestyle? What suits your personal style? What suits your self esteem? Ask specific questions here. Someone will have done what you're asking about and will be able to give you an honest answer.

Actually write a pros and cons list! Sometimes the act of actually writing things down can help to clarify your mind.

And once you've made a decision you'll feel better. Hang in there. K xox

Hi @Spillsy, I had lumpectomy & sentinel node biopsy in Aug 2016 followed by traditional mastectomy & auxiliary clearance.  At the time I wasn't given a choice.  As I was having chemo & radio it was best to wait until after treatment for reconstruction. I am now going down that pathway & thinking of having prophylactic mastectomy on other side with double reconstruction. I had a traditional mastectomy on left & I have been told by 2 surgeons even with no cancer on right they won't do a nipple sparing mastectomy as the nipples are the end points of the ducts where cancer goes to, however they will do a skin sparing on that side. It is more difficult when you are given choices but find out as much information & risks as possible to help you. Good luck & let us know how you get along!

It might help to ask to join the breast reconstruction group. Yes, some of the stories there can be a bit confronting, but you will find some real life information from women who have shared their experiences. Big decisions, @spillsy  Good luck. Mxx

Thank you, 

Bugger!  Sorry to hear further surgery is required ..... all the best with your decision making - our lovely ladies will jump on & offer you their best advice

In the mean time .... big hugs coming your way from Forster xxxx