Forum Discussion

Allicat's avatar
Allicat
Member
15 years ago

Implant Reconstruction

I had a mastectomy & immediate reconstruction 4 days ago. How weird is that. I think that on some level I didn't believe that it would actually happen & that I would still be me afterwards.

I was in hospital for 3 nights when they had said it could be up to a week so that was good. I feel a bit stiff & sore but it is ok as long as I am careful not to move my arm too much. I had been really nervous about the drain but it wasn't nearly as creepy as I had imagined. These are the good points.

On the other hand, I didn't like being in the hospital. Especially at first when it was hard to move & I had to call the nurse to unhook me from various things every time I needed to go to the toilet.

And then there is the real problem..

I had only one side done & the plan was that the silicone implant should go straight in, or if there wasn't enough skin left then I would have to have an expander. But, it turned out the surgeon put in an expander because there wasn't an implant small enough!

When I met the plastic surgeon beforehand he asked did I want the other side enlarged at the same time (which would make it easier make the breasts match) but I didn't. My breasts are quite small & I'm happy with that. He said that was ok & he would do his best to match the existing breast. He saw what size they were at that time so how come he was then apparently caught out during the operation & didn't have an appropriate implant?

Surely it can't be the smallest implant anyone has ever wanted? And even if it is, shouldn't he have planned for that beforehand?

I feel quite confused and upset by this. It means I will need to have another operation to replace the expander with a permanent implant which is upsetting & also it means I have lost some trust that the doctors know what they're doing.

I have an appointment on Thursday, to check how it is healing and to plan what happens next.

4 Replies

  • Allicat's avatar
    Allicat
    Member
    15 years ago

    So, I had a plastics appointment today and got the situation sorted out. They were hoping to put the implant straight in but because I am at the extreme small end of the market they didn't have a range of sizes available as they normally would & the smallest was too large so they put in the expander as a temporary placeholder. It seems like a custom implant will need to be made - I have another appointment in a couple of weeks when we will look at what size will be needed.

    The part that had annoyed me was why didn't they just have the correct size implant ready beforehand. But the registrar explained about how they need to get the exact right size and made it seem reasonable that they have to do it in 2 operations to be able to get it right. He did acknowledge that it was a shame which was nice.

    The part that confused me was the people who I asked about this kept telling me the expander was to expand the skin. The registrar clarified that in my case the expander is not being used to expand anything, it's just keeping the place ready for the permanent implant.

  • Allicat's avatar
    Allicat
    Member
    15 years ago

    So, I had a plastics appointment today and got the situation sorted out. They were hoping to put the implant straight in but because I am at the extreme small end of the market they didn't have a range of sizes available as they normally would & the smallest was too large so they put in the expander as a temporary placeholder. It seems like a custom implant will need to be made - I have another appointment in a couple of weeks when we will look at what size will be needed.

    The part that had annoyed me was why didn't they just have the correct size implant ready beforehand. But the registrar explained about how they need to get the exact right size and made it seem reasonable that they have to do it in 2 operations to be able to get it right. He did acknowledge that it was a shame which was nice.

    The part that confused me was the people who I asked about this kept telling me the expander was to expand the skin. The registrar clarified that in my case the expander is not being used to expand anything, it's just keeping the place ready for the permanent implant.

  • Allicat's avatar
    Allicat
    Member
    15 years ago

    I was measured beforehand & there may even have been doubt then about whether the smallest size would be small enough. I don't remember that but my sister says I mentioned it to her. But it wasn't raised as a serious problem - he was seeming quite hopeful of being able to put an implant straight in, although there was the small possibility there wouldn't be enough skin & then I would need an expander. Then at the pre-admission clinic when I talked to one of the junior surgeons I asked about the possibility of needing an expander and he was saying not to worry about that as the implant should be able to go straight in. On the day of the operation when the plastic surgeon drew texta marks on me before the operation he was still saying that the implant could most likely go straight in.

    Today I saw the breast surgeon who did the mastectomy but don't see the plastic surgeon who did the reconstruction until Monday.

    The breast surgeon said that I am having the expander to stretch the skin & then the 130 gram implant is going in. 130 apparently being the smallest size they come in. 

    If it is right that the 130 grams implant is going to go in then I guess I am just fussing over nothing - I'm just having the normal procedure. I do understand that this is the normal procedure but I am not sure that she is right in my case. The expander which is currently in is 100 grams & it is already larger than the non-operated on side. Maybe it somehow becomes smaller as it settles down after the operation?

    I am certain that the plastics registrar said 130 would be too big but I didn't argue with the breast surgeon because it doesn't really matter what she thinks as she is not involved with the choosing of the implant.

    I am going to try to research the matter tomorrow & then hopefully get a plan sorted out with the plastic surgeon on Monday.

  • MandaMoo's avatar
    MandaMoo
    Member
    15 years ago

    That is disappointing.  Were you measured beforehand?  I had a skin sparing mastectomy and tissue expander inserted so my experience is different but I was measured beforehand so my surgeon could have the right size expander available.