Questions about reconstruction

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JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 7/14/2008 5:06 PM (GMT -7)   
It has been 3 1/2 years since my mastectomy. I had 2 rounds of chemo, AC and Taxol, 35 radiation treatments. I changed insurances at the end of the treatment and can no longer use the wonderful plastic surgeon I believe in. Finally, after all this time I am so frustrated at wearing t-type shirts and button collar blouses, I have decided to consider reconstruction. My sister had a tram as did another friend, my friend had saline implants several years ago (after rads) and my daughter had silicon implants (simple double mast). My sister hates her breast and so does another friend, Carols saline implants looked like baseballs and my daughter's silicon implants look very natural and are comfortable compared to the saline expander implants she first used.
 
When I made an appointment today to discuss "implants" with a plastic surgeon, the nurse told me that I probably was not a candidate for "any implants" since I had radiation. Something about a constricture. (I don't know what that is).  Anybody out there who can advise me. Appointment is July 31. I also plan to get another opinion. Not many surgeons here use my insurance, United Health Care.
 
JUJU

MNlady13
Veteran Member


Date Joined Jul 2003
Total Posts : 2044
   Posted 7/15/2008 6:40 PM (GMT -7)   
I have not had reconstruction, but did have radiation. It is my understanding that radiation restricts the amount of stretch in the skin, which may eliminate an implant. I do not know if the same problem applies various "flap" (i.e. tram flap) procedures. I am sure the plastic surgeon will have more information for you. In the meantime there is a lot of good information on reconstruction at www.imaginis.com. Good luck to you. Hugs, Lauri
Dxed 04/11/1996
"Go confidently into the direction of your dreams. Live the life you always imagined" Thoreau
 
Life is not measured by the number of breaths we take, but by the moments that take our breath away.


JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 7/17/2008 3:42 PM (GMT -7)   

Thanks for the info. I visited that site and it was informative.

I guess I am just oblivious to some things about this disease, but no one ever told me that there was any problem with any reconstruction type after radiation. I guess they were saving that for my first PS visit after radiation. Well, um, I am just now making it and I am just now being told. Wish I had been told sooner and I might have considered reconstruction after the initial 6 month post radiation wait.

Judy


reegee
New Member


Date Joined Jul 2008
Total Posts : 7
   Posted 7/17/2008 5:20 PM (GMT -7)   
I had a double mastectomy and reconstruction. The reconstruction went bad and I needed a tram on one side with a small implant and the other side just an implant. If I could do it all again I would chose a tram for each side but the reconstruction does not look the way I thought, I didnt expect to still see the scars but they are both across the breasts and it bothers me. I dont show them to my own husband. But I had radiation and I have implants so Id look around and I look at it this way at least I dont have to stuff a bra or hide my chest. It looks like I have something good but when I look at them I want to cry,..

Good luck to all

Brnadebt
Veteran Member


Date Joined Jul 2005
Total Posts : 688
   Posted 7/17/2008 6:20 PM (GMT -7)   
Hi Juju
 
Long time no talk to!!! Im glad to see you are posting again, even if I have not been.
Well as you know I had my tram done a little over a year ago and for the most part Im very happy with the results. I would advise you not to do a tram unless you need the tummy tuck. I enjoy my results very much with clothes on but I do have alot of scars.
My best advise to you is to do alot of research and go into it with an open mind. I would do the recon all over again if that helps you any.
 
Take care, Bernadette
 
 
 
 
 
 
 
 
 
 
 

JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 7/18/2008 3:16 PM (GMT -7)   
Thanks, Regee and Bernadette, for the information and advise. No, Bern, I have not posted much lately, but I always know that if I have a question regarding this disease, someone here knows the answer or how to find it.

I guess now all I have to do is wait until the 31 st. I will look up as much info on the internet as possible, but nothing will replace that appointment that day.

Thanks for the help, everyone.
Judy

gma
Veteran Member


Date Joined Jul 2003
Total Posts : 2921
   Posted 7/19/2008 5:34 AM (GMT -7)   
Judy, please think long and hard about a tram. It is major surgery, takes a long recuperation time and even after healing it takes a longer time to feel normal. My daughter who never had the issues I had still complains about her midriff area hurting. That is where they tunnel the muscle cut from the abdomen up to your breast area to form the breast. I ran into more serious problems with contaminated sutures distributed by the major suture company. My abdominal area is one big hernia due to infection and all the antibiotics have taken have caused other health issues. My surgery was in 1997 and the contaminated sutures were supposedly recalled in 1995. I read recently that they are still being used in Iraq on our soldiers. The sad part is that this problem was kept so quiet no one knows about it. 20/20 had a show about it or I would never have known, either. Ask your surgeon if he knows about it. If not email me and I will tell you more. If you are reasonably healthy and active right now I would not mess with breasts. I am guessing you have to be over 50 to have a daughter with breast cancer. I was 58 when I had surgery almost 12 years ago and believe me it has aged my body if not my mind. Hugs, MK


JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 7/19/2008 1:09 PM (GMT -7)   
Thanks for the reply. Yes, not only am I over 50, I will be 62 on the 31st -- day of the appointment. I am in excellent health bp 100/60 - always - taking only arimidex, thyroid medication and some lyrica for strange pains in both feet that started last October and continues somewhat today. I have pretty much decided that if I don't like what this doctor says, I'll go back to my old PS, and I really believe he will tell me the truth. Then, I can make my decision.

As I indicated, I am tired of the t-shirt look -- not that I will wear low cut dresses, etc. but I want something more stylish than a "uniform". I'll let you know what he says.

Judy

babyseeester
Veteran Member


Date Joined Oct 2004
Total Posts : 826
   Posted 7/26/2008 8:01 PM (GMT -7)   
Judy,
 
I had a tram and love the results.  I didn't even think about reconstruction until a year after my mast.  I hated wearing the prosthesis.  I know everyone is different, but I have no regrets about having it done.  My PS was great and did a fantastic job.  I love having cleavage again.  I had a lift/reduction on the other side, too.  I was very informed about the surgery before going into see the PS for the first visit.  He kept telling me I was his most educated patient (regarding the procedure).  Let us know what your decision is.  Take care.
L & H,
Kathy


JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 8/1/2008 9:31 AM (GMT -7)   
Hi, everyone. I believe I now have my answer regarding radiation and reconstruction. Tram is the "Best" option and outcome, according to the PS I saw yesterday and my old PS that I talked with this morning. However, my old PS said that a a successful implant has a lot to do with the skin and that he can usually tell if an implant has a good chance of working by feeling the skin's texture and comparing to other skin in the area, and that if it "fails", all the patient loses is time -- the other option is still available. According to old PS, a PS was sued recently for trying implants with a radiated mastectomy area.  For this reason, old PS says that PS's are being very careful using the implants as well as the LD procedure coupled with implants.
 
Got a lot of thinking to do, but I am really against a tram at my age -- surgery is way too long as well as recovery times.
 
Thanks everyone for your input ,and I hope this provides information to others out there in this predicament.
 
Judy

Tiger4513
New Member


Date Joined Aug 2008
Total Posts : 2
   Posted 8/6/2008 4:17 PM (GMT -7)   
 
 

Hi,

 

I hope I can help you on your breast reconstruction question.  I was dx with breast cancer back in February.  I just turned 58.  I had surgery to remove it and the lymph nodes.  When that was completed my plastic surgeon took over that operation and placed expanders in.  So in other words it was 2 surgeries in one.  Expanders are not the most comfortable thing in the world (thank God they are temporary).  They are very uncomfortable at first, but as they are inflated they become more tolerable.  Mine are fully expanded now to where I want them.  However, the surgeon is on hold as I am still in chemo and then I am to go for radiation after all my chemo treatments are done.  The plastic surgeon can not do the flap surgery now until all chemo and radiation treatments are completed.  But I have questioned my plastic surgeon and my chemo oncologist in length if those treatments will affect the implants.  They both reassure me it won't.  The reason I can't have the implants during chemo and radiation is because they attack the immune system as explained to me.  They don't want to risk invasive surgery and inviting infection, thus I have to wait.  No big deal...I can wait.

 

One thing I would stress is when you seek out a plastic surgeon make sure he is state board certified.  They are required to keep up the latest information and treatments in their areas of practice and must keep up on training in their fields of practice.  Others are not required to do so. 

 

My plastic surgeon (in Iowa) is state board certified and he is a gem!  He is totally fantastic about answering questions and being totally upfront with me about information.  If you live in Iowa or near I will be happy to pass his name along to you if you would like it.  I live in Des Moines Metro area.

 

I wish you all the best and if I can answer any other questions please ask. May God Bless you.

 

Karen

 

 

 

Post Edited (Tiger4513) : 8/6/2008 5:21:55 PM (GMT-6)


JUJU8872
Regular Member


Date Joined Jun 2005
Total Posts : 349
   Posted 8/6/2008 5:01 PM (GMT -7)   
Hi, Tiger, and thanks for the reply. I really am surprised by the range of reconstruction variables I hear about. When I was diagnosed in December 2004, my teaching hospital, University of Alabama Birmingham, would not do reconstruction of any type since I had to have rads. I had to wait for six months after rad treatment. Isn't it strange how times have changed in just 3 1/2 years. Yes, both PS I have seen are board certified, my fav is the first at his teaching hospital trained to do the new silicon implants. I'll probably be seeing him an a couple of months to see just where I am. I can change insurances in January. My daughter opted for a double mastectomy in February 2007 and she too complained about the temporary expanders. Loves her new silicon breast implants, though. She did not have to have chemo or rads.

Thanks,
Judy
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