Reconstruction after Lumpectomy???

easyquilts

Hi...I am wondering if anyone was so disatisfied with their breast size or appearance after a lumpectomy and radiation that they had something done to improve the situation.

I have noticed that my right breast is now much smaller than my left one.....I'm a 38C... and I am nt happy with that, but am not sure if I should even consider doing anything to correct the situation, or even if it's common to "do something".....What would I do?

Thank you in advance for your advice and comments....I'm feeling a little confused.

 Sandy

susan_CNY

Hi Sandy, I wear a prosthesis to fill out my bras since lumpectomy, alone my affected breast looks OK but definately not a pair at all ( my surgery was to the smaller side already) . I have read that after rads is more difficult for PS due to skin, but not absolutely impossible. I was 52 when dx with bc and still don't regret having a partial mast 5 years later, yes dealing with the prosthesis can be annoying, but I am a big baby and want NO more surgery. If you feel strongly about this you should try talking to a Plastic Surgeon. Good luck with whatever you decide.

monee

My radiated side is much smaller than the non radiated side.  I am disappionted too. However recon to a radiated breast is too involved for me, so I'm living with it.

KAK

Hi, Sandy.  Hi, everyone.

I'm in the same boat as everyone here.  Had a significant lumpectomy 4 wks. ago to the breast that was already a little smaller.  Now it's a lot smaller & I just started radiation.  The lumpectomy was more of a "slab-ectomy" - the surgeon took out quite a lot of tissue.  I'm not very busty to begin with (38B) but I'm definitely lopsided now (very much like my avatar!!).  What's with the radiation thing?  Why is PS such a big deal after radiation?  Anyone know?  Why is slightly thicker skin a big deal for PS?

Kathi

nagem

Radiated skin has less elasticity and heals less quickly, according to the plastic surgeon I consulted. However, I was also told that the situation improves over time, so procedures that are not feasible immediately after radiation may become reasonable options months or years down the line. 

lvtwoqlt

I was lopsided after my first lumpectomy for ADH (pre-cancer), a-cup left side and c-cup on right side. My insurance paid for the mastectomy products to make me even. I got several bras and 2 prost to make me appear even. I donated them after my bilat mast last year to the fitter to give to someone who doesn't have insurance.

roseg

I'd think carefully about this.

I've read more than a few very unhappy stories by women who had this or that done to their radiated lumpectomy breast and ended up with hard-to-heal infections and wounds.

I think you'd be better off to have the non-cancer breast reduced. 

Annabella58

Hi, I had rads after my lumpectomy and walked around lopsided for 6 years until I got another bc diagnosis in the same girl.

I wasn't OK w/ having no boob, so went with mastectomy and immediate recon.  Yeah, I got some complications in that the skin broke down and had to be "patched" with tummy skin from my C section.  But I had great circulation in that boob and it healed beautifully and is good and strong.  I still don't match, I'd had to have had a reduction and lift on the non cancer girl, but my miracle worker, Dr. Passaretti of Darien, Ct was able to put back what was gone.

I was lucky and had a great PS...do think carefully but I am here to say it certainly can be done.

I also ended up with a better looking previous scar from c-section.  a bonus!  AND he got rid of the scarring and indent from the lumpectomy so I came out better than I went in. .

Good luck to you

annie

Annabella58

oh p.s. Kathi:

I'm a busty busterson also (or was) DD on the non cancer boob and prob. now a large B/C on the new foob.

And I am 5'1" so it does get interesting in bras fitting, padding, etc.  But I am managing.

easyquilts

Thanks to everyone for sharing your experiences and your advice.  I will probably end up living with the way things are now...I'm a little unhappy about the difference in sizes, but don't really want to have any surgery.  Maybe later on....I don't know.

I'm just beginning to think about this, and to look at options.....I just didn't expect this to happen, although Im sure I knew about the possibility...Just did't click in my mind, I guess... Things were such a blur when decisons were being made..You know what I'm talking about, I'm sure.  We all knw how those first few weeks are... <sigh>

 Thanks again....Sandy

Jaydee

Hi easyquilts,

I had the same concerns as you - I am DD on one side and the lumpectomy side is smaller though it was before treatment.   I considered doing something about it but have decided to wait a bit.  I have lost some weight and find that as time goes by things aren't looking too bad.  I wear bras with lycra in them and quite honestly to the onlooker my boobs match.  What worries me about my rads is that on another thread some ladies have reported shrinkage afterwards.  Wouldn't it be awful to try to match and have this happen!  Don't know if anyone knows how likely this is.  Another view is that breast tissue tends to re-arrange itself after time so maybe dents etc. become less noticeable to us.  I am one year out of surgery.  Best wishes, Jaydee.

easyquilts

Jaydee...Actually, I didn't really notice much of a change 'till I started my rads.  At first, I thought it was my imagination, but no....it was real...My rad/oncol explained that it was a combo of the lumpectomy and the rads......The swelling was going down in the area of the surgery, and the rads were shrinking the tissue.....So.....

I probably won't do anything about this....I don't want more surgery, that's for sure.  I might consider it if I were thirty, but I'm sixty-five now, and it isn't the big deal it might have been thirty years ago.  Besides, I think you have to be looking for it to notice right away.  

OTOH, when I am dressing, I really hate seeing the difference.....It bothers me.  Thank goodnes for my good Bali bras with the soft underwire....They are wonderful, and when they go on sale again at Kohl's I plan to get a couple more.  They do a great job.

Got to head for the shower and start my day.....Ohio Stars (my quilt club) meets today, and that's always fun....

Sandy

hostanut

Sandy,

     Two + years ago I had a lumpectomy followed by rads.  Both breasts were small, and I decided last Sept. to have implants bilaterally. (I also had a deep scar from the lumpectomy and knew I wanted that revised anyway.)  Well, within 6 wks. of surgery I experienced a contracture.  It softened up some, but I always felt a hardness where the rads had been, plus I had a tenderness from the implant being shoved by the contracture.  I finally said,"Enough!!" and a week ago yesterday had a mast. completion with immediate DIEP flap reconstruction.  Now I finally have a breast that FEELS like me.  At the moment I look a bit like the Bride of Frankenstein, but my ps is such a perfectionist, I know I'll be great when all is said and done.  I'm simply a work in progress.  I also have the peace of mind that I no longer have the hardness, wondering if anything is growing beneath.  It may seem like overkill, but for me, it was the answer.  Even my 1st day post-op., which was rough, and my husb. asked,"So.......was it worth it?"   I said," Absolutely!!"    Good luck with your decision!

Nancy

easyquilts

Thanks, Nancy, for sharing your story....I'm so glad things are working out well for you, and that you are happy with your decision.

I probably won't do anything.....At least not just now.  I'm not wild about more surgery.  There might come a time when I will do something, but I really doubt it. We'll see how things go when I try to wear sweaters this winter...That might change my mind.....<g>

 God Bless,

Sandy

pinoideae

I have been lopsided a couple of times, I guess I obsess about symmetry.  First lumpectomy, radiation, reduction to radiation side (ps and I did not know what would happen when going in for surgery).  Reduction to good boob to match, and then pedicle tram on previous bc side, now going to have small implant (very likely the smallest available) on pedicle side (apparently they can do this by inserting implant through the side of breast on pedicle tram boob) and then fuller implant on good boob side.  Then nipple reconstruction, and thankfully, I am done. Right now I have to insert a cut out padded bra on good boob side to not look lopsided in clothing.  The padded bra cut out fits and stays in place well in the stretchy camisoles that have a kind of a built in stretcy bra thing.

easyquilts

Wow, Summer....That's a lot of surgery!  I'm not sure I could do a of that.  I certainly wish you good luck with it all.....You are one brave lady!

Sandy

pinoideae

Thanks easyquilts, just trying to get my pre-cancer boobs back...almost there.

BethNY

Lumpectomy + radiation yup, you can have reconstruction.

here are two different stories: same situations, but used different methods of recon:

http://www.breastreconstruction.org/Beth.html

http://www.breastreconstruction.org/GraceAnn.html

easyquilts

Hi Beth....Wonderful stories...Thanks so much.

Sandy

LisaF

Also, for those who haven't had surgery done yet, you may want to explore what I did.  I was a 40 DD/DDD and knew I would have to have a lot of tissue removed from the cancerous breast.  So I was able to have both breasts reduced, as I knew the BS would be removing lots of tissue.  My BS was about to have very wide margins ( over 2.5 cm!) and not worry about how it would look because the plastic surgeon took over after she did her job.

I haven't had radiation yet, and in my mind my breasts are a bit smaller than I would like, but I'm still getting used to it.  But, doing it all at the same time worked very well.

Lisa  

OG56

Thanks Beth for sharing your recon story. I didn't realize either that radiation could pose a problem for future breast surgery. I learn something new on the boards every time!

easyquilts

Lisa...Thank you so much for sharing your story.....You will get used to your breast size after a whie, I hope.  Some things just take time. 

I've never been "uneven" before, so am trying to get used to my situation, too.  I'm going to give it a while before making any decisions.  As I have said before, I really don't want to have another surgery.  And, it's probably not as bad as I think it is....I've been focusing on my right breast since May, so it's only natural for me to "see" a problem.

 Sandy

BethNY

Ohmaha girl that wasn't my own story, just a woman named Beth that we profiled on the web site I work for.

I started with a lumpectomy, but eventually had bilateral mastectomies and immediate free flap reconstruction.

But, yes, we do learn something new here every day.  I don't know what'd I do without these boards either.

nancy258

Has anyone heard of a procedure where a PS would re-arrange the tissue in your breast to even out a dent?  My BS suggested this might be possible once I get through radiation.  I have an area pulled in slightly under my nipple on the underside of my breast.  She said the tissue stuck to the internal scar tissue.  The size isn't really different, in fact my left breast which has had a lumpectomy and two re-excisions still appears slightly larger than my good right breast.

KAK

BethNY, thanks so much for those two links.  And thanks to everyone here for sharing your stories.  Really, really helpful. 

I've gone back & forth about this, but have all along leaned toward some kind of PS.  I had a very substantive lumpectomy (I call it a slab-ectomy!) last month that has healed into a deformity, adhesions, scar tissue & pain around the aureolar incision.  I'm getting rads now, which is going well.  I'm doing the 3-weeker, so I'll be done in a week & so far no skin reactions or other changes to speak of.  Now that there are shorter protocol options for external radiation, like the 3-week & the 2x/day x 5 days ones, it will be interesting to see if there are better outcomes over time in terms of how much shrinkage or other breast reactions women have.  If the outcomes are better, then maybe surgery after rads will be less of an issue than it seems to be now.

I saw my surgeon this past Friday to ask her about all this.  She said I would need to wait six months after rads for plastic surgery, but she said the whole thing about the skin thickness & circulation is an issue when the patient smokes or is diabetic or heals slowly or has other issues relating to circulation, none of which are pertinent to me.  So, she thought I would do well with it.  I was encouraged by what she said & by everyone's stories here.  The two links Beth provided with the photos are very encouraging & both women's surgical outcomes looked great!

Kathi

Wndalina

Hello gang!

On Sept 12th I had lumpectomy, SNB, AND a bi-lateral breast reduction.  I was a 40 DDD going in, and am now a low C.  Pre-surgery, my PS said my right (non-infected) breast was clearly larger than my right - at least a half cup size or more.  Bra shopping was horrible - I didn't have money to buy a special bra with one cup on one side and another on the left.  Well, low and behold the left smaller one gets the DCIS.  So, I opted for the reduction at the SAME time to finally be more equal - my silver lining so to speak.

My PS works with my BS all the time and is very familiar with the process I will go through.  He moved the fat around and I have no indication of the lumpectomy other than the incision scar.  My BS was in awe of how well the PS did it.  My PS even has my left one slightly larger - not like before - so that when rads start, they won't be so obviously different.

I am VERY happy being smaller - I hated my chest to start with - HATED it.  So, if I have a recurrance, at least I got to live a life with a normal sized chest for a bit.

I know this doesn't help you now Sandy, but if others haven't had surgery yet, this might prove to enter their minds as a thought.  I don't regret one minute of it.  The healing is coming about nicely.  I think my fear of what it would it would look like and feel like was much worse than it actually is.  I am finally getting familiar with the girls and they really are quite friendly and don't appear to hold a grudge against me for having them part ways with some of the fat tissue. :-)

Good luck in getting more comfortable with you current situation.  I did not see a lot of discussions anywhere about reductions, mostly mastectomies, so I went with my gut.

Roya

I had my lumpectomy on June 20th.  Before that I have some sagging after the birth and nursing of my now 4 year old.  My doc sent me to consult with a plastic surgeon and I am getting a breast evening out and bilateral lift one year from my date of surgery.......all of which is included in medical coverage.  This is also considered as reconstruction and I am happy about that.

dgrizwold

I was diagnosed in June 2007 two lumpectomies later and radiation... I had breast agumentation in September of this year.. both breast were beautiful and even for two weeks..my left breast ( b c side) is now smaller because the implant is having a tough time dropping.... my ps said for us to wait it out another couple of months and if there is no change back in for sugery to create another pocket... so I will keep you posted but I have to say..... if you dont feel good about the way your breast looks there are plastic surgeons that will do a breast agumentation.... I have been on this board hoping to find a successful story about someone anyone that has opted for the decsion I made.. I always wanted implants.... now I have them...... I am truly blessed to have got my b c before it spread ..... everyday is a blessing and life is way too short to not make youself happy....... good luck to you....

easyquilts

Although my right breast (bc side) is now smaller than the left one, I am getting used to it.. The shape is still nice, so I will probably not opt for any more surgery.....Not unless a recurrence happens! I might feel a little differently if I were a young woman, but at 65, I am content with things as they are.

 Sandy

 

jennifer808

Hi ladies,

I, too, had a lumpectomy & rads (2005-06) and experienced a significant size difference over time.  I haven;t read every post on the thread, so forgive me if I repeat some info here.  It took almost three years post-rads for the size difference to fully manifest.  My surgeon said that this is because rads cause "tissue damage" to the skin and innards of the breast and that it takes a while to get to its final state.  I am about to go for a PS consult, but will tell you all that the skin on the affected breast is significantly different than on the other.  It's thicker and seems to have virtually no elasticity, thus making me wonder how the surgeon will be able to "stretch" it to accomodate an implant.In the meantime, I have been using some little "water" bra inserts I bought at Target for $12 or so.  they work great and give me excellent symmetry when dressed.  Good luck to everyone!

Jennifer

KAK

I actually find it amusing sometimes to have a boob and a half, especially when I wear something casual & a bit clingy, & I don't have my prosthesis on, & I catch someone wondering why one nipple is 3" higher than the other.  LOL