Beware: Athletes who choose reconstruction may regret it

mdg

As far as the abs and such - I had a hard time doing abs for a long time.  I had a lot of rib pain on the upper right side.  I can tell you that the thing that has made my aches and pains go away is yoga.  I can't believe how much this has helped me.  I have been doing it for 1 1 /2 years now 1-2 times a week and I think it should be recommended to all BMX patients.  My ribs no longer hurt.  My shoulders have regained their range of motion.  My arms are stronger.  And most of all, yoga helps me clear all the BC junk out of my head and have a positive outlook on things.  Just wanted to share....FYI

Not-Me

I am not sure if I have the sub sternum TE?  I have an appointment Monday and realize that I do not know that much about reconstruction.  I need to ask questions about this, and also about his experience with athletic women.  In this area, he is known as the very best, and I am in a major metropolitan area.  

I certainly do want to resume lifting weights.  I only lift ten pound weights anyways, as I bulk up too much in the arms with anything more.  

I agree with mdg about the yoga and will start it back as soon as I get the okay.  It is essential to all of us, in the aging process.  I really find that it helps with my snowboarding as well.

What Qs should I be asking the PS on Monday?  

Thanks!   

NatsFan

This is a bit off the original topic, but remember that anyone with any nodes removed is also at risk for lymphedema.  You need to take care to build up upper body strength slowly and safely.  Believe me, you do NOT want to trigger lymphedema. 

Here are some guidelines from the Stepup-Speakout.org  lymphedema website about how how those of us who had any nodes removed can exercise safely now that we have lymphedema or are at increased risk for LE. Here are the links.

stepup-speakout.org/Handout%20...

stepup-speakout.org/Trainer%20...

The first link gives some quick guidelines on safe exercise. If you want to start or resume your exercise program, this documents can give you some helpful ideas about exercising safely. 

The second document is designed for exercise professionals.  You may want to print out a copy of this and give it to your personal trainer or yoga instructor or any other fitness professional you use.  The document will familiarize them with lymphedema risks.  With better informaiton, they can work with you to make sure you're not inadvertently engaging in risky behavior that could trigger lymphedema. 

bhlri

This is a great Post and discussion. I am not a super athlete but am a dancer. I volunteer and rescue big dogs and work with them. Have 4 of my own. I just can't think when will I be able to go back to dancing and working with my dogs. Need my full use of arms and no pains in my back . I am having tough time sitting up for long time and driving for more than 30 mins. Having back pain issues. I was so fit prior to surgery that this is depressing me. My husband and I have plans of opening our own no

Kill shelter and I just don't know if I will be able to do any of it. I hope BC doesn't take away that from us. Need to talk to my PS after reading this. Thank you!

DocBabs

I think I'm one of the fortunate ones here. I am a competitive tennis player and I had a BMX with silicon implants with Alloderm and no real problems or limitations that I can see.I have some distortion with certain movements but I expected that since the implants are under the pec muscle. I went almost immediately to PT after surgery. I also have a total shoulder replacement on my dominant arm and I was particularly concerned about not losing any ROM or strength in that arm.I do not do push ups only because of my previous shoulder problems not because of the implants. I do agree with the poster that said you should thoroughly discuss your lifestyle with your PS so everyone knows what limitations may or may not be ahead.I would never dissuade anyone from having implant reconstruction.I think it's the least complicated of all the options and it can always be changed.

lisa-e

A quick comment - DocBabs - you say that implant reconstruction can always be changed.  I think while it is true that implants can be removed if necessary, that does not mean all of the damage that caused by the implants would be reversed by the surgery.  

I think implant surgery is an insult to the body in that it interferes with muscle function.  A woman who is considering really should consult not only with plastic surgeons to get their opinion on how the surgery would affect their athletic ability,  In addition, I think consults with several physical therapists are in order so they completely understand how they might be affected.  

exbrnxgrl

Not-me,

I think you mean sub pectoral. That is where the TE is placed, under the muscle, because the breast tissue has been removed.

EileenKaye1

My biggest problem with implants was excessive scar tissue. Just had implant and scar tissue removed. What a relief. Range of motion is almost at 100%. Undergoing breast reconstruction with fat grafting. Eileen

Gran

lisa-e:  I totally agree with your statement to DocBabs that the damage that was done can never be un-done.  That is what I am facing now if I have my subpectoral implants removed.  Muscle tissue that was cut never bonds together again to heal, and I don't know how much of mine was damaged beyond repair, let alone the possible nerve damage that I am being tested for on the 21st.  If the nerves are damaged or cut, then the muscles (in my case the serratus anterior) will not function.

What was done cannot just be changed back.  Also, if a change is needed then it means facing yet another surgery and recovery period for one thing, and, if your health insurance is lousy like mine is (because I have to get private insurance and even the best policy they have has a $3,000 deductible plus a 20-40% co-insurance depending where you go to have the procedure done) then if I choose to take my implants out I will most likely be facing enormous medical bills.

I also think it is important to speak with lots of different people about the effects of the surgery:  PS, physical  therapists, a physiatrist (rehab doctor) and especially athletic women who have had the same specific surgery and have important stories to tell about their results -- good and bad.  That is the whole purpose of this thread:  To help women who are pre-mastectomy and are trying to decide what to do, as well as those of us who have had surgery and have had either no problems (the lucky ones) or those like me who have been severely affected in our athletic lives.

Gran 

DocBabs

Gran, From what I have read it is rare to have any permanent damage to the pec muscles as a result of implantation.The implants are placed through a muscle splitting technique that allows the muscle to remain connected to the breastbone and it's insertion at the shoulder. When the word rare is used it implies that it could be possible and in your case it would appear to be so.I have bilateral THRs ,with a lot of muscles cut, and yet I have no decrease in leg function. I'm sure that there are some that have problems.Complications can occur with any surgery but that doesn't mean that the surgery should be avoided.For the majority, the results are favorable the most of the time. 

JMHO

Gran

DocBabs,

You said yourself that you are one of the lucky ones.  Many are not so lucky.  This thread is to bring together women to talk about the problems they have had and the solutions they may have found, as well as counsel women newly diagnosed who have questions and concerns.  I am glad you don't have any issues, but many of us do.

When I spoke to the mastectomy surgeon she told me that even if I took the implants out I would not regain function because there is too much damage to the pec muscle.  Those were the words of the surgeon who performed the mastectomies and works with the PS that finished the job by placing subpectoral tissue expanders.  A different PS told me I would at least get rid of the distortion problem with the implants if I removed them, but he has no idea what he will find as far as muscle damage when he goes in.  He never told me that there would be little to no damage.  Also, it could have been the serratus anterior or it's nerve that was damaged -- that would explain a lot of the shoulder instability I am experiencing.  I am a nurse, so I know all about constructive language that surgeons use to cover their butts.

Your blanket statement that "For the majority, the results are favorable most of the time." doesn't mean much.  The majority of who?  I am talking about serious athletes here, not your average middle aged woman who does mild to moderate exercise.  The exercise many of us do is (or was) extreme -- and we are the people having the problems.  I'm glad you don't have any problems, but I don't think you should be making statements about the majority.

Gran

lisa-e

DocBabs, I also have had bilateral hip replacements.  I think it is disingenuous to compare hip replacements to implant reconstruction  following mastectomy.  Hip replacement restores function, while reconstruction is cosmetic.  I was willing to take a risk that I would have permanent side effects after having my hips replaced because I was in severe pain and unable to walk without a cane, let alone participate in any athletic endeavor.   I was not be willing to take the risk of surgical complications that would limit my ability to climb for a surgery I consider cosmetic.

DocBabs

My reference to hip replacement was only in regard to muscle cutting,unless you've had an anterior replacement done.I guess all i'm really trying to say is that I found the original post to be very frightening to those that are contemplating the process and I wanted them to know that this complication is not common.For many, reconstruction goes far beyond being only cosmetic.

lisa-e

DocBAbs, the original post was intended to be cautionary.  If you are the one who has complications from  surgery, it sucks.  Before any surgery, you need to be well informed of the risks so you can make a truly informed decision - if you think the benefit is worth the risk.   If I had relied solely on the plastic surgeon my breast surgeon asked me to see so I could make an informed decision, I would have had reconstruction.  After further consultations with several physical therapists and an osteopathic physician I decided against it.  The benefit - a more normal appearance - wasn't worth it.

When I say reconstruction is cosmetic that is not meant to downplay it's importance for many women.  I am saying what is restored is outward appearance - not function, including sexual feeling.  

Outfield

Orthopedic surgeons have honest discussions with people all the time about the options after an ACL tear.  Some people don't need a repair because their activities are biking and walking.  Some people need the strongest graft they can possibly have because they're going to return to their Division I basketball teams.  It's so disturbing to me that so many plastic surgeons don't have these types of discussions with women after mastectomy.  Implants will obviously effect the function of the pecs by changing the force vectors within the muscle.  That's not going to matter for some women, but if there's good reason to think that it will matter I think it needs to be on the table.  

Gran

Hi Outfield,

Your point is well explained.  I totally agree.  I think I had 2 or 3 appointments to talk about the implants before I even had the TE's placed, just because I was so concerned about how cut pecs would affect my physical performance.  I was never told anything about how the shoulder girdle can become destabilized, even though I have since seen articles detailing this.  I was also never told about implant distortion even though if you look hard enough you can find those articles, too.

I actually hired a PhD medical anthropologist friend of mine who has access to the best databases in the world to do this research for me.  The research is out there and available to the surgeons, but much harder for regular women to locate without having access to full medical libraries and reference librarians to help sift through the data.

 I think in my case the PS should have told me that since I had so many concerns about my pecs being cut, I should just have the mastectomies first and then do more research on my own to see if reconstruction was the right path for me.  I felt so pressured to conform and, to my own discredit, I went along with it.

I'll never forget the first time I had the green light to use my arms again ( I waited an extra 2 weeks to make sure I wouldn't cause damage) and I went down to ride my bicycle on the indoor trainer but the back tire was flat.  I tried to pump it up with a hand pump that I had always used all my life, and I was unable to do so.  I was horrified!  I wrote an email to my PS and told her I can't even pump up my bicycle tire, let alone do anything extreme and I asked for her help.  She totally blew me off -- she wrote back, but not with an ounce of compassion or any ideas to help me.  She didn't even suggest physical therapy.  And guess what?  I still cannot pump my tires to their full pressure with that pump like I used to.  That is hardly an extreme sport!

I realize now that she gave me the standard implant surgery like everybody else gets, even though I thought she was taking special measures.  Hard enough to be sold out by a surgeon, but a female surgeon who is a triathlete -- well, that hurt even more.

Gran

Erica3681

Hi Gran,

I've been following this thread and just wanted to say that I hope you're not too hard on yourself about this--you clearly asked the appropriate questions; it's just that the answers you received were inadequate.

I'm active, though definitely not a serious athlete, but I did care about being able to do everything I'd been doing before (walking, hiking, working out). When I had a consult about reconstruction, because I'd had radiation on one side and was deemed too thin for most flap surgeries, I was advised to have lat flap reconstruction. I was at a Harvard teaching hospital, yet I feel the risks of muscle weakness and pain were totally downplayed by the PS. Even with the information I had, I began feeling very anxious and decided to have my BMX without reconstruction. Only later did I really become aware (through reading on this website and elsewhere) of the many possible complications from the type of reconstruction I had been considering.

One thing that I have heard is that it is particularly women such as yourself, who have very well-developed pecs due to strenuous athletic activity, who are prone to "animation deformity." So, I think it's very appropriate that you post here to let athletic women know about the problems they may encounter if they proceed with implant reconstruction.

I feel there's a lot to be said for delaying reconstruction--more time to research your options and possible complications, plus time to see what it's like to live breast-free. Some women don't like it and become more committed than ever to having reconstruction while others realize they're happy without it. On my non-profit website, BreastFree.org, I frequently hear from women who are considering deconstructing, i.e. removing their implants. Most who go ahead with it are glad they did. Many, though not all, experience complete alleviation of pain and a renewed ability to engage in athletic activities.

Barbara

1Athena1

Not sure I am too comfortable with the sweeping, rather alarmist language in the thread title. Recon surgery can go badly for anyone, athlete or not. Important not to generalize from one's own experience. Especially since size, shape and body type matter.

Gran

Hi Erica, 

Thanks for your comments and support.  I will check out your web site BreastFree.org.  

I, too, had my surgeries at a Harvard Teaching Hospital, so I expected the surgeons would be up-to-date and be able to find answers to the questions I was asking.

I am so glad you listened to your feelings and acted accordingly by not having reconstruction.  I didn't listen to my gut feelings.  You're right, sometimes I am hard on myself for making the wrong decision.  That is why I wanted to start this thread so I could at least make serious athletes aware of the many downsides of reconstruction that we often don't hear about from our doctors.  Had I read a thread like this before my surgery I would have opted to wait and do more research before considering any reconstruction.  It can always be done later, so there is no need to rush one's decision.  

Thanks again for writing!

Gran

NatsFan

Gran - I agree that you were not given adequate answers.  When I met with my PS I told her that maintaining strength and being athletic were important to me, which is why she recommended a DIEP flap over implants. Fortunately I had the belly fat for a DIEP.  I know that someone with very low bodyfat might not be a candidate for flap surgery, but all of that should have at least been explained to you so you could have weighed the pros and cons for yourself. 

I had a staged skin-sparing DIEP with t/e placement to get me through active treatment.  As others have said, delaying recon gave me the time to do additional research.  In the end I decided to go ahead with the DIEP when active treatment was over, but I could have changed my mind and gone with implants or no recon had I wished.  Had DIEP not been available to me, I would have seriously considered no recon.  I know that t/e and implants are different, but having the t/e in my chest for 9 months killed any thought that I might be happy with implants. 

You'd hate to think that $$ has anything to do with it, but flap surgery is often several hours long and I've read that the insurance payment isn't significantly different than that for implant recon - meaning that even if the surgeon is skilled in both types of recon, there's a financial incentive to do implants rather than flap surgery.  They can do 2-3 implants surgeries in the same time it takes to do one flap surgery. 

Beesie

I for one am glad that Gran started this thread and I think the title is 100% accurate. Athletes should beware before they undergo reconstruction. They should discuss with their PS what types of activities they do because if they don't, they might regret their choice of reconstruction or even their decision to have reconstruction. That seems to me to be excellent, practical advice. Reading the responses, it's clear that quite a number of women have had problems - so it's not at though these types of problems are that rare.

When women make the MX or BMX decision, they are thinking about the benefits of getting rid of the cancer and reducing their future breast cancer risk. The possibility of long term problems rarely enters into the decision-making process and it's rarely brought up by those who've already gone through the process, not even by those who are experiencing problems. As a result, too many women go into the surgery without understanding what might happen. Don't we have an obligation to be honest about the risks so that anyone choosing a MX and reconstruction can make an educated decision?

Are all women negatively affected?  No, of course not.  But a surprisingly high percentage of women, particularly those who have implant reconstruction, do experience long-term problems.  Most of the problems are manageable but not everyone is so lucky.  And what is manageable to one woman might not be manageable to another.  Lifestyle - including one's involvement with athletics - is a factor.  For me, I'm not particularly athletic, although I admit that there are some activities that I used to do that I just don't do anymore because I don't like how my implant reconstructed breast reacts and feels afterwards.  Where I notice my MX and reconstruction the most is when I do something that I don't usually do - travelling and dealing with suitcases is one example. Lifting heavy suitcases into and out of the car, or hoisting them onto and off of baggage carousels always leaves me with an achy breast for several days.  Since vacations are supposed to be fun and carefree, honestly, this is one of those small things that really p!$$@$ me off. 

I didn't comment earlier because I don't have anything to add to a discussion about concerns with reconstruction for athletes.  But I am surprised at some of the criticism that's now coming out about this thread.  If someone started a thread that was titled "Reconstruction is the best!", no one would be suggesting that the title and thread are inappropriate because not everyone is so happy with their reconstruction results.

rozem

Gran - thank you for starting this thread and no I do not think its alarmist at all.  Thats what this discussion board is for.  Actually I wish wish wish someone had warned me about lat flap surgery this way - i would have never done it.  My PS totally downplayed the pain and physical limitations i would have with this surgery.  The LD flap combined with implants under the pecs has totally thrown off my body.  I feel so off center.  I had a very frank discussion with my PS, the nurse navigator and his fellow before this surgery.  My EXACT words were "im young and active and i do not want this surgery to comprimise this" all of them said i would be fine - the only thing i would not be able to do is "mountain climb" referring to not be able to do extreme sports. 

- I have had several meetings with patient relations and the CEO of the university hospital where i was treated and have shared my experience as well as some of those of the women on this site who were kind enough to email me.  I told them that flippant remarks like "you just wont be able to mountain climb" are totally inaccurate and do not, in any way, give the patient the real risks of this surgery.  I told the entire plastics dept (whom i met with) that if they had to live in my shoes for even one day I doubt they would EVER recommend this surgery or at the very least give the real risks.  I am trying to get the surgical consent forms to include much more specific  complications that go beyond the stardard: infections, etc.  Will this help me? no, but if i can spare even one woman the nightmare of this surgery then thats what i will do. 

does every woman have the same issues? no ,however I think there is enough of us with varying degrees of complications that full disclosure is very important for these types of surgeries

Outfield

Beesie, thanks for that post.  I was feeling that, but unable to put it into words.

Gran, I think you mentioned back somewhere about concerns that insurance won't pay to have the implants removed.  The WHCRA (Womens' Health Care Rights Act) of the 1990's mandates that if an insurance company cover mastectomy, they cover complications of mastectomy and reconstruction.  I think the act was mainly meant to ensure everyone could have access to reconstruction, but I used it to my advantage to get a small surgery to release a tethering axillary cord covered (my cord was not the usual axillary cording, which does not generally require surgery).

Although I never seriously considered reconstruction and have fairly happily stayed flat, I am a pretty darn serious athlete at the sports I do - very different from yours - and this thread has been one that has really stirred my empathy.  I was more than disappointed with my interactions with two plastic surgeons when I was trying to get my cord taken care of.  First utterly blew me off and didn't even examine me, second had no clue what to do.  They were so focused on their assembly lines of reconstructions they had no time for someone like me, who as it turned out needed a 15 minute procedure that I got done by a PS specializing in burns.  I figured with his burns training he'd have more interest in functional issues, and he did.  My probem was that when I raised my arm suddenly, I'd get this YANK! when the cord went taut.  I had good range of motion, but it was uncomfortable and really distracting when I was jumping up for a ball over my head.  I am sure that either of the first two PS's, had they cared to put a little effort into it, could have done what was essentially the same as a vasectomy on my cord - tiny incision, remove a few cm of it - but they didn't respect my functional goals enough to put in that effort.

I think there's a not-so-subtle objectification of women in the PS/reconstruction industry, that treats everybody the same.  We're not.  We're more than how our breasts look.

Gran, I wish you all the best luck with this.  I was thinking about you today, and what came to mind was the amazing recovery of abdominal muscles after a woman has a baby.  The skin, not so much, but my muscles at least made a heck of a lot of recovery from that stretching.

Gran

NatsFan, Beesie, rozem, and Outfield,

Thanks for your stories and your support.  I am dedicated to making this thread a place where athletes can go to find out information from women who have had various procedures with various results -- women who have been there!

NatsFan, my PS did talk about DIEP but I did not have enough fat to do it.  I had few if any choices:  silicone implants or nothing.  And nothing was never really presented as a REAL option.

Beesie, Thanks for being so supportive.  I write this thread with a lot of regret for decisions I made, but also with hope of helping others.  Every woman must choose her own path, but she must be made fully aware of what each path could entail.  Who better to tell a woman who is struggling with these decisions than women who have ALREADY struggled and have valuable information to share.  

rozem, I am so sorry for your situation.  I had one PS tell me that he could do wonders with my lats and I freaked.  No way was he going to touch my latissimus dorsi muscles!  As a former bodybuilder I knew that would be a terrible mistake for me because they are critical muscles in everyday life.  And you not only have the lats involved, but also the pecs.  Now I feel like the lucky one!  I applaud all that you have done and are doing to educate the doctors and staff.  You have also posted a very important chunk of information here on this thread for any woman whose doctor is trying to talk her into the same or a similar surgery.  Kudos to you for your guts and determination.  PM me if you want to talk more.

Outfield, I have private insurance since my employer doesn't provide group insurance to per diem employees.  My insurance company wins every time by making me pay large deductibles and large co-insurance payments.  They can get away with not paying for a fairly large percentage of the cost in this way without breaking the WHCRA laws.  It is obscene what they will not pay for!  I also wanted to say I'm sorry that you had such trouble finding someone to treat your condition.  It's like trying to find a carpenter do do a small job -- all they want are big jobs.  Your cord problem was affecting your quality of life -- even if most women would not care if they could jump up to catch a ball over their heads, what matters is that it matters a lot to you.  I think many doctors don't understand that an athlete who is dedicated to her sport MUST be able to perform that sport unimpeded by problems that can be fixed.  Otherwise, quality of life diminishes.  

Gran

mawhinney

Up until 10 years ago it was thought that  after a mastectomy woman should not participate in any form of exercise. Thankfully that is no longer true!  I belong to a cancer survivor dragonboat team. About 11 years ago  several members of my team participated in a study on the benefits of exercise for women that had been diagnosed with breast cancer. The study proved that exercise was beneficial both physicallly & emotionally. Today we have over 100 survivor members and race around the world.  There is an inspiring documentary film, Awaken the Dragon, about our team showing at film festivals around the country. Hope you get a chance to see it.

This has been a great discussion.  Please consider that some of the discomfort and pain folks are experiencing may have resulted from the primary surgery.  Removing a cancerous tumor can involve cutting into & damaging the chest wall, muscles, veins &/or nerves. Scar tissue may develop and tighten. Thus some of the pain folks are experiencing may possibly be a result of the original surgery.

Gran

mawhinney,

You are an inspiration!  I will look for the film.  All of us owe you women a debt of gratitude for participating in the study re: exercise after mastectomy.  You ladies took us out of the dark ages!  Kudos to you all!

I agree with you that some of our problems could have come from our original mastectomy procedures.  In my case, the nerve that controls the serratus anterior muscle is in a location close to the latissimus dorsi area, and according to my operative report the mastectomy surgeon went over into that area to remove breast tissue.  I am sure she was careful not to cut the nerve, but it could have inadvertently been damaged by her.  I am having a nerve conduction study done to check on that nerve.  The PS who put in the TE's and then the implants never went that lateral so she could not have damaged it.  

You see, I have 2 problems going on (as if one isn't enough!).  The first is as explained here, with the possibility of nerve damage that could be causing shoulder girdle instability, and the second problem I have is distortion of the silicone implants themselves because my pec muscles are very strong.  They feel horrible when they are contorted, and it seems that the simplest activities cause them to distort and/or make me feel like I am wearing an iron bra.  Soon I should have some answers.

Thanks so much for posting about the study, and for talking about your dragon boats.  I'm gonna have to google that right now!

Gran

argynis

It is now definite that I will have a masectomy for my right breast and maybe also for my right one depending on the result of the genetic test.

Doing reconstruction using a muscle or getting implants is no option for me - in my eyes that would be insane to do for a young and very active person.

The only option for me is a DIEP flap which should be possible (I have enough belly tissue for one small breast) and I could also get a skin sparing masectomy. It is not clear yet if I need radiation as they have not yet biopsied the lymphnodes (they will do that during masectomy) but there is evidence that 1 or 2 may be affected from the PEt/CT scan.

I have the feeling that the plastic surgeon wants to wait till after the chemotherapy with reconstruction but the surgeon that does the masectomy said that this would mean I loose my breast skin as he could not do a skin sparing masectomy without immediate reconstruction - is that true? He said the skin would not survive. Can anybody tell me if that is really the case? It is also such a pain to reach them personally and get appointmens.

dltnhm

Argynnis-

I had a SS NS UMX with immediate DIEP reconstruction. I had met with my MO and RO prior to my surgery. I discussed various DIEP reconstruction options with my entire team (BS, PS, MO, and RO).

Initially I was considering TE "placeholders" at surgery. I was concerned about damage to my intended reconstructed breast from rads. My PS discussed both with me, but leaned heavily toward immediate DIEP. He said that it would be possible to use fat grafting if there was loss or contracture due to rads.

But having TE placeholders between SS NS and DIEP is something others have done.



Each of us has to decide what is best and will work for us. I am thankful that I went the route that I did. I had a six week recovery, but was cleared to run after that and ran through chemo and rads. My surgical sites healed well. I am having an outpatient surgery to remove a small flap of skin that was added at the time of my initial surgery. My RO and PS agreed that no surgery take place on that breast until 6 months post rads. That seems to be a fairly standard wait time between rads and surgery.



I hope this helps.



I high recommend you read up on exercising safely. Natsfan posted links on this thread on March 9th. Make certain you discuss PT with your BS and PS prior to surgery so it's on everyone's radar. Some BS send you to have presurgical measurements regarding LE. (I did not have this, but some patients did).



You also might get some answers to your NS SS placeholding if you start your own thread - something along the lines:

"Anyone have Skin Sparing with TE and delayed DIEP?"



Place it in the Surgery- before, during, and after.



Hang in there and keep adking questions and seeking info. Knowledge is power!



Diana

Gran

Argynnis,

I will write you a PM with some advice.

Granis

curveball

@argynnis,
I had a skin & areola sparing left mastectomy last June, with no TE as a "placeholder", and have not yet had reconstructive surgery. The left side of my chest looks strange, like a balloon with the air let out, but the skin is still quite alive. Neither the breast surgeon who did my mastectomy nor the PS I have consulted about planned DIEP reconstruction have said anything about potential problems in using this spared skin for delayed reconstruction. I also faced a possible need for radiation after MX because of the location of the tumor--that was one reason my reconstruction wasn't done immediately. I ended up not needing rads, so I can't tell you how that might affect the spared skin. If you have DIEP, there is the option of using the skin from your abdomen, if the spared breast skin has been too damaged by radiation.