Two types of reconstruction

BCTrish

Hi All,

I am new here.  I am a long time breast cancer survivor.  I was diagnosed in 1996 at the age of 37.  Cancer was aggressive and nodes were involved.  I had a right breast mastectomy followed by chemotherapy (CAF).  Two years after treatment I had reconstruction done with TRAM FLAP.  I had a total hysterectomy in 2000 as there was a family history of both breast and ovarian cancer in my family tree. Life has been good.....I have remained cancer free for almost 18 years!

About 11 years ago I changed oncologists.  My new oncologist suggested genetic testing.  I tested positive for the BRCA 1.  I have been doing the surveillance thing since then but had been toying around with having my left breast removed.  Last year I had a pretty good scare.  Also this past summer my oldest daughter did genetic testing.  She tested negative.....but was prepared to do what she needed if the results warranted.  So after much discussion and full support of my family and friends I made the decision to have my left breast removed.  My surgery is scheduled for June 2.  

Now finally to my question.  My right breast is a TRAM.  My PS said it will be tough to match that but he can do it.   We talked about a Latissimus Dorsi but he feels he will get just as good a result using the tissue expander/implant with eventual revisions on the TRAM breast.  Has anyone out there had this done?  Two different type reconstructions?  Also....I know I will be very unbalanced this summer.  Has anyone used a breast form to even things out during the filling process?  If so what kind?

Thanks in advance for your answers.  I am a teacher and tend to always look ahead and troubleshoot.  

nihahi

bctrish......I have had implant recon in the past, and now have a muscle sparing Tram free recon. I'm not sure from your post what type of Tram you already have. From my experience, I will tell you that an implant breast feels NOTHING like a flap recon. I would ask your PS if he means "good result" in looks, or in looks and feel. Very different in my opinion.  Does your PS do other types of flaps other than the Lat flap? If not, have you considered getting a second or third opinion, from PS's that do things like GAP flaps. There are now a variety of flap types that can successfully be done, without the inherent muscle involvement of a lat flap, which often requires an implant also, to give "volume". 

Hope you have success in which ever path you choose.

kareenie

how about autologous fat grafting? it is a very  natural result in looks and feel. especially appropriate  for a prophy mx reconstruction. if you can do skin  sparing mx withh immediate fg so much the better.

jbdayton

I was offered the same solution of an implant after having a bilateral DIEP that turned into a single DIEP due to bad veins.  I absolutely detest the idea of an implant.  I started researching other options. there are several other types of flaps.  You may have to go somewhere else to get the flap you want.  

Look at prma-enhance.com or breastcenter.com to see your other options.

I am going to do my other breast with a flap using my hip and upper butt for my next flap.  Not my PS's favorite tissue but he is going to do it for me.  Fight for what you want.