Reconstruction after Lumpectomy

Dogsneverlie

Hello!  My journey began in October 2013 with several biopsies, a lumpectomy in December, lumpectomy in February and RADS that I just finished in May.  I know that I am fortunate because so many wonderful women out here have had masectomies and when I think of reconstruction for myself because I am one full size smaller at least on my left side, I feel a little guilty, like I should just move on and leave well enough alone but every morning after my shower when I look in the mirror, what I see as a deformity is a constant reminder of BC.  I pray it will never return but I think we just never know.

So on August 5 I will meet with a surgeon and get her opinion.  I was curious if there are any other lumpectomy friends out here thinking about some reconstruction, what did you decide, what was it like, etc?

I am thinking about implants on both to balance them out; I have never had full breasts - I would not necessarily go much larger but certainly fuller.

I would love to hear back from you!

Donna

GwennyMD

I had lumpetomy in Feb 2013.  After lypmh nodes were taken they decided to give me 6 months of chemo. I have a long family history of BC including my mom, one of my sisters and two of my aunts.  Since I had tumors in both breasts and in 2 lymph nodes I decided to get rid of breasts.  Chemo was horrible and I never want to do it again.  Therefore, I had BMX with immediate reconstruction.  I chose to have a DIEP instead of implants because I wanted to use my own tissue.  Purely a personal decision.  I hope you are happy with whatever decision you make.

lane4

Hi, Dogsneverlie --You certainly can get reconstruction for your lumpectomy breast, but I would caution you about a couple of things. First, you may want to wait a while (at least a year) to let the radiated breast settle. Secondly, implants have a very high complication rate in radiated tissue. I, like you, ended up with a noticeably smaller breast after radiation, enough so that I got fitted for a partial prosthesis to balance the difference. I consulted with two plastic surgeons and decided to wait until a year after rads to have anything done. 

The first thing we did was reduce and lift the healthy breast. In fact, I had a liposuction reduction and a crescent lift which did not result in internal scarring. I had asked about fat grafting for my radiated breast. At that time, most plastic surgeons were not comfortable grafting fat into a breast, although they would use fat grafting to improve reconstructed breasts after the breast tissue had been removed. The thinking then was that placing fat, which stores estrogen, into breast tissue could fuel a cancer recurrence and the fat that doesn't survive could cause lumps that may appear to be cancer. Well, in the year after my contralateral reduction, my radiated breast appeared to get a little smaller, so I asked again about fat grafting. As it turned out, the plastic surgery community in general decided that fat grafting is acceptable after the results of a study showed that it did not appear to increase recurrence risk. So, I had fat grafted into my radiated breast. 

If I could do it over, I would have the fat grafting first, then adjust the opposite breast only if needed. I should have waited a couple of years, but I was so anxious to get back to an acceptable amount of symmetry. But it's all good, because it would have taken a load of fat and probably several grafting sessions to get me back to where I was to start with. I'm quite happy now with my lifted and very symmetrical breasts. 

I'd be curious to know what you decide to do. Please don't feel guilty about wanting your symmetry back -- it really helps you to move forward when you don't see a deformity in the mirror every day.

ruthbru

I would second the advice to wait a year from when you were done with rads. The first summer after treatment I could not wear my favorite swimsuit because the difference in size was so noticeable. I LOVED that suit though so kept it & the next summer was thrilled to find that the fat had shifted around enough so that I could wear again and it looked just fine.

Dogsneverlie

I wondered about waiting.............I am sure the surgeon will most likely say the same..........very upsetting isn't it?  To be so out of balance and just wanting your life back to the way it was before BC.  I will make sure to post after the August 5 appointment.  I would really like to do the fat grafting and hope she does not tell me to wait until next June but if that is the right way to do it, that is what I will do.