Lumpectomy and reconstruction

Daisy-Donna

I had a lumpectomy and a re-excision for breast cancer 3 years ago. After chemo I received 6 weeks of radiation. I have never been happy with the look of my left breast since. It is significantly smaller with a large indent. Has anyone had reconstruction after a lumpectomy with radiation? I am having a consult in a few weeks and was looking to hear about any experiences.

chimp1

from chimp1

good luck to you... i went to the plastic surgeon today. i have very large breasts. one had a lumpectomy because of cancer. i have scarring, redness, inflammation , neck pain, upper back pain, and a indent where they took out the tissue. i want a breast reduction on both breasts to make them smaller and the same size so i wont have this neck pain. the surgeon was nice but i had the impression he didnt think it would get approved through insurance. in fact , i am the one who has to gather all my information from my primary care doctor, back surgeon, etc about my back pain. they wont do any footwork for me. should i go to another surgeon? is this normal practice?

Fixmyradboob

I had a lumpectomy and re-excision in June 2014 and radiation in September 2014. Now a year later, I am having my first consultation for reconstruction tomorrow, another consultation next week with another doctor and a third consultation with Dr. Khouri in Miami on Oct 6th (yay!!) I did a small consultation with a surgeon before radiation began, but was basically told that a flap would be my only option, unless I wanted to go ahead and go back under for a "finishing mastectomy" and get full implants. But I had my heart set that my <1cm, grade 1, stage 1 did not feel right to do a full mastectomy, so pressed forward with only lumpectomy and radiation. My indentation is not that bad (looks like the right side of my breast is flattened against an invisible table) and you cant really see my scar unless I lift my arms up naked. I do see the difference in the radiated side is already more perky, partly b/c the way they pin-tucked up the incision it added a smidge of fullness at the top; I can see how my unradiated side will soon look droopy by comparison.

I would love to hear experiences too - and will share what these doctors say. Based on research I feel like Dr. Khouri is the only one who has the approach to deal with radiated skin effectively.... but we will see what they all say.

ual0307

good morning ladies,

I'm not in the same position as you. I had right side MX with rads in 2013

I did a PS consult with 6 drs. because flaps sounded terrible and implants would be risky. I consulted with Khouri because I loved the thought of the fat transfer.

I actually chose the fat transfer but with another dr in Orlando. I love him. The procedures aren't bad. The fat transfer is slow, but I hope worth the wait. I've had 3 so far. Fourth is next month. The rad damage was extensive but it is healing. I've actually started to feel a little more on that side.

I don't have volume yet but the skin feels great, the tightness in my chest is gone, and the area is now smooth with no more dents or adhesions. I hope I mentioned it's slow.

Good luck with your decision and treatment.

lane4

Daisy-Donna - Check into fat grafting for your radiated breast. The fat can be placed in the indented area as well as throughout the breast to increase the size. (It is possible that it will need to be done in more than one grafting session.) The plastic surgeon you choose should ideally have a lot of experience with fat grafting, as the surgeon's skill and technique are the most important factors in the outcome.

Daisy-Donna

I've been reading about the fat grafting and it sounds very interesting with the added bonus of liposuction. I definitely have some areas that could contribute. My appointment with the plastic surgeon is Wednesday. Not sure about her experience in fat grafting. I am definitely going to ask about it. I'm in the Northeast so its not feasible for me to go to Miami for a consult with Dr. Khouri.hoping that there is someone up here that has experience. I will post an update after my appointment.

Daisy-Donna

Fixmyradboob - Love the name! How did your first consult go?

owlwatcher

Dear Fix, That procedure is so new where I am in California.It is barely starting. you are smart to go to someone that has so much experience.

BethL

I had a lumpectomy in 2005, but a very large area was removed above my nipple and when the incision was closed it literally pulled my nipple up. I joked that it looked like my breasts were winking at you. Complete with an eyebrow (scar).The breast was much smaller than the other. I had mammosite radiation and started to see a lot of changes 5 years after the radiation. Scarring actually got worse and I started having pain, I made an appt then for a ps. Even though my breast size was ok on the "good" side, my ps put implants bilaterally stating that the fullness would not be the same if she didn't. It was a very small implant on the unaffected side but I could see what she meant. A year after that I had a mastopexy on the good side to lift the nipple to the same level as the radiated side. A suggestion would be to get a few opinions, I probably would have chosen a different surgeon if I had looked, but I used one a friend used. I think there are better options out there as some others have mentioned.

Daisy-Donna

So had my consult yesterday. The PS said she wouldn't recommend fat grafting with a lumpectomy because of possible calcifications and how they might appear on a mammogram especially since my journey began with cancerous calcifications. She recommends a small implant and then do a lift on the other side. She did say ifmy oncologist and radiologist were ok with the graft then she would do it. Waiting to hear back from them to see how to proceed.