Reasons for delaying reconstruction?

elise24601

I'm planning my mastectomy with immediate reconstruction for end of next week.

Several women I've spoken to told me that their reconstruction had to be delayed (not by choice). I'm wondering what are the reasons for this? Would it be something going wrong during the initial mastectomy?

I'm really scared of this happening to me.

Reckless

It was more likely due to subsequent radiation or chemotherapy treatments

Kicks

It can depend on your DX. (You haven't filled in your Profile so no idea what type of BC you are dealing with. . With IBC - it is common for recon (if it's wanted) to be put off for a year.

Kicks

OOPS. - Dreaded double post!

laura_ingalls

Hi ladies.

I have only just started chemo and will have surgery after four months.

I know very little about surgery. Just trying to get through chemo right now. But my onco mentioned surgery in passing to me today...she was telling me I will have to take 6 weeks off from work when I have surgery. They may need to do a mastectomy or a lumpectomy in one breast

So again I don't know too much about reconstruction or surgery but ever since I found out I was going to have surgery I had planned on delaying reconstruction. The reason: I am planning to have more children as soon as I can get the medical clearance to be pregnant again and I don't want any artificial fillers amalgams etc in my body while I am pregnant. I figure I can wear a prosthetic for a few years.

I am an engineer...I think in terms of function not really form I guess. So for me the breasts were for breastfeeding. I will get the reconstruction done after children just so my body is balanced and I don't end up with back pain.

Am I crazy for thinking this way? Is there anything wrong with my plans?

If you have input I would humbly appreciate it.

I hope all of you are doing well.

Hugs.

Laura*

cookiegal

Laura I don't know why anyone would need 6 weeks off for a lumpectomy. Also if you have a lumpectomy, reconstruction is not usually needed, sometimes people have a revision later on.

Since you are having chemo before surgery, hopefully you can shrink the mass, have a lump, and rads. (Rads do take 6 weeks if you are not doing canadian fraction, I did not work, but many people do.) I probably could have worked the first 4 weeks.

That being said Laura, there is nothing wrong with your plan. All of these choices are personal. Some people are totally comfortable reconstructed, some people hate it. Some wear a prosthesis, some don't. I really think the only wrong plan is one that someone else pushed on you.

Maya15

Hi Elise, I can't speak to your situation because it depends on your diagnosis, but for me the reason I have to delay reconstruction (not my choice) is because they think it's likely I will need radiation after mastectomy. They won't know for sure until the surgery pathology report comes back, but radiation can permanently damage the reconstructed breast so they advised me to wait.

nicsilz

I had a mastectomy 4 weeks ago and my reconstruction had to be delayed because while I had quit smoking a few months ago, I continued to use the patch. My plastic surgeon said (and this was confirmed with other opinions) that the restriction in may blood vessels from nicotine takes up to six months to correct itself. If I had done reconstruction immediately, there was a very good chance that the wound would not heal and I would have many, many complications. This has happened to many women whose surgeons either didn't ask about nicotine history, or didn't know better.

nicsilz

Also consider finding a surgeon that can do reconstruction using your own fat tissue and not implants. It isn't an option for everyone...but if you're worried about implants you can look into that. My good friend had two very healthy amazing boys several years after having bilateral mastectomy, chemo, radiation and reconstruction with implants.

ElaineTherese

elise,

Many women delay reconstruction because they will be having radiation treatments, and radiation can damage the skin/area that will be part of the reconstruction process. If radiation is not part of your treatment plan, you can pursue reconstruction immediately.

Laura,

I agree with cookiegal. If chemo shrinks your cancer enough, you may be able to get a lumpectomy, which DOES NOT require six weeks off from work. (I went back to work part-time the day after my lumpectomy, and was back full-time the next week). My chemo cleaned out the active cancer in my breast and compromised lymph node. My surgeon ended up taking out a golf-ball sized amount of tissue from my affected breast. There is a small dent in my right breast above my nipple; I have not bother to research or pursue reconstruction because the small dent is insignificant to me. I'm not sure whether that breast would still be able to breast feed, but my left breast has been untouched. Of course, I'm 48 and finished having kids, so this is theoretical for me. Best wishes with your treatment, and I hope you retain your fertility!