Ready to give up on reconstruction

dollarmom10

Hoping there is someone out there that has had a similar experience with reconstruction that can offer some advice.

Here's my surgery story...had a skin sparing BMX in October 2014 with no reconstruction. This was recommended to me because I was having radiation to my left side after the mastectomy. Finished radiation in December 2014. Finally in September 2015 my.plastic surgeon put in tissue expanders. I had them filled over the span of 4 months. The right breast expanded easily. The left breast did not. I swear the expander pushed up rather than out. It felt like it was touching my collar bone. There was capsular contracture of the left expander. Left the expanders in and full for 3 months beforw finally having the exchange to silicone implants. Right side did fine...left side is deformed. I healed fine and with no complications but because of the radiation, I have a significant dent right in the middle of the left breast, no "underboob" as I call it, and it is up a little higher than the right. In July 2016 I had my first fat grafting to both breasts. I feel that it made some difference in the size of the left breast, but unfortunately did not fix the dent. I just had another fat grafting last week, and I know it is too soon to judge the breast, but the dent is still there and now my breast has a few more creases and lumps. I am so sad and starting to think that all of this surgery is just a waste. I don't know if there is hope for me. I can't find anything like my results when I search Google. I wish I could share pictures somewhere! Maybe then I could find someone like me. I want to know if there is hope for a better end result if I keep doing surgery or if I should just call it a day and remove everything and live life flat chested.

Thanks in advance for any advice!

nihahi

I am so sorry that you have these struggles. If you look at my history, you will see that I went through no recon, expander, implant, implant rupture, re-implant, capsular contracture and finally a Tram free recon. I did not have radiation. I do know that radiation can cause many issues with implant recon. I know that once you have had one incident of capsular contracture the chances of another are greatly increased. Fat grafting typically results in minimal changes to contour, and can be "short lived" for some women.

Have you considered recon using one of the free flap methods? There is still hope for you to have successful recon.

dollarmom10

Hey!

Thank you for your reply. You sure have gone through a lot with your recon! I'm glad you've had success finally! My ps said that he would recommend a diep flap as a last resort. I have considered the flap surgery, but then also thought of how it may not work and then I get scared! I'm not sure how many more surgeries and drains I can mentally handle. ☺ I haven't completely ruled it out just yet.

nihahi

It is understandable to have fears of any surgery, and no one really looks forward to adding "yet another" to their personal list. Don't feel that you aren't strong enough or brave enough. You just need to have confidence in your team. Do you have any info on how many flap recons your current PS does? If he doesn't do them often, he likely isn't going to want to go in that direction. From what you have said....I bet his flap numbers are pretty low, and that would not make me comfortable with his plan for you.

In my opinion.....you would benefit from getting some second/third opinions from some PS who do alot of flap surgeries, and are skilled microsurgeons. It surprised me to read that your PS considers that type of recon to be a "last resort" scenario, especially with your radiation. It doesn't usually work that way.....many, many women who have rads are told implant recon is not an option for them. Of course, there could be valid reasons why you aren't a candidate, but I would ask for more detail on why your PS views it that way.

I'm certainly not trying to push you towards a certain type of surgery, but.....I have been through all the scenarios, and the flap recon breast is the absolute closest to a natural, warm, "all me" recon you can get. I was 63 when I had my tram free....healed well, very, very minimal pain, uneventful healing and was hiking 3 months later with a backpack. If I could do it....I bet you can too.

You are far from at the end of your options. Take care.

debiann

I had DEIP flap surgery. It took 4 surgeries to "get it right". The initial surgery took 13 hours. Although the process has been long, I'm totally loving the results. My breasts feel warm and natural.

If you are a candidate for a flap surgery, you may want to consider abandoning the implants now, before investing anymore time in a procedure that doesn't seem to be working for you.

A second opinion would be a good idea. While my original surgeon was good, after two revisions my lefty was still shaped funny and very painful. He told me that was the best result I could get. His plan was to do a nipple recon in his office, however he moved before I scheduled the procedure, so I had to use a different PS and I'm sure happy I did! The next PS recommended a nipple/areola recon along with a third revision. He felt he could improve the shape of lefty and remove the necrosis that was causing me pain. What a great job he did!

I understand how difficult it is to go through so much surgery only to be disappointed. After my first three surgeries, the pain was getting to be so overwhelming I thought about getting lefty removed. Neither the PS or BS took my complaints seriously, saying the pain was normal and it was still healing. Believe me, it was neither normal or healing pain. The second PS, although not a micro-surgeon so he could not have performed the initial DIEP, did a really incredible job fixing things up.

Good luck to you.

dollarmom10

Thanks ladies! I have often thought about getting a second opinion, but shyed away from it because of my fear of making my surgeon feel bad. Crazy, I know! I am a people pleaser so I often put my needs last. I am only 37 years old and don't think I can be happy with myself with the way I look now. So many people say to just be grateful that I'm alive and cancer free, but they really don't understand how even something like your appearance can make it hard to move on. It's a daily reminder of cancer which sucks! I am going to start researching other plastic surgeons in my area.

mustlovepoodles

Oh dear! Don't spend one more single minute worrying about what your doctor is going to think if you get a second opinion. People get second opinions all the time. It's part of their business. Any doctor that can't handle that doesn't deserve your money or your trust.

When I went to pick up records to take for a second opinion, my plastic surgeon happened to overhear me. She came barreling out of the back yelling, "I told you I could put implants in there!" My husband and I just stood there, shocked. I felt terrible about hurting her feelings...until DH pushed me out to the car and said, "WTH was THAT?!" and then *I* got angry! How dare a doctor get mad at me for asking another doctor for his or her opinion! The utter gall! We hit the gas and never looked back.

ual0307

radiation and recon is a bitch.

I had several fat grafts....no te, no flap. There was little cosmetic improvement after the first five although it did ileviate all tightness and pain. In frustration I waited 9 months for the skin to better rejuvenate. When I did the sixth, I finally had expansion and softened the skin.

I am now almost 4 years from umx, and hope the seventh finishes the job.

Good luck.