Delayed reconstruction

MO17

I live in a very rural area and there are no plastic surgeons in the area. I will have to drive (have someone else drive me) 2 hours to the plastic surgeon for expanders to be placed after surgery. My plastic surgeon said I can have the procedure done as soon as 24 hours after the bilateral mastectomy. I'm having surgery done on April 28th and was thinking about having the expander surgery on May 1st. I live alone and my cousin will be staying with me for the first 5 days following the mastectomy, so she would be able to transport me to the plastic surgeon. Am I being unrealistic to plan it too soon? I work and have used most of my short term disability with illness relating to the chemotherapy treatments. I only have 5 1/2 weeks to get back to work. Time is a huge factor for me.

Moderators

Hi MO17, and welcome to Breastcancer.org!

You've come to the best place for support -- you're sure to get some advice soon from others here who have been through this and can help!

Thanks for posting -- we look forward to hearing more from you soon!

--The Mods

Alli

is there a breast surgeon near your PS? Just hate for you to have two surgeries so close together when they could be done at the same time.

Midwest_Laura

I agree with Alli. Most women have their TE's placed immediately after the breast surgery. Immediate, as in still on the operating table. The breast surgeon and the plastic surgeon should work together for a single, coordinated surgery.

MO17

I have no choice. It will have to be done post mastectomy. I'm just seeking advise if I should wait the few days or wait weeks, or if I should give up all together on reconstruction.I only have the 5 weeks of paid leave. I am on my own. Now other source of income or support.

hummingbirdlover

Hello!

I had BMX followed by delayed reconstruction. I was annoyed at first because I couldn't understand why they couldn't do both surgeries at once, but whatever the reasons, that's the way it ended up for me. I waited five months before I had my expanders placed. I was completely healed up and strong and was happy I waited. It did mean a little more time off of work (for 3 surgeries and 3 recoveries) but overall I'm happy with how everything went and was grateful for the recovery time in between surgeries. I recovered very quickly from the surgery to have the expanders placed (but spent one night in the hospital), worked all of the way through my fills and then just took a very short time off for the exchange surgery. To be honest, I was glad I had those few months in between the BMX surgery and the TE placement surgery. I wish you all the best in your journey!!

MinusTwo

MO17 - As others have said, the TEs are usually placed while you're still on the operating table after the mastectomy. The BS and PS work together. I can't imagine having another major surgery that soon. Your tissues & muscles & nerves & skin & blood vessels will all be swollen & painful. You won't even be sure yet that there are no infections. In fact, you probably will not even have the results back from the surgical biopsy to completely identify the type & grade of your cancer. Not to mention that I don't think you want to have anesthesia twice that close together. At best, I think that takes more than a week to work it's way out of your body.

Why not make the drive upfront and have both the mastectomy & TE placement done at once at the PS city?

You do have a choice. It is always your choice since it's your body. If you feel you must go to the local surgeon for the mastectomy, I would not schedule reconstruction for at least 6 months. In fact, you could wait a year & build your paid disability back up. Then of course you will have to make the drive for fills to your TE and eventually for for exchange surgery.

Yes, I live alone. Yes I had reconstruction. Yes I went through it alone w/help only for the first week after mastectomy and two days after the exchange surgery - nine months later. I drove to every chemo alone, and to every radiation. So yes, I've been there and I understand. Try to make it as easy on yourself as you can.

MamaOz

I am not sure where you are, but the expanders should be placed during your mastectomy surgery with both drs in attendance... I have several friends who have just had this done

MO17

Unfortunately, it has been almost a year battling CIGNA just to get approval for the mastectomy because there was not a general surgeon in the area on my plan. The PS was applying for surgical practice at the local hospital at the time I was diagnosed and didn't see a problem with the timing (I went through chemo first). Now a year later, and he hasn't been approved. I've been seeing the two Drs for nearly a year and starting over after all this is very disturbing. I just want to put this cancer behind me and move on with my life.

Alli

MO17

I'm sorry that you are in this insurance dilemma. I totally get wanting to put BC behind you.

I had a two week period between my BMX and my direct to implant surgery. My delay was to evaluate whether or not my previously radiated skin would heal or if I would need some sort of flap surgery.

Having the 2 weeks between was doable though not ideal. I felt like I was just getting back to feeling good when I had the second surgery. So... If you could wait 2 weeks between I think that would be my minimum suggestion. You may even be able to make that 5 week return to work time frame that you need. No way would I have been able to have surgeries just a few days apart.

If your PS does direct to implant, I think it is a great way to go as long as you aren't wanting to go larger. No need for the TE process with fills and a later exchange surgery. Also, pre pectoral placement recovery seems much easier that what many with below the muscle placement experience.

Good luck to you as you are having to make these decisions.

Lisey

MO17, I had immediate TES and regretted them immediately. Had them removed and decided to live flat and fabulous. Having no reconstruction is amazing, and I suggest before you decide, you join the closed flat and fabulous facebook group. . There are thousands of us. The breast cancer mods just put a study up showing over 66% of women with recon have complications. Go to the latest research thread to see it. There are so many benefits to waiting and trying out flat. I look thinner, younger, and no boob sweat, bras, or surgeries.

MO17

Thank you all for your input. I have been a DD since Jr High. My daughter as well. I cant imagine going flat, but am considering. I am also considering using the creepy PS who is local and is on my insurance just to get it done. The two week suggestion that Alli wrote is a good consideration as well. So much to consider under a very stressful time in life! I will get feedback from my GS and make a final decision by tomorrow. Thanks again for all of your support and input.

Alli

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MO17-have you made Amy definitive plans yet?

Where are you located?

Once you have a definitive plan, you will feel so much better

Please keep us posted. If you have any more questions , please don't hesitate to ask.

Alli

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