Frankenboob fears

beeline

Hi all, I'm hoping someone with similar experience can weigh in and alleviate my fears -- or let me know realistically what to expect. I am about years out from a right-side MX, followed by chemo and rads. For various reasons I have been flat during this time. I am now scheduled to start the recon process with TE placement in September. The plan is to slowly stretch my radiated side until we can replace with an implant and then do a very small implant on my healthy (and super saggy) side. I was an A post kids and aiming for a B now.

I am suddenly just imagining the worst outcome -- half an orange bolted to my right side with no give or stretch due to the radiation, totally unmatching my left side. (I also for some reason imagine this as a boob-job gone wrong, but I know I'm being crazy there.) I have talked it all through with my PS who I trust, but who has warned me about the challenges of implant recon post-rads. He recommends flap surgery, but unfortunately I'm not a candidate for DIEP and not interested in the more complicated GAP, etc. flaps. I have emphasized that what is important to me is how I look in a bra or with clothes on, but I don't really want to look like a monster naked (I don't currently mind the flat side naked, but I def don't want to look worse).

Has anyone else had a similar recon -- single-sided MX with or w/out rads and then something for symmetry on the other side? Are you happy with the results? How symmetrical or not are you? Any feedback appreciated!

Runrcrb

why aren’t you a candidate for DIEP? I can’t answer for how an implant will do on the radiated side. My radiated side was fairly damaged but after diep is was good - PS could replace much of the damaged skin with belly skin.

DiveCat

I am not sure if it has changed (maybe, techniques have changed a lot even since 6 years ago!) but I know a few years ago sometimes surgeons would do fat grafting on a radiated side before going ahead with TE and implants to plump and soften/prepare skin better. Maybe check with your surgeon?

I also was not a candidate for DIEP or other flaps (nor did I want them at the time) but I also was prophylactic so no radiation. I am also bilateral so I am sorry I am not helping much as I just wanted to chime in on the fat grafting...but I am quite happy with my implants (I have Natrelle Inspira SSMs now, but have has a couple others) and find them reasonably squishy (though more like...a thick banana pudding than a natural breast, so movement is a bit different).

I know there are other women on here who have gone through similar surgeries to yours so hoping they choke in for you soon

beeline

Thank you both for replying!

Runcrb, I don't don't have enough fat in my stomach apparently. I carry it all in my butt/thighs. I even did a consult with the New Orleans place everyone talks about and they said the same thing.

Divecat, I should have mentioned I did indeed have fat grafting for exactly that reason! That's part of why the TE placement isn't scheduled until Sept because my PS wants to give the fat cells time to do their work. It's great to hear that your implants are reasonably squishy -- love the banana pudding analogy

DiveCat

Oh that's great, then you are least setting yourself up well then. I hope it goes very well for you.

Yes, obviously different implants have different cohesiveness (firmness) and it's a balance of keeping rippling down without being too hard, etc. I had Allergan 410s for many years until November and they definitely were not jigglers.

I have to give credit to my sister for the pudding comparison - I just added the banana part. We were texting today (after my fat grafting surgery) and somehow she got on topic of how they were slower to “move" toward armpitthan her real breast tissue when she laid on her back (she had BMX in November and implants put in In December) - like pudding. But still jiggly and they DO move!

LaughingGull

Hi beeline

I understand your disappointment about your options.

I was in a similar situation after unilateral mastectomy two years ago. My remaining breast was small and saggy, the operated side was tight because of radiation. The plan for the reconstruction was: cancer side, stretching and implant; non-cancer side, implant and lift, to make things even. I was warned that my breasts would not be perfectly even. Indeed, seeing the position of the expander and the position of the remaining boob, especially the nipple, it was hard to see how the final result could be good, and the PS was open that I would not look even.

In the end, I opted for a second, prophylactic mastectomy on the non-cancer side. The decision was not driven by cosmetics, but by screening concerns -extremely dense breasts with cancer never showing up in screening, be that ultrasound, mammogram or MRI. Having the remaining breast removed, and implants placed on both sides, made things even. I look good, and even, in bra and clothes, including bathing suits. However, I wish I could have kept my remaining breast, even if that would make me look uneven. I also have an appreciation now for natural, including saggy, breasts: my perfectly round and voluminous implants look even but...fake. I try to be kind to myself about this.

Breast cancer is deadly. Giving up your breasts is hard. The options for reconstruction are not perfect, and come with trade-offs. If I were in your feet I would write every option on a table or graph, with pros and cons spelled out in detail (including: keeping cancer breast and said breast causing your early death), to help you make the decision, and to make it easier to focus on the pros, and be at peace with your decision once you make it.

Best,

LaughingGull

beeline

Hi LaughingGull, you put it all very well and much more eloquently than I could have. I also have dense breasts and my tumour wasn't visible on MRI, so there is a consideration to remove the healthy one as well... at the same time, I feel I want to keep it even if it is changed for symmetry. I suspect what I am really going through is another round of mourning for my breasts, small and saggy as they are/were. Having better options would no doubt help, but I suspect I would still feel sad for the loss. x

LaughingGull

The prophylactic mastectomy will still be there down the road. You can try the reconstruction that they are proposing, and if you don't like it, you can always go for the prophylactic. Best of luck with your decision and dont forget to be kind to yourself

LaughingGull

beeline

Thanks LaughingGull, I think the kindness to ourselves is the hardest part! But yes, I was thinking I can try this now and maybe down the road there will be other/better options.