Reconstruction

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All Member Posts: 1
edited June 2014 in High Risk for Breast Cancer
I will be facing a bilateral mastectomy, my surgeon suggests talking to women that have already gone through this.  I have talked to one that did no reconstruction, one a silicone implant and one with a tram flap.  Using my own tissue appeals to me but the length of time on the table DOES not.
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  • lbrewer
    lbrewer Member Posts: 766
    edited July 2009

    You should research DIEP flaps also.  It is longer than implant surgery but less than tram.  It does not use the muscle as tram does.  Most surgeons do not perform this surgery as it requires expertise in microsurgery.  Check out diepsisters.com for more info.

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  • Deirdre1
    Deirdre1 Member Posts: 1,461
    edited July 2009

    In addition to what lbrewer stated you might want to go the reconstruction forum on this same site, where women share their experiences (good and bad) every day.. Good luck.

    My own reconstruction was silicone implants after bi-lateral - I thought about the natural tissue way but first TRAMS can harm your abdominal muscle and as lbrewer stated the DIEP flaps take two experienced surgeons because the surgery takes so long as well as the microsurgery..    My intention was to have the fully cohesives but they are not approved in the US I had to take the next best thing which for me was the silcone gel (but not fully cohesive and there is a difference)!  THey do feel a lot like regular tissue except where the flap doesn't completely cover the bottom portion and then I can, sometimes feel the implant through the skin..  But I have textured and they are a bit more "rough" than the smooth surfaces..  Good luck!

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  • dlb823
    dlb823 Member Posts: 9,430
    edited July 2009

    All ~ I had a Diep about a year ago (unilateral, 7.5 hrs.), and, you're right, the time on the table does not appeal at all.  In fact, I was very scared about it.  But, I knew I was in great hands (UCLA), and I eventually decided I'd rather get it all done at once (mast+recon).  And, as others have pointed out when this question is asked, we sleep through it, so really have no concept of the time once we're out.

    Unless you have other health issues that would make a long surgery especially worrisome, I'd say pick a highly skilled plastic/vascular/reconstructive surgeon at a top-notch hospital, and don't let the length of the surgery dissuade you from doing what you want.  I also rationalized that no competent surgeon and team would expose me to something my body couldn't withstand -- especially when it was not mandatory.     

    Good luck whatever you decide, and stay with us now ~    Deanna

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  • LISAMG
    LISAMG Member Posts: 639
    edited July 2009

    All, where are you located? DIEP tissue transfers are the latest cutting edge reconstruction type of procedures done by highly Experienced micro-vascular plastic surgeons. The pioneers who do this, do it everyday all the time. Surgery for a PBM average 6-8 hours, not 12-18 hours like many less experienced surgeons,,,a huge difference. Seek different opinions and remember surgeons will ONLY recommend their specialty. Decide what YOU want and find the surgeons best for you.

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  • lbrewer
    lbrewer Member Posts: 766
    edited July 2009

    Be sure to ask HOW MANY DIEP PROCEDURES the doctor has done.  It is important to find a surgeon who does them routinely, not just someone who says they can do it.

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  • mawhinney
    mawhinney Member Posts: 1,377
    edited August 2009

    Consider that the going under and coming out of anesthesia is the most difficult part and not how long you are under. If a DEIP is done at the time of the matectomy, you may only need one trip to the operating room.

     Implant reconstruction involves anesthesia when you have the mastectomy and again when the expanders are installed (unless the expanders were put in immediately after the mastectomy). When it it time for the exchange from expanders to implants you will again need anesthesia. If you need a revision as I did more anesthesia!

    Also consIder with a DEIP your recovery may be longer as you will have two  large incisions from 2 major surgeries.

    So many decisions!

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  • happy29
    happy29 Member Posts: 296
    edited August 2009

    Hi I am in the same boat. I have three consultations with plastics. The one this week is two hours away in NYC with Dr Allen- I think he pioneered the flap procedures. I am going to see if he would consider doing an outer thigh transfer of tissue. Any one heard of that?

    Also the other doctors -one also does flaps and the other uses implants. I am confused , overwhelmed and very anxious! How am I supposed to know the right decision?

    The thought of going out of town is frightening and using a different breast surgeon for the mastectomy. Also the lodging for my hubby and how many times would I have to go back. It makes me think I should stay local and just choose implants because they seem easier but yer I hear of infections. I guess there is no quick fix because it is cancer :( 

     help anyone.

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  • LeeMcC
    LeeMcC Member Posts: 152
    edited August 2009

    Me, too. In the same boat. I talked with Dr. Marga Massey by phone consult on Saturday, and I'm considering having DIEP or GAP done with her in Charleston (3 hours from Charlotte, NC). I'm also seeing Dr. Craigie in Charleston for DIEP, as well as a PS here at home for implants.

    I've ruled out DIEP at NOLA, cause I can't write the upfront check ... and I don't want to have three plane trips/hotel expenses for all the phases. BUT, I do agree with the others on this forum who say make sure you have an experienced microsurgeon if you choose DIEP.

    I'm overwhelmed at the choices between DIEP and implants, and I keep going back and forth. I don't like that implants are hard and have no sensation. I also don't like that they don't last forever (I'm 47, so does that mean I'll need a new pair of "sisters" when I'm 60 or 65?). But the microsurgery involves additional incisions and drains at the tummy or butt ... and wearing Spanx for compression for 2 months! Ugh!

    I'll post here next week after my various consults. I'm hoping some kind of "Aha!" moment helps me decide ... then I can feel assured and at peace while I wait for the surgery date! (which I hope is in September)

    Lee

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  • jillisucat
    jillisucat Member Posts: 451
    edited August 2009

    I had DIEP reconstruction at Johns Hopkins in Baltimore, MD, and definitely am happy with my choice.

    I have a friend who had Dr. Allen in NY for DIEP, he pioneered the DIEP and has an excellent reputation.  My friends stayed in Hope Lodge in NYC, I think there is one in every big city and they will let you stay there for free when traveling for cancer treatment.  Definitely worth checking out!

    Good luck!

    Jill

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  • Daudine
    Daudine Member Posts: 221
    edited September 2009

    I had a propylactic bilateral mastectomy with implants. I was one hour and a half on the table.

    I really don't think that the time spent on the table is the worst part of the surgery ;o)))))

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