to do or not to do reconstruction ...?
I had both my breasts removed in March. I have healed very nicely even though I did have some compications from surgery. I have not had any kind of reconstruction as of yet & my DR suggests I still wait a while ....
I am still unsure about the whole reconstruction issue. Yes every so often when I look in the mirror it bothers me to not have boobs anymore ... and other times it is no big deal. When I go out I do not wear fake boobs ... even when I go swimming I go flat chested ... covered with my swimming suit of course ... LOL
I would like others' opinions on reconstruction versus no boobs ... my husband does not care one way or the other & has left this up to me ....
thanks for any input 
)
Comments
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Hi njdalex10,
I think you'll find that no one is going to to tell you definitely one way or the other as to what to do. This is such an individual decision, with so many variables. Its NEAT that your hubby has put no pressure on you. Mine is the same.
Like you, I have both breasts removed. (2nd one about a month ago) Heres what influenced my decision to opt for no reconstruction.
Age. Im middish 50's and hubby and I were pleased not to go this route with more risk from more surgery, and then if things go wrong, more surgery again. Remember even risk has to be weighed up individually. In my case it wouldve had quite a few implications that would not necessarily be so for others, like having to stop Tamox for surgery. For me, I'm really happy that Im not going to have anything false under my skin, and right now Im doing research on environmental estrogens (not manufactured by the body) and among many things, seeing if this is related to reconstruction options. It is indeed a huge field to study.
On another note, if youre in the public eye a lot, it may be very important and therefore worthwhile to you where the benefits outweigh the risks. For me that is not a problem either. Another thought is weather. We have quite a long "cold season" where you can wear bulkier clothing and you can get away with it. I'll be probably going flat mostly.
I think its great to be able to choose the size of breastforms you want. At least with these, if you dont like them you can easily opt for something else, whereas reconstruction leaves you with far more serious problems if you arent satisfied. Ive read a lot of horror stories but then to be fair, what we really need is to see what percentage of people are having no problems as to those who do, if that weighs into the equation a lot, and to me it did... then you have consider how problematic. We can all probably live with small problems but big ones are another matter. Even if we can find out that percentage between the worst problems as opposed to the best outcomes, one woman will choose differently to another as to what's important for her.
Hope that helps in some way, and hopefully others will weigh in too. I think, as your Doc says wait a while, take that time to read up and study on what others are saying and what other options there are and if they suit you. Time is a great leveler and it cant hurt to wait a bit.
Musical
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Njdalex10,
As Musical posted it is a very personal decision. Whatever YOU feel is right for you is best, not what others think or try to pressure you to do. However, sometimes we may not be sure exactly which way to go or have feelings we could go either way, with or without reconstruction. If it is helpful to read about the decision process other women have gone through, or to see a listing of Pros and Cons, I would strongly suggest you check out the BreastFree.org website. There is a specific section on deciding not to reconstruct and the rationale behind that decision.
There is also a page that has the personal stories of several women who have posted their reasons for making their decision regarding reconstruction. I think you may find this link very helpful.
I personally decided not to reconstruct after having bilateral mastectomy. I was a Stage 3C with many positive nodes and felt that reconstruction might interfere with future detection of cancer spread. In addition I soon developed lymphedema in my left arm following surgery and did not want to further damage my lymphatic system with more surgery. I have been very happy with my decision and feel totally at peace with both going flat or wearing a lightweight prosthesis when I feel like it. The healing process was quicker and I have gotten back to a very active and "normal" life where cancer plays a much less prominent role.
I wish you the best in your decision process and future health!
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I had a left mx in March 2008 and opted for delayed recon (leave the options open). For many months I said probably not after two hospitalizations during chemo (one for neutropenia and another for staph from a PICC line). However, the last few months I have gotten my energy back, feel better, etc and I realize I have a profound sadness about my body and appearance- I work in a Corporate environment so the foob is much more normal and I wear it all the time etc, love swimming but am very self conscious SO I am looking into DIEP recon.
I am VERY glad I waited initially and was able to finish chemo and rads and everything else- and glad I had a skin sparing mx so my options were open- there isnt a time limit on recon so if you are not comfortable now you can do it later and never do it if that fits you!
Kristy
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I also wrestled with the decision, and before my bmx, I met with a plastic surgeon. I'm not sure what swayed me to go the 'no recon' route...I think for me, I just didn't want to go through more painful surgeries so that I could look 'normal'. I don't want to pretend like this didn't happen, and I actually don't mind my scars or flat chest. I don't wear foobs...I go flat. I have lymphedema of the right arm and truncal lymphedema on both sides - wearing a bra is painful. So I don't and it's awesome.
For me, recon. just doesn't feel right. But that's just me - I have awesome friends who did recon. and are thrilled with the results, so do what feels right to you. It took some serious evaluating, and talking with my husband (awesome - he didn't want me to do recon. b/c he said he didn't want me to go through any more surgery - I am so blessed.), and I'm happy with the decision I made.
And if I ever decide I want to, that option is still there. Best of luck to you!
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I had a left mx 8/08, and decided to "wait and see" about recon. My sister had a pedicle TRAM, in the same surgery as her mx and i thought, ahead of time, that that's what i'd do. By the time i got to it tho, I knew it would have to be a flap procedure -- i can't stand the thought of implants. I also was unwilling to lose muscle -- i had an incisional hernia after my hysterectomy -- so i figured it had to be DIEP. But where i had the mx doesn't do one-surgery mx and DIEP, and all the places that did were very inconvenient. So ... i decided to give myself time to think and see how i adjusted.
I was badly depressed for months, but it got better (with help from a very good therapist). I also had a lot of physical therapy, so i have full range of motion, no pain, etc. I always wear a prosthesis -- despite losing some weight, I'm still 34C, and the remaining breast really needs a bra -- but i don't even notice it. Honestly, i mostly forget it's "not me" until i take it off.
Even at the worst times, there were 3 points that weighed against recon... 1. I had several complications after the hysterectomy (bowel obstruction, hernia) and really couldn't face any more. 2. The breast wouldn't have any sensation. 3. DIEP would leave me with *another* numb area, this one on my belly -- i already have a bit of that from the hysterectomy scar, and it really bothers me. Doesn't seem worth it to have a bigger one, just for a cosmetic effect on the numb part of my chest. (You may notice, i'm awfully sensitive to the feel of things, maybe less so than to the image).
One other thing went into the mix: my husband turned pale when he heard that DIEP takes 8-10 hours. He's been terrific, never tried to make decisions for me and didn't on this either -- but i realized that he'd be the one sitting and waiting while i slept through the surgery ...
So i never followed up on recon, and it seems OK. In fact, i just realized recently -- i feel normal again. I'm different, of course, but i feel OK inside my skin again. I've even - very occasionally - changed at the lap swim without going into a cubicle. Not often tho -- don't want to scare the ladies ....
A very personal decision indeed -- you need to balance your "have to" and "want to" and "can't face that" and come up with a decision.
Hugs!
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njdalex10, as I knew would be the case, greater posts followed mine, which should really help.
"One other thing went into the mix: my husband turned pale when he heard that DIEP takes 8-10 hours. He's been terrific, never tried to make decisions for me and didn't on this either -- but i realized that he'd be the one sitting and waiting while i slept through the surgery ..."
I think that is really really a nice thought Mouser. For those of us with great supportive Hubbies we need to say things like this. My hubby has already turned a ghostly white at my dx. Sat through 2 sep Mast. ops and Im sooo glad he doesnt have any more added weight to bear that is for us, unecessary.
Musical
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I decided to have reconstruction because I didn't want to look in the mirror every day and be constantly reminded that I had BC. I was very blessed in that I was able to have a skin and nipple sparing bilateral mastectomy. My BS put the incision under the fold of my breast so it will eventually be barely visible. My PS said when I am all healed no one would even be able to tell I had a mastectomy. I did lose sensation in the nipple but it wasn't big on my erogenous zones anyway! Although recon did require an extra surgery I was completely done within 4 months after my MX. I thought this was a short period of time considering it will probably be about 15 years until my implants will need to be replaced. I have been very happy with my results and my decision.
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This is my personal thought for you, as I'm facing BMX next Tuesday.
A month ago, I found myself looking at the bra department in clothing stores - and feeling great relief imagining the day I wouldn't have to go through the racks trying to find one that fit, that I didn't have to immediately whip off at the end of a long day, that didn't leave indents in my side ... and although I believe many people will notice my breasts are gone, tough. I hope they just give me a nod, or do nothing, and I'll be good. Let you know in a month or two though. My insides are so much more interesting than my outsides anyway.
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Nice to have Kate's pro-recon input, because I'm going to be another no-recon story!
I didn't want the further surgery or time. I work in front of the public in sales and wear all the sames clothes I used to except ones specific for cleavage. I was transferred to a new location 5 weeks ago and on Thursday mentioned to one of the women about my flat chest and she was absolutely FLOORED. She had no idea! I've heard the word "gobsmacked" and now I know what it looks like! lol
I even wear tight tees and don't worry. I was very large before 42D and am still heavier than I want to be, but I enjoy my slimmer profile and not having to wear bras. The arthritis in my neck and back is MUCH better. I wear my flat chest with pride and am famous on this site for saying, "I'm not going to wear fake boobs to make YOU feel better!" That's what I told a co-worker who was horrified that I wasn't going to wear foobs!
My options are still open, and so are yours. If I had had a single mast, I'm pretty sure I would have had reconstruction just for the weight balance. That's a totally different story and one I can't tell.
Best of luck!
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You will know when you really want reconstruction. My husband is pretty laid back but I don't think he knows how long the procedure lasts. I opted for nothing for 3 years,.decided on reconstruction and ended up with recurrence. I am glad I don't have to deal with the surgery although my surgery didn't allow for implants and the plan was to do a tummy tuck and no muscles were involved. Obviously you need a little extra tummy. I finally went to a specialty bra place and found two lovely bras and the prosthetic forms weren't anything like I thought they would be. Light and when inseted felt like a real boob. If I weighed 120 lbs. I wouldn't care. I would just go from a banana shape to a pear. There are a lot of pear shaped bodies out there looking good. Problem is I look more like the grinch (or without my hair, Uncle Fester) so to make my clothes look better I will wear the prosthetic out of the house.
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I am 18 month out. I did not have any reconstruction and I have no regrets . It is personal decision for you. I can see why some women would do so it just was not right for me. It sounded painful as hell too.
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This is such a personal choice....I know that for me, recon was a tough road, but since I am large chested, it just didn't feel right, to have nothing there. So I had a lat flap and I've never looked back.
That said, I am going for a prophy on the other girl to match and to get my reccurrence % d own to that lovely 1%.
But it won't be a lat flap!! I am very, very please with the natural look and feel of the breast and she feels just like me now (2 1/2 years out, takes some time) and I worry about her and buy her bras just like her big sister. Hubby accepted her just fine, altho no cherry on top yet.
It's your call, but this can wait, hon. You can recon years down the road if you want to. And some ladies prefer free also. All yours.
hugs
annie
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I chose to look at it like couch cushions: still me, just new stuffing
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I think it's great we live in a time when we can make these decisions. :0) I had one removed - no reconstruction but a reduction - quite a big reduction, on the other side so when I have to wear something fake, it's easier to even out.
I'm planning on getting fitted for a prosthesis in the near future. For me, I didn't want reconstruction because I wanted to have the surgery and just get on with my life and not have to have fills done, etc. But I'm not saying that's wrong for anybody but me - I just knew it wasn't me. I'm a HUGE worrier and I know I'd worry about if they were leaking or if something wasn't right. I know it's silly, but I know me. My surgeon put a lot of pressure on me to have reconstruction, which I did not appreciate. I'm happy with my decision. If I had to have both removed, I think I would have gone the same route.
I understand how traumatic it can be for some women to lose their breast(s) and I think it's great that we have so many options. If you want to see photos of reconstruction on actual women, and women with no breasts, etc., check out The Scar Project (google it). All different kinds of breast cancer scars on the most beautiful (inside and out!) women!
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anniealso- I just love your posts especially the no cherry on top comment! You always make me smile! :-)
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Hi Ladies! I still have a while before I make my decision (probably next summer), but have been thinking about it a lot lately. I had a left mx on May 24th. I have been wearing a very large, heavy prosthesis since then (I'm a size d\dd). By the end of the day I can't wait to get my bra off! But I wait until bedtime because I feel so awkward without it. My biggest issue is the dent in my chest and how visible it is. Also, even when I wear a shirt that isn't real low, I can't even slightly bend over or people can see the whole scarred area, because with the heavy pros. my bra hangs away from the chest and everything can be seen.
I would love to just have my other breast removed and not do recon., but I'm thinking clothing would look better, and I wouldn't have to worry about the big dents in my chest with recon.
How do you all deal with this?
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With both breasts off and no weight, my tops don't tend to dip open. I have no many pretty tops I wear and I'm still quite comfortable without breasts.
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I am 39 yr old. I reconstructed with saline implants just 3 months ago after struggling with the choice of to reconstruct or not to. I decided to give it a try and if I hate it I can have them removed. I never had a strong feeling either way, even after 9 months of thinking about it.
I do enjoy my cleavage (36D) a lot, and even naked they look pretty good, but I am not sure if I'll keep them once one needs to be replaced. Here's why: so far I am still encouraged to wear a bra day and night to keep everything where the doctor put it ( I expected to never need a bra again and never droop). I miss sleeping on my stomach (I can sleep on my side). And just this week I needed an echocardiogram (heart ultrasound) where I learned that the implants get in the way and make obtaining a clear image of the heart much more difficult. Arrrrgh! (FYI: there are other types of echocardiograms that work fine but are more intrusive.) And perhaps another reason this may be my one and only stint with recon breasts is the beautiful images by David Jay's The SCAR Project. His flat-chested women look beautiful! Honestly, I am more self-conscious about my fat belly than my chest with or without recon. LOL
Good luck.
BTW, the fills and implant exchange surgery were not bad at all in my experience (way less pain and healing than BMX). I read horror stories about recon, but did not experience any difficulty. I think unfortunately many more people post who had negative experiences than positive with recon.
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I had a unilateral mx with implant and I regret it. It has caused me pain. The only reconstruction I would consider is the Brava System done in Miami Florida. It is truly amazing. It will be the choice of the future. The procedure uses your liposuctioned fat to 'grow' a new breast. There is a another thread discussing this. PM me if you need help finding it.
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makingway,
I got so excited when I saw your post and immediately googled and read about the procedure. I haven't had a mx and hope I never will. But I do know that I will go with a bmx if I hear any noise from these girls in the future. At one point I was considering a prophylactic and honestly what stopped me is the long surgery and recovery for reconstruction. After research I felt my choice would be diep which I would have to travel far from home to have.
Since I live a little over two hours from Miami that seemed to be another plus if I made this choice. But then my brain started working overtime and here is the big question..................If this procedure grows new breast tissue then aren't we starting all over again being high risk? On the website they actually say it grows new breast tissue. I am not crazy about the breast tissue I have since it grew cancer.
In continuing to read about this procedure I was left with the impression that is more for breast enlargement rather than reconstruction, Yes it did clearly say it could be used for reconstruction but I still say why would I want to grow more of my breast tissue?
Just some thoughts.
Caren
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Caren,
I agree that there is a concern with this fat grafting reconstruction that any remaining breast cells left behind after a mastectomy could actually be stimulated to multiply -- not a good thing. And since it's virtually impossible to remove every single breast cell during a mastectomy, there will always be some left over.
Although I've chosen not to have reconstruction after a bilateral mastectomy, I try to keep informed about viable new options for reconstruction. Especially since fat grafting is relatively non-invasive (although you have to have several liposuction procedures, each involving general anesthesia in a hospital, with all the attendant infection risks), I wanted to learn about it. I spend time in Miami, so I went to see Dr. Khouri last spring. The Brava system, as he explained it, definitely does stimulate tissue growth. On the other hand, my own research found that expansion with tissue expanders (for the placement of implants) also stimulates growth of new tissue, but there's been absolutely no indication that it promotes recurrence.
So, maybe the Brava system is safe and won't put women at higher risk for recurrence. One thing that is appealing -- Dr. Khouri says that the injected fat forms its own blood supply and that this can help restore skin and muscle that's been radiated. I think fat grafting is an intriguing idea for reconstruction and I believe it may be the wave of the future, but I'd need to see some studies demonstrating safety before I'd consider it.
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