Reconstruction options

Fingersntoes · December 2010

I am having a mastectomy Dec 28 after going through lumpectomy (margins not clear). PS gave me 3 options: implant, implant with lattisimus dorsi flap (sp?), or TRAM flap.

I am looking into TRAM for the tummy tuck benefit. The only thing keeping me from doing it is recovery, longer and more painful than implant.

I would really appreciate anyone imput about pros/cons of all options. I havent rule out implant yet so I would love some imput on that too.

Thank you!

mom3band1g · December 2010

I had a mast in March and just had my exchange surgery this past Tuesday (had radiation in between). I did TE's and then silicon implants. I chose implants because I have 4 young kids and I wanted to be recovered as quickly as possible. The other 2 options you are looking at just scared me because they were so much more invasive and the recovery is much longer. That is just me though and many women have done the other options. There is a part of me that can't believe I didn't do the tummy tuck one. My Aunt did do that and she really would not recommend it because of the recovery.

I'm sorry you have to make this decision, it is not easy at all.

CTMOM1234 · December 2010

Here's the reconstruction forum link -- lots of wonderful information there:

http://community.breastcancer.org/forum/44

as an aside, I was dealing with the option of mastectomy v. lump and rads. and had I gone the former, was going to proceed with DIEP reconstruction as I did not want implants. Met with a plastic surgeon prior to my lumpectomy just in case margins weren't OK.

CandDsMom · December 2010

I had a free TRAM - I am overall happy with the warmth and softness of the breasts although I have had a lot of complications mostly because my initial plastic surgeon just wasn't very good and I was too scared at the time of diagnosis to do much research. I switched to a specialty PS and have had good results on my revisions to date though.

Anyway, are you talking about a free TRAM or a regular TRAM? I would definitely NOT do the regular TRAM - they take your whole rectus muscle which you need for abdominal and core strength as you age. There is a good chance you'd be left with a big bulging belly after that just because the abdominal wall is not supported enought. If you want a flap, I'd personally go for a DIEP - it is a free TRAM without taking ANY muscle, which means the recovery is going to be better. Check out www.breastcenter.com or www.drmarga.com to see more info about options. Full disclosure: I switched to Dr DellaCroce in New Orleans to do my revisions and I have been very pleased with the results. Good luck with everything!

Anonymous · December 2010

Fingersntoes- I did a NSM with TE's and had my exchange surgery in June. I have to say that my experience with implants doesn't seem to be as positive as some. They feel very unnatural on my chest. I would think that anytime you're using your own tissue it would just have to feel more normal than putting something artificial in your body. My other concern is having to have these implants replaced years down the road. I was not considered a good candidate for a TRAM or I definitely would have considered it. I have been reading about the fat grafting where they create a breast purely from your own fat. Supposedly you retain more sensation and it is a much less invasive procedure. Unfortunately, this is still in the early stages so not that many surgeons are trained in the procedure.

Reconstruction options

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