Need help: No immediate recon

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Danadane
Danadane Member Posts: 27
edited June 2014 in Living Without Reconstruction After a Mastectomy

Hi,



My BMX was moved up to Oct. 4th and I don't feel comfortable moving so quickly into reconstruction without having talked to other plastic surgeons about options. My breast surgeon said that she would prefer me to have immediate reconstruction because if not then she has to save the skin in a different way. Does anyone know what that means? Is it really such a bid deal? And, last but not least, should I make sure to ask her to save the skin in a certain way (I have seen some reference to "dog ears")?



Any thought will be greatly appreciated!!!



Thanks,

Dana

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  • NatsFan
    NatsFan Member Posts: 3,745
    edited September 2011

    Dana - see if your surgeon can do a skin-sparing bmx with tissue expander placement.  That will get you through active treatment and give you the time you need to decide without compromising your ability to choose different options.  Skin-sparing also gives the best cosmetic result. 

    If you decide to do implants, the expanders can be filled then swapped out.  If you decide to go with DIEP, the expanders will act to keep the skin from healing flat.  If you can get a consult with a ps before your surgery, that will give you a lot more knowledge.  I had a skin-sparing bmx with tissue expander placement, and a delayed DIEP several months later.  I'm very pleased with the result, and I can wear a bathing suit, even a very low cut one, and no one would ever know that I'd had a bmx.  Good luck!

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  • ma111
    ma111 Member Posts: 1,376
    edited September 2011

    Consider telling her you don't want to move it up because you have not talked with other PS yet. You need to be comfortable in what you decide to do.

    If you need radiation post op than expanders can be contraindicatied, ask your PS.

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  • Danadane
    Danadane Member Posts: 27
    edited September 2011

    NatsFan and Ma111..... Thanks so much for your suggestions and for responding so quickly! Way too many decisions in too short a time.



    Wishing you both peace and healing!



    Thanks,

    Dana

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  • NatsFan
    NatsFan Member Posts: 3,745
    edited September 2011

    Ma - Good point about the expanders and rads.  Different doctors have different policies about expanders and rads.  I was originally scheduled for an immediate DIEP, but came up with a positive node prior to surgery.  Since radiation was a possibility, the ps work with bs and put in tissue expanders at the time of the bmx because I might need rads.  However, my SIL was scheduled for t/e placement at her bmx, but the minute she came up with positive node she was told she couldn't have tissue expanders in because she might need rads.  Completely opposite policies when it came to tissue expanders and rads.  And they wonder why we go crazy trying to sort it all out!

    Dana - if you want a good website that explains the different recon procedures, Hopkins Avon Breast Center has an excellent site:   http://www.hopkinsmedicine.org/avon_foundation_breast_center/treatments_services/reconstructive_breast_surgery/  The site explains all about tissue expanders, implants, DIEP, TUG, etc.  

    And as Ma says, if you want to consult with a ps prior to surgery, then just tell the surgeon you'd prefer to keep your original appointment so you get time to consult.  Good luck!

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  • marial
    marial Member Posts: 255
    edited September 2011

    I Had a skin sparing mastectomy last Dec..no expanders put in..I will be starting reconstruction in Nov..my breast surgeon was against doing any immediate reconstruction before I finished chemo for some reason..

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  • Sassa
    Sassa Member Posts: 1,588
    edited September 2011

    Marial,

    Like you, I was diagnosed with a very aggressive breast cancer.  My oncologist, who I spoke to before my mastectomy, told me she preferred I waited on any type of reconstruction.  She wanted to have a full range of treatment options available to her to treat my cancer for the first two years (recurrence chance was greatest for the first two year after diagnosis/chemo) and did not want to have to work around any restrictions with reconstruction. 

    This also included tissue expanders as the metal ports in the expanders would prevent me from having a CT/PET scan.

    Her preference made a lot of sense to me.

    Perhaps your doctor feels the same and knew your oncologist's view on reconstruction.

    I started reconstruction 2 1/2 years after chemo was finished.

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