Plastic Surgeon Who Will

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Mopsy
Mopsy Member Posts: 49
edited June 2014 in Living Without Reconstruction After a Mastectomy

I am so glad I found this forum!  My mastectomy surgeon, though highly recommended, is giving me such pressure for reconstruction.  But I just know it's not for me.  Here is my question, and I did read several pages and could not find this topic:  What should the mastectomy surgeon do for a nice "finish" if you do not want reconstruction?  Or is that what a plastic surgeon's does?  Are your arm/shoulder/back muscles intact after mastectomy, or is there something that should be done there also?  Should I look for a more open-minded mastectomy surgeon?  Thank you!

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  • Outfield
    Outfield Member Posts: 1,109
    edited February 2012

    Mopsy, there's another active thread about this titled something like "can dog ears be avoided?"

    After a usual mastectomy, arm/shoulder/back muscles should be intact, but there can be all sorts of dysfunction depending on your particular surgery.  Nerve injury is common, especially during axillary node dissection, and some women develop frozen shoulder.  On the side of my large invasive cancer my BS took the sheath of my pectoralis muscle, then I had radiation there. The musculature still functions, but it's stiff and easily sore.   I play basketball with several women who are absolutely fine - same surgery.

    I think if the surgeon knows you are not having reconstruction, they can be more careful about not leaving extra skin.  I was adamant about no reconstruction and my BS thought I might need a scar revision, but I really think she did a nice job cosmetically with my BMX.  She left no flaps or loose anything, other than a slight pucker of the scar in my armpit on the side with the ALD. Cosmetically, I don't think I need any more surgery.  My chest is flat, flat, flat - really a 12 year old boy with no nipples.  The scars run under my pecs, almost in the old inframammary fold.  It's a tidy look. 

    While I get it that some women really, really want reconstruction, I find the minimalization of my preferences condescending and disempowering.  My surgery was 7/2010, I'd do the same thing today, and I have reasons for having decided what I decided that wouldn't be likely to change.  I really appreciated that my BS listened to me about this.  I didn't get this pushy message from her, I got it from patient ed materials.  If my BS had pushed me, I probably would have felt that I had to go forward with the surgery because I had this big aggressive tumour, but I would have felt violated in the process by letting someone who had shown me such disrepspect do the surgery.   

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  • Sher
    Sher Member Posts: 540
    edited March 2012

    The original plan for me was to have the PS assist the BS during my BMX.  They both knew I did not then or in the future want reconstruction.  But on the day of my surgery, while waiting in the holding area ready to go into the OR, my BS came in and said someone else would be assisting.  At that point I should have objected or at least asked for more information on who and why the change in assisting surgeons. 

    I'm an overweight 63 year old woman (60 at the time of BMX) and my results cosmetically were not good.  I was left with large fat pads underarm plus pointy dog ear things in the center of my chest and a skin fold/pucker thing where the drain tube ran on prophy side.  Last year I did have revision with some of the excess tissue being removed.  At that point the fat pad which was larger on the prophy side, was causing me considerable discomfort.  The procedure I opted for was for the BS to smooth me out a bit without going too crazy.  He would have needed to extend the incision a bit around to my back to get the tissue completely smooth and I thought that was too extensive, especially on the side where I'd had nodes removed. 

    I do believe body type has a lot to do with results, but also think the skill of the surgeon plays a big part.  I remember reading after the BMX that mastectomy done with a diagonal incision often has better results for women that are heavier.  My advice would be to find a surgeon that can and will give the results you want without the need for additional surgery.

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  • cinnamonsmiles
    cinnamonsmiles Member Posts: 779
    edited March 2012

    I think we have to really look at the pros and cons of our medical team. I do that often. There are some things I can put up with with for a really good medical professional, and things that cross the line and I will not tolerate. 

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