Reconstruction

Hi MGDSMC,

There are some interesting articles Breastcancer.org reviewed on this topic that you may be interested in reading:

• After Mastectomy, Few Women Referred to Plastic Surgeons to Discuss Reconstruction Options
• Reconstruction After Breast Cancer Surgery Usually Not Discussed

Hope this helps!

--The Mods

Hi,

I'm not African-American so hope you don't mind my post. The one step implant is not a general option. It can be used only under a specific set of circumstances. Generally only if the mx is skin sparing and you are going for an A- small C cup size. You also need to have a ps who is trained to do this and use of Alloderm seems important too. My ps was very honest and said that the ultimate decision would be made during surgery because medical necessity would trump cosmetic wants. Even though I was not interested in flap surgery my ps presented me with all the options because he said he felt I needed to be speaking directly to a doctor about this and not Dr. google. As for what makes the ps most money, I belong to an all inclusive HMO ( kind of like the club Med of HMO's) and the doctors are salaried. All this being said, I agree that many ps's do not present all reconstruction options to their patients.

Caryn

@mgdsmc,

Actually, what I originally got was a link to an online video on my health-care provider's website, but I had dial-up access at the time, so they loaned me a copy on disk to make it easier to view. I think they give the MX/LX link or video to all newly diagnosed early-stage BC patients, and IIRC that video refers to the other one, or there may be a link from that one to the reconstruction options video. I didn't talk to the PS until after I had seen the video.

I was also told by the first PS I consulted that I was not a candidate for any flap surgery, and I started a thread about that. I later went to a different PS and was told that DIEP is an option for me after all. I was really glad about that--I didn't realize until talking with the first PS how little I wanted to have implants. The video said flap surgeries are generally "stable and trouble free" once they heal, whereas implants can act up at any time and would almost certainly have to be replaced at least once, and maybe two or three times, during the rest of my life (I'm 56). And now after hearing about the prolonged discomfort some of the other women in the June MX thread have had with their TE, I don't want anything to do with them! I have't had my reconstruction yet. I'll be halfway through chemo next week; then the PS likes to wait at least two months afterwards to let you recover from that, before doing the reconstruction.

Right after my diagnosis, I did want to have immediate reconstruction, but due to the location of my tumor there was a possibility I would have to have radiation treatment even with MX, so it has ended up being delayed. I also didn't know at the time whether I would be having chemo, but I suppose if not for the possible need for RT, I could have had an immediate reconstruction and done chemo after that. I did have a skin sparing MX with my areola but not nipple remaining, for the original breast skin to be available for use in the reconstruction.

I don't remember any more whether the video I saw mentioned immediate reconstruction vs delayed. It may have. I also don't recall whether it differentiated between immediate implant and TE with later exchange. I may have gotten info about immediate reconstruction from one of the books I read rather than the video. One other thing about the videos, at least some of the women interviewed for them were black. I believe they were all actual breast cancer patients. One chose no reconstruction, one used a prosthesis and one had an implant.

Don't answer if you don't want to, but I'm curious, are you asking this question for a research project? Because I notice your signature says you had lumpectomy, not MX, and I would not have expected you need reconstruction yourself with a 1 cm lump.