Implants or Lose 100lbs- Surgery Monday!

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nostrilb
nostrilb Member Posts: 24
edited July 2014 in Breast Reconstruction


I am having surgery on Monday, a mastectomy and expander put in for an implant.I wanted the DIEP procedure, but my doctor will not consent unless I loose 80lbs.I am worried about the look of the implant, the medical concerns considering my size, and the fact that my beautiful DDD breasts will become, at best, an awkward looking C- cup.


So my thinking is that I can spend 4-5 months prepping for an implant which I really don’t want, or I could spend the same 4-5 months losing weight so that in the end I could have the DIEP procedure.Both viable options both will include an annoying 4-5 months, but if I can’t lose the weight, I don’t have a breast.


Any advice or insight would be great appreciated!Anyone here over 200lbs and have implants?How do they look/feel?


Thank you!

Comments

  • Moderators
    Moderators Member Posts: 25,912
    edited October 2013


    We are so sorry you are going through all this!


    Certainly, losing weight has many long-term health benefits. Here is a short article that may help:


    http://www.breastcancer.org/risk/factors/weight


    Naturally, none of this is easy, and waiting that long is a very tough thing. If you do decide to lose the weight, there are a few great topics on our boards where members help motivate each other.


    Thinking of you as you make this tough decision.


    The Mods

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited October 2013


    Considering the time frame, can they refer you to a medically supervised weight loss program? I think this would be a difficult goal on your own.

  • sandra4611
    sandra4611 Member Posts: 2,913
    edited October 2013


    Nostrilb,


    I had a BMX with immediate reconstruction (implants) 9 weeks ago. I weighed 244 and had FFF breasts. The breast tissue they took off weighed over 10 lbs. I got cute, perky D cup implants. No one ever said a word to me about weight being an issue in the procedure I chose. I could have had DIEP, etc...any and all were offered at my major medical center, but I decided I didn't want to deal with trying to recover from two surgical areas at the same time. Also when you use your own tissue, if you lose weight, your new boobs loose weight too and get smaller. Implants stay the same. Not everyone would have made the same decision I did. We are all different.


    Can you get a second opinion?

  • sandra4611
    sandra4611 Member Posts: 2,913
    edited October 2013


    Forgot to say, my husband says the implant feels just like my natural breast did when I was 21. I have saline implants. They are not hard at all. I'm having so much fun going without a bra. (Haven't worn one for about 6 weeks now. It's such a wonderful free feeling after lugging around those mega-boobs my whole adult life.

  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited October 2013


    nostrilb - I had a BMX with immediate reconstruction (with tissue expanders) in December 2011. I weighed 204 pounds. At no point was my weight a factor.


    I got saline implants because that's all my PS did, and I really didn't want the lengthy process of a DIEP.


    My tumor was 100% ER+ and the Oncologist wanted me to take Arimidex for five years. I tried to refuse, saying there was no estrogen in my system, being post menopausal, and having had a hysterectomy. She told me that my body was still producing estrogen, especially in belly fat.


    At that point I went on a medically-supervised weight loss program and lost 60 pounds. It took 9 months to reach my goal. We delayed my implant exchange to see how I looked after weight loss. (The TEs looked HUGE!)


    The PS put in 700cc saline implants. I love them - I wear a 38DDD bra, and DH says they feel real!


    I know how hard it is to make these kinds of decisions. I hope more members come along to share their stories. All you can do is research, ask questions, and ultimately go with your gut.


    Like sandra461 said, can you get a second opinion? I know time is short...


    Hope you find a decision that brings you peace!!!






    sandra4611 - isn't it great to have perky New Girls? (My old ones were 40DDD/E but hung nearly to my waist and my bra size should have been 40 LONG.) I haven't gone braless since 5th grade... and even though I don't now, it's nice to know I can.

  • sandra4611
    sandra4611 Member Posts: 2,913
    edited October 2013


    Ha-ha Blessings. 40 long...too funny! I only had a bra on while I had bandages. After that my PS said do what is comfortable. It didn't matter if I wore one or not...so I didn't. I don't think I've gone without a bra in 50 years! I feel absolutely wicked! Love it!

  • GointoCarolina
    GointoCarolina Member Posts: 753
    edited October 2013


    You can have tissue expanders placed at time of mastectomy as a "place holder" and have flap surgery at a later time.. Check out this link


    http://drmarga.com/burn-no-bridges.html

  • My3Ksmom
    My3Ksmom Member Posts: 3
    edited October 2013


    You were lucky that you were given a choice. I was told by the plastic surgeon that he wouldn't let me do ANY reconstruction or reduction until I lost 105 pounds period.


    There is no way I can do it by dieting, been there tried that over and over and over. I am going for Bariatric Surgery and my Surgeon, Plastic Surgeon and regular MD couldn't be happier.


    I just want to have 2 normal shaped breasts and will do all I can to lose the weight to get to that prize.

  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited October 2013


    Wishing you all the best, My3Ksmom!

  • sandra4611
    sandra4611 Member Posts: 2,913
    edited October 2013


    My3Ksmom,


    I had a gastric bypass ten years ago this month. It was an open RNY not a lap band and not done with laproscopic surgery like many are today. I was 317, 5'7" and 54 yrs old, got around with a cane & an oxygen tank, and had co-morbidities as long as your arm. I lost 160 lbs, was no longer diabetic and all the other health problems went away. I became a group fitness instructor during that time and continued working full time as an accountant and teaching 2 cardio fitness classes after work every day and on Saturdays. My husband and I are ballroom dancers and had a nice business teaching two classes a week. I was way too skinny, size 8, so I gained a little back and was 180 wearing a size 10-12 for several years. As you age, your metabolism changes and even though my exercise level stayed the same, I put on about 10 lbs a year and was a size 16, about 220, at the beginning of this year at 64, now 5' 6 1/2". (You shrink as you age, even without osteoporosis.)


    A week later I had a moderate brain stem stroke that affected my eyes, ears, voice, and balance. A month after that my docs found I had a large aneurysm in the ascending aorta of my heart which would need open heart surgery probably after stroke rehab. I had to quit work, quit teaching everything, quit dancing, and take a boat load of meds. I sat in my recliner feeling sorry for myself and gaining weight. By the end of June when I had a mammogram & biopsy, I was 244 with breast cancer. Three life threatening things in 6 months? Seriously?


    My surgery was two months ago. They took over 10 lbs of breast tissue during the double mastectomy and I left the hospital at 232. I'm 228 now, slowly going in the right direction even though I can't exercise due to chronic anemia. (8 and circling the drain.) You'd think the 2 units of healthy iron rich blood I got in the hospital after the BMX would have made those numbers go up. Also have B-12 issues and vitamin D deficiency (common 9-10 years after RNY) but the docs are working on it. I get an iron infusion Monday so I'm looking forward to having some energy and getting back to walking. I go back to surgery a month from now to replace the TE with an implant and to change out the one implant I already have for a different kind to match.


    Even with being too fat, still recovering from a stroke, having a bum heart, and being anemic, no one on my breast care team has ever said one word about losing weight in order to have reconstruction or that my chances of having a successful outcome depended on my weight.. PLEASE get a second opinion!

  • besa
    besa Member Posts: 1,088
    edited October 2013


    I agree with above posters - please get 2nd or even 3rd opinions,,,,,,,


    A quick pubmed search turned up this 2012 abstract...


    http://www.ncbi.nlm.nih.gov/pubmed/22743936


    You can lookup additional published medical journal articles on the topic in pubmed - for example putting the search terms:


    "diep breast reconstruction body weight " The website for pubmed searches is:


    http://www.ncbi.nlm.nih.gov/pubmed/

  • nostrilb
    nostrilb Member Posts: 24
    edited November 2013


    Thank you so much for all your responses! With your feedback, I decided to trust my doctor, and go ahead with the tissue expander. A review of http://www.ncbi.nlm.nih.gov/pubmed/ did show a higher rates of death with the DIEP procedure in obese women. My doctor says he has never done an expander and implant in someone my size, so he is not sure what to expect. Apparently, women my size do not get reconstruction. Or, at least with him. It's a wakeup call. I didn't think a size 22 was so detrimental for surgery. It is what it is. Thank you again everyone. Oh, surgery went well, and I am healing quickly.


  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited November 2013


    nostrilb - so glad your surgery went well... may you continue to heal rapidly, and completely!!!

  • RoseBuds
    RoseBuds Member Posts: 74
    edited November 2013


    I too am a size 20/22 I am 5'5" and 215 lbs. I had a BMX in March 2011 and like you had been told I was too fat for reconstruction. So I went flat! But flat was not really flat it was more concaved, so I did lots of research and found a PS who works with all weights of people and we looked at all the options open to me. I could have had many diffrent types of flap done, tummy back, but, thighs but I went with TE's I had them put in last Friday and I am recovering well. I have photos on the picture forum .


    Kathy

  • christine47
    christine47 Member Posts: 1,454
    edited November 2013


    rosebud, saw your picture, you are off to a fantastic start!

  • cheryla13
    cheryla13 Member Posts: 14
    edited January 2014

    RoseBuds: I'm very overweight and just had my TE exchange surgery 12/17/13 and am having a difficult time with the results.  I've gained 50 pds since the DMX and TE were put into place.  Feeling very sad and frustrated.  May I see your pictures for some frame of reference?  Maybe what I have is ok just tweaked by my weight gain.

    Cheryl

  • nostrilb
    nostrilb Member Posts: 24
    edited January 2014

    I am 4 fills into the expander process, and while I have access to the photos now, I am too scared to look.  To get my BMI down to an acceptable weight for the DIEP, I only have to lose 50lbs, so I am trying.  The fill process will take until the end of May, so end of May or 50lbs, either way I will have a new boob. 

  • nostrilb
    nostrilb Member Posts: 24
    edited March 2014

    I lost 30lbs and had my visit with the plastic surgeon Thursday.  He looked at me and basically said that my stomach is too large, and my body shape will not work well for the flap.  But good job on the weight loss, and keep going.  Yeah.  Some women will lose weight in their stomach, but I am not one of them.  He said it needs to be much smaller for the blood vessels for the surgery, and he still wants to do the implant.  Or, I can lose a ton more weight, and get down to a normal size.  Am I the only plus size woman that has had breast cancer?  I really do not want this implant.  I feel like it will be a place holder for what I had, and then my other breast will be reduced and changed to look like it.  I have lost enough already.  I am ready to look at the photos, because I still have no idea what I will look like like either way.  Why is this process so hard?  Women go through this every day, yet I have to go online anonymously just to get information?!  I am so incredibly angry and I want to quit, but I will not let him win and take the easy way out.  I will lose the weight, and he will have to deal with me.  I will get what I want.   

  • nostrilb
    nostrilb Member Posts: 24
    edited July 2014

    Update, I am down 45lbs, and the doctor will not do the flap.  I got a second opinion at Mayo clinic, and they see no reason why I can't have the flap surgery.  Instead of getting my implant at the end of the month, I will be waiting until November to get my new boobie!  The extent of the surgery scares me greatly, but it is the right choice for me.  I worked very hard to get here, and I am excited for the outcome. 

  • Ridley
    Ridley Member Posts: 634
    edited July 2014


    Nostrib -- congrats on your weight loss -- that is wonderful and as you noted the result of very hard work. 

    I was overweight (technically obese based on BMI) when I had my bilat DIEP last December.  I had no trouble with the surgery or recovery (I had a few spitting stiches that had to be removed, but I've seen lots of women with those, so I don't think they are weight related.)   If you are not already exercising, I encourage you to ramp that up as you wait for surgery, as I think that helped me get through the surgery and recovery.  I was lucky to have no co-morbidities other than weight when I went into the surgery and I am an active long-distance walker.  My surgeon actually commented to my family at the end of my surgery on how healthy I was:)

  • besa
    besa Member Posts: 1,088
    edited July 2014

    Nostrib-- Another congratulations on your weight loss.  Glad to hear you got a 2nd opinion and are now scheduled to have a DIEP - the type of surgery you want!  This is good news.

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