IGAP vs: Implants

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Gr8full
Gr8full Member Posts: 12
edited July 2014 in Breast Reconstruction

Hi All!  Just got diagnosed with DCIS a few days ago.  I got clear margins on lumpectomy but due to medical history I have a high risk for reoccurrence and am leaning towards a BMX with reconstruction and trying to decide between IGAP and Implants.  I have been researching the pros and cons but would love to read about personal experiences.  I know I have to live with the consequences of what I choose and want to have as few regrets as possible down the road.  Anyone willing to share?  Thanks!

 Happy

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  • RebzAmy
    RebzAmy Member Posts: 322
    edited June 2014

    I had the IGAP because I didn't have much left after the mastectomy to put an implant behind.  I also had preventative surgery to the other side and had the IGAP.  The results are spectacular BUT the operation was long and I felt pretty rough when I woke up and stayed in hospital  for a week and when I went home I was okay and the next day just pottered around the house and actually made dinner in the evening.  A good plastic surgeon makes all the difference!

    Any more questions please ask. :)

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  • Gr8full
    Gr8full Member Posts: 12
    edited June 2014

    Thanks for sharing RebzAmy! 

    May I ask... where do your incisions lie?  What kind of scar did it leave behind? My PS is looking at my "saddle bag" area because that's were I have lots of tissue to work with but from what I have read, most have it under the buttocks (I haven't found anything written so far about having it done on the saddle bag area).  I'm not too concerned about the scars because I don't wear short-shorts anyway and my bathing suits are usually the "boy-short" type.  But, I am curious about what to expect.

    Another question... while in recovery, did you have to lie flat on your back or were you able to sit...and if so for how long?  Since my PS is looking at the side/saddle bag area she said she'd have to do one side at a time with 6 months in between.  I'm not looking forward to that long and drawn out process but I think in the long run I would be happier with the results.

    It sounds like you are happy with your decision and have no regrets?  The implant option sounds so much easier but I'm thinking about down the road and having trouble with them (leakage, slipping, muscle spasms).  I think I prefer a longer/harder road now but then being more satisfied in the long run.

    Thanks! 

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  • RebzAmy
    RebzAmy Member Posts: 322
    edited June 2014

    Hi again,

    the scar lies across the section that is taken from your behind area and the scars left there for me weren't great but over time they've faded - or at least the oldest one has and i'm told the other one will too.  I just had some liposuction to my leg to remove fat and fill up an area which needed filling which was sort of where your cleavage starts and you get a natural slope - I didn't have that natural slope but I do now since the liposuction and lipofill to that area - it's amazing.

    I was only lying flat until I felt well enough to get up.  i wasn't told about staying straight or staying on my back but the area was uncomfortable so I tended to sit on one butt cheek and over time it became less uncomfortable until now when I don't even think about it.  I also didn't want to think about having to have implants taken out and replaced in 10 years time or them moving or just having a foreign body inside me.

    I had 2 1/2 years inbetween each operation.

    Hope that helps.

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2014

    Dear Gr8full, Welcome to the BCO community. You have joined a knowledgeable and supportive group who can lend wisdom and information and caring through the breast cancer process. Please keep us posted on your decisions. The Mods

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  • Ally2345
    Ally2345 Member Posts: 320
    edited July 2014

    Gr8full- Glad you found this Board early in your dx.  I did not find it until after my bilateral mastectomy.  I, too, was diagnosed with DCIS and I elected to have the PBMX.  I went the implant route and have been doing very well (knock on wood, she says LOL).  The TEs are a bit uncomfortable but you get used to them.  The main thing, if you go the implant route, is to have a long talk with your PS BEFORE the first surgery.  The TEs that the PS uses has a great impact on the implant that can be used.  You want to convey your hopes, wishes, etc. early so the proper implant can be inserted.  We are lucky to have a great resource in Whippetmom (she has a thread) in that she does medical research and knows all about implants, TEs, etc. and she can make suggestions for implants that might be right for you given your bandwidth, height, weight, etc.  Having to make all these decisions is almost overwhelming...I was so concerned about making the "wrong" choice but came to realize, there really isn't a wrong choice.  You just need to find the best option for you.  Know you have lots of support here!

    Ally

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thanks so much for all the replys! I really appreciate it. I go in tomorrow to talk with the PS and she's going to show me photos of her patients...before and after... so I am looking forward to that and we'll see where this leads. Always interested in hearing other's stories and if anyone has specifically had this done on the saddlebag area I'm especially interested to hear about the experience... haven't found anyone yet who has had that particular procedure done. Thanks so much!!

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  • GointoCarolina
    GointoCarolina Member Posts: 753
    edited July 2014

    Gr8full,check out the Charleston Bound and NOLA threads.Lots and lots of info about all the different flap procedures.Good luck!

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thanks!  I will!  

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thanks!!  Heading out to see the doc now!  :)

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

    Gr8full - Consider getting a copy of the latest edition of Kathy Steligo's "Breast Reconstruction Guidebook"  The best I have seen on the topic. I think it will help you decide.   The book  gives you information about the different breast reconstruction options (including numerous flap options) and also info on how to choose a skilled ps.  www.breastrecon.com   or from    amazon.com    (Also think about possibly seeing a 2nd or 3rd plastic surgeon to get other opinions and to make sure you have the best fit and most experienced ps possible.)

    Not exactly answering your question- I have bilateral reconstruction.  One side is a DIEP and the other side, done later, is a prophylactic nipple sparing sGAP (so a much higher donor site than IGAP).  I did not want implant reconstruction. (I went to NOLA for the sGAP) .  With any  reconstruction you ( and especially a microvascular reconstruction) you want to go to a very experience ps- if possible someone who has done literally thousands on their own (when not in training) and does them on a regular (if possible weekly basis). I am happy with the type of reconstruction I had -it was the right decision for me.

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thank you, besa... I will check it out!  :)

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thank you so much Ally!  :)  I am still considering the implant option... just found out they won't be able to save my nipples so I'm looking at the recon vs: tattoo options.  What was your experience with this?

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Just found out today that after much consideration, my PS does not think the flap is a viable option for me as originally proposed so now it looks like I'll be doing the implants.  Now I am on another learning curve and a new decision making process.  To expand or not to expand... :) 

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  • Ally2345
    Ally2345 Member Posts: 320
    edited July 2014

    Gr8full-  If you choose the expansion route, get with Whippetmom early so you can figure out the correct expander and best implant for you.  She is extremely helpful.  I decided that I was going the 3-D tattoo route rather than have nipples created.  For me, that just felt like the right choice.  I liked the idea of not having to worry about nipples showing through clothing and I thought the 3D nips looked amazing.  I am trying to research tattoo artist as Vinnie is not an easy option for me but he seems to be the only one that you can find out information on.  There are several girls that have appointments with Vinnie in the next few months so it will be interesting to follow them.

    Best of luck sorting through all this info...it is a lot to process but you will make the right decision for you!

    Ally

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  • Gr8full
    Gr8full Member Posts: 12
    edited July 2014

    Thanks Ally!  I have been reading a lot about her and stayed up 'til about 3 am last night reading a lot of the threads.  I guess I will get out my measuring tape and write her a note.  I am leaning toward the Sientra gummy bears but am still very green on the subject so we'll see.  I would really appreciate her input so I will write her.  I am also leaning towards the nipple tattoos...the thought of never really having to wear a bra again sounds very appealing...kind of like a consolation prize to all of this, eh?    I've checked out Vinnie and I am only about 5 hours away from him so I think I might try to get an appointment...I think I should have enough advance notice time since I hear you have to wait until about 5 months after surgery.  Thanks for your encouragement and advice!!!  

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  • Ally2345
    Ally2345 Member Posts: 320
    edited July 2014

    Gr8full-  So envious you are only 5 hours from the "Nipple Master."   I thought I would just get the implant my friend had not even realizing there were different heights, projections,widths not to mention the role of the TE.  Whippetmom has been great and at least now I participate in the conversation.  Have a great week-end!!

    Ally

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  • nevinsdb
    nevinsdb Member Posts: 11
    edited July 2014

    GR8FUL  you have a close resource in  carolina charleston center for natural breast reconstuction doctors (they will answer any questions when  you write to them and they send out a great news letter.( 186637426270  )NATURALBREASTRECONSTRUCTION.COM. i have gotten alot of my questions answered though the realself website for plastic surgery also..there are lots of resources in florida also..dr Hartog in orlando  is one... i am  currently expanded and now reconsidering using a natural flap under my breast skin shell and fat grafting instead of risking silicone toxicity...so many decisions to make and dont drink the FDA koolaid they try to sell you !!! this is your body and these implants are never tested at body temperature

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  • bethcw
    bethcw Member Posts: 98
    edited July 2014

    GR8full,  I am also a UNC lady.  After consulting with a couple of the UNC PS's I chose to have my flap reconstruction in Charleston with Dr. Craigie and Dr. Kline with the Center for Natural Breast Reconstruction.  I felt very strongly from the beginning that I did not want implants (my personal choice).  The UNC doctors wanted to do implants or a lat flap for me, and cannot do bilateral reconstructions.  The Charleston doctors work as a team so that they can do both sides in the same surgery (also possible with the New Orleans doctors, but Drs. Craigie and Kline are closer and they take almost all insurance where the New Orleans doctors are mostly out of network).  I have been very pleased with my decision and my care has been excellent.  I have one SGap flap side, and one PAP flap side (after some radiation complications in between).  Let me know if you want any other information.  Beth

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  • rebeccakay
    rebeccakay Member Posts: 4
    edited July 2014

    Hey, 


    What did you opt for? I'm actually currently recovering from my IGAP reconstruction. Aesthetically everything looks way better than I expected. I wanted natural reconstruction, and because of my size, IGAP was really the only option for me (not enough fat). I would definitely recommend it, however, I would warn you that the recovery is LONG. I've basically been on bed rest for 4 weeks, and expect to continue on as such for another 2 weeks.

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  • Moderators
    Moderators Member Posts: 25,912
    edited July 2014

    Welcome to BCO rebeccakay

    We hope your recovery continues to go well and you get the finished results you wanted.

    The Mods

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