Reconstruction on larger woman:Need advice ASAP

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Betsy918
Betsy918 Member Posts: 13
edited March 2016 in Surgery - Before, During, and After

Hi..Just came from meeting with the plastic surgeon to discuss my options. I am a large (42G, size 20) woman. I was hoping to get smaller breasts out of this, as I've always wanted a reduction. What I was told was a woman as large as I am is not likely to get good results with a reduction, that if I was a healthy woman, he would have me lose weight before doing a reduction. (He was nice about it, but it still hurt to hear.) Then he said that reducing a breast after a partial mastectomy is a problem as it moves the tissue around making it hard to find the area the cancer was in later if you have to go back in (my surgeon basically told me the same thing, so I believe that) and that reduction surgery after radiation can also be a problem. Next I was told that if I opted for a bilateral mastectomy I should be prepared not to be able to get to a "D" cup, or perhaps even a C, as even the largest implants on a large woman have a big space to fill, and it's not necessarily outward projecting, so he couldn't give me an accurate prediction of my breast size post implant.

Basically, it seems I have to decide with permanently living with much larger breasts than I want, or possibly permanently living with smaller breasts than will make me feel like I look good in my clothes. (I at least want to project larger than my belly, just not as large as I do now!)

Can any other larger woman give me advice on how your results turned out with implants? I have to make a decision soon!

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Comments

  • Ridley
    Ridley Member Posts: 634
    edited March 2016

    have you considered diep surgery, where they use your own tissue from your lower stomach and transplant to reconstruct your breasts? There are a few threads on the board with lots of women who have gone this route.

    When I talked to one plastic surgeon, she didn't think I would be happy with implants based on my size. I didn't want implants anyway. I'm over two years out from bilateral mastectomies and diep recon and am very happy with the results.

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  • Betsy918
    Betsy918 Member Posts: 13
    edited March 2016

    Thanks...Unfortunately not a candidate as I've had three previous abdominal surgeries with a huge midline scar. Was told the capillaries have to be "virginal" in order to connect properly, and mine would be scarred.

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2016

    I was a 40 B/C before surgery. I had mentor mid profile 421cc put in. I am nearly the same size now. Just enough for me to have something up top but not enough to worry about them getting in the way. I checked my path report re: weight of tissue removed and based my final fill on that. Except for the weird pec distortion I am perfectly happy with them. And the no bra part - ahhhhh.

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  • grammakathy
    grammakathy Member Posts: 407
    edited March 2016

    I did the same as farmerlucy, and based my implant size on what was removed and went somewhat smaller. I was a 42C before Mx and now am a 38C (due to weight loss). At my first meeting with my MO, he explained that the extra weight I was carrying had hormones in them that could feed stray cancer cells. That motivated me to lose 50 pounds during the next year. I had never been successful before but this news changed me. Good luck in your decision making

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  • Kicks
    Kicks Member Posts: 4,131
    edited March 2016

    If you posted these questions in the Breast Reconstruction Forum you might get more replies for ones who have gone through similar.

    The only suggestion I have is if you are unhappy with what this PS told you then a second opinion would probably be a good idea. I have not had recon and am on the smaller side (34 A/B so no experiences to pass on.

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  • chef127
    chef127 Member Posts: 891
    edited March 2016

    Betsy,

    I would take Kicks advise and get a new PS. The whole concept of a breast reduction is to make larger breasts smaller and at the same time perkier.

    I had a partial mx (lumpectomy) on my very large breast and my remaining tissue was re distributed to achieve a better cosmetic result and my tumor bed was not lost. The radiation boosts were directed to that area. Why would the drs say it would be lost??

    The lx removed over 10cm of tissue plus skin and looks OK, but the scar is 6" across the 9-10 o'clock position of my breast. I can live with that. 6 months post rads I had a reduction on the other breast (34F++) now a 34 D ish to match.(still too big) but the result is perfect. I could have had another surgery to revise the scar but I chose not to.

    If you have a lot of breast tissue compared to the size of the tumor there is no reason a talented surgeon couldn't do a partial mx without leaving you deformed unless it is multi focal. I had a tough time finding a surgeon to do a lx vs mx but I did and it worked out for me. The thought of having a mx and trying to achieve a matching pair with an implant and a reduction seemed too complicated.

    I hope you find both a breast surgeon and PS who can give you what you need and want.

    xoxMaureen

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  • Betsy918
    Betsy918 Member Posts: 13
    edited March 2016

    Thanks for your reply...but yes it is mutlfocal, 3 tumors in the same quadrant. Was just told this morning that a partial is not an option for me.

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  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited March 2016

    Betsy918 -

    In 2011 I was dx'd with multifocal IDC and chose a BMX with immediate recon in the form of TEs and implants.

    At that time I was a 40-42DDD, and well over 200 pounds, at a size 18. My PS chose the largest size implants for me, and during the BMX, he created very large pockets before he placed the TEs.

    Then I met my MO. She wanted me on AIs, but I argued with her that I was 1) post-menopausal, and 2) had a hysterectomy, so there was NO estrogen in my body for the meds to get rid of!

    She very kindly pointed out that estrogen is manufactured in belly fat, and since my cancer was 100% ER +, she really wanted me to get some excess weight off.

    I went the drastic route... a medically supervised fast, and lost 60 pounds and a whole lotta inches. I put a hold on my fills, as we couldn't predict what my body would look like after weight loss. When I went back to see my PS, he looked at my 600cc TEs and said "Oh my gosh... you look so small and they look HUGE!!!!"

    I ended up having 700cc saline high profile implants put in. He had to do lateral capsulorraphies (had to make the pockets smaller) in order to make sure the implants didn't flop around.

    Even with my weight loss, they still fit my body without looking like stripper boobs.

    Us gals with plenty of padding have a lot of control over how much projection our implants have - sometimes it's just a matter of reducing a small amount of belly. (I was amazed when I could actually see my feet in the shower for the first time.)

    If you haven't already, there is a thread on here called BREAST IMPLANT SIZING 101, started by Whippetmom, who is an absolute expert on sizing issues. She's pretty much heard it all over the years, and I have never met anyone who has such an innate knowledge of how a specific implant will look on a person's body type.

    You will need to have your height, weight, and measurements available, and she can provide you with the best guidance possible. You REALLY want her input on this!

    Here's the link:

    https://community.breastcancer.org/forum/44/topics/746448?page=454#post_4662022

    Wishing you the best!


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