Nervous - how much communciation with PS before implants?

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MyJourneys
MyJourneys Member Posts: 143
edited October 2016 in Breast Reconstruction

How often did you meet with your plastic surgeon before the surgery?

I've seen/talked to my PS once, and at that time she said that I didn't need to make any decisions at that time (implant vs flap, round vs anatomical, etc.). However, when I talked to the nurse navigator about a follow-up appointment to fine-tune details and tell her about my decisions, she said something to the effect that the plastic surgeons don't usually talk to patients more than once - that they've already met with and talked to the patient and have pictures and that's all they need.

Does this sound realistic? I'm feeling nervous about this. It seems that I'm expected to just go for my mastectomy and they'll do what they can to reconstruct based on what looks best. They're the experts, that's true, but I feel like I don't have closure, in a way.

Am I making sense? Am I expecting too much? Is it normal for patients to talk to their PS only once before surgery?

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  • littleblueflowers
    littleblueflowers Member Posts: 2,000
    edited October 2016

    Nope. If you dont feel comfortable find a different surgeon. I interviewed 4 plastic surgeons before picking one. I interviewed my current one for almost 2 hours the first time, and have had 2 follow up q and a sessions, and numerous e mails. Find someone who makes you feel comfortable. This is the time to be high maintenance! Good luck!

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  • reflect
    reflect Member Posts: 576
    edited October 2016

    Take your time and find a PS who is willing to meet with you more than once if need be! It's a big deal.

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  • MyJourneys
    MyJourneys Member Posts: 143
    edited October 2016

    I should have clarified that I'm scheduled for a mastectomy and an immediate implant on my left side, and a lumpectomy on my right side. I don't know if that makes a difference in your answers.

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited October 2016

    I have a phenomenal PS - and only met him once prior to DIEP surgery. It was a good meeting, however - we spent time discussing my options, he drew me pictures and showed me where on my body the tissue flap would come from, we talked about outcomes and expectations - and I felt confident when I left that visit. I had three follow-up visits prior to surgery, and met with his NP each time. I expected I would see him but realized there was really no need. He's primarily a surgeon and specializes in DIEP and free TRAM (each taking an entire day) and has a very good supporting staff, and I expect he's not actually IN the office all that much.

    I did see him again immediately prior to surgery, and he asked me to confirm all of the decisions I'd already made and we'd already discussed. He told me again what he planned to do, marked me up and walked with me to surgery.

    Would I have liked more appointments with him? Probably, but I also realize they weren't necessary. I have seen him a couple of times during follow-up visits, and met with him recently to discuss Stage 2. I am beyond pleased with my results, and feel well cared-for by him and his entire practice.

    Take your time finding the right PS for you - but be prepared that they may not be able to meet with you as often as you'd like, given their schedules.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited October 2016

    I had a consult with my PS prior to mastectomy where we discussed all of my options, including direct to implant. I ended up doing bi-lateral skin and nipple sparing mastectomy with tissue expanders. I saw the PS before the surgery in pre-op, where we confirmed and marked. My PS was a bit unusual in that he does not use a nursing staff or PA, and is in solo private practice. I filled very slowly - 25ccs a week until I reached 550 on the left 600 on the right - and he did every fill himself. We spent a great deal of time together so that when it was time to exchange we were both on the same page, no surprises.

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  • MyJourneys
    MyJourneys Member Posts: 143
    edited October 2016

    <<Take your time finding the right PS for you - but be prepared that they may not be able to meet with you as often as you'd like, given their schedules.>>

    Nancy, it sounded like you made all your decisions at that initial meeting, so you didn't need a follow-up. Mine told me not to make any decisions - that I had time to research and decide (we were waiting on MRI results and a biopsy on my other side, so we couldn't make final decisions yet).

    That's what I'm wondering about - when am I supposed to discuss those final decisions? Does the PS talk to me 10 minutes before surgery to find out whether they're doing a DIEP or other flap, or implant, or whatever? Wouldn't they need to prepare farther in advance than that?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited October 2016

    Most plastic surgeons do not do flap surgeries, other than latissimus dorsi. DIEP or other abdominal, posterior or thigh flap recon needs to be done by a microvascular plastic surgeon, who specializes in those procedures and there are actually not that many of them nationwide. You would definitely not be electing implants or flap in pre-op. Generally that decision has been made well in advance, and the consideration shortly before is directly related to that choice and potential complications.

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  • MyJourneys
    MyJourneys Member Posts: 143
    edited October 2016

    Thanks, SpecialK! That's what worries me - since we weren't able to make important decisions at that first consult, we really need to make sure we're on the same page before the surgery. I'm very likely going with implants so we wouldn't need as much lead time for those, but even so, we'd need to decide what kind, etc., before the day of surgery. (At least I'd think we would.)

    I think the nurse navigator didn't understand that we were still waiting on an MRI and subsequent biopsy on the (previously clear) breast and couldn't make decisions until the results from that were known.

    I'll email or call to talk again to make sure we're on the same page. Thanks everyone!

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  • MyJourneys
    MyJourneys Member Posts: 143
    edited October 2016

    Just wanted to update. It seemed my nurse navigator didn't realize we didn't make any decisions at our initial meeting and were waiting on more imaging and test results. When I explained the situation via email, she said it wouldn't be a problem getting another appointment with my PS, and the PS's nurse called me later that day to answer questions and told me to come to the office to see samples of different implants and talk to the PS again.

    I think this has just shown me that we're our own best advocates and need to make sure to keep the lines of communication open. This is just too important to take chances and assume we're all on the same page without making absolutely certain.

    Thanks, again, for your advice.

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