newly diagnosed,questions about reconstruction

There are so many wonderful/informative threads on BC.org -- and I'm not even sure how I located this one! But would love advice.

You can see my BC DX from my signature, but I'm really torn between going UMX or BMX. I think everyone's stories and situation are so different. It's what makes the world go round in a good way! Mine: I'm already flat!!! Ha ha. AA probably although I like to think A cup. So -- out of this, I also feel I may as well go a little, wee-bit bigger. Small B is ALL I want. I do want recon.

Has anyone gone UMX with the "thought" that they might do the healthy side a year/two later if: something is seen, they can't take the stress, etc. I really don't fear having another surgery somewhere down the road but almost want to see: how bad is the UMX and TE. I've spoken to 3 PS's and am going with a combo of one at MD Anderson and local in NC (who I love and will do the fills if I go TE and perhaps the rest because I liked her so much). I have also considered and am a candidate for nipple/skin-sparing and immediate implant but my radiation status of course is uncertain and the TE, as much as I dread, may be the better choice since I can't go much bigger likely with immediate. I will have to do an implant on the good side, too. No doubt there. I know it's all a hassle but I'm determined to be positive about it.

Does insurance cover if we remove the "healthy" breast down the road? I can't quite get it out of my mind that my right breast -- although MRI etc has showed nothing -- is not healthy. Why? Because my tumor (maybe 2 of them now) were not seen until I pointed it out. Years of "diagnostic" mammos due to family history too. Supposed to better than regular mammo. I do not trust mammo and never will again. If I can't have the MRIs, I want BMX. My doctors know this, btw.

How do we manage the system unless we complete BMX from the start? I feel pressured to take it all now without time to think. And I have to get the cancer out on 2/27.

I AGONIZED over this decision, but finally decided that no matter what reconstruction decision my body is changing, I will grieve and also get used to it. I have decided to go unilateral, and live with any assymetry. PS says he can get good results.

The thing that most affected me was the thought of doing less surgery and lesspotential surgical complications. I won't be numb on my left side, I won't have risk of nerve issues or cording on my left side, I'll be able to use my left arm for recovery. My oncologist also reassured me that threat of recurrence is not that much higher for me than for anyone else. In my case, tamoxifen will be a protection and perhaps chemo too. I don't know yet. Anyway, it was great to talk to an oncologist about the threat of recurrence. I guess I didn't quite trust my surgeon on this.

That's how I made my decision but I want to be clear that I am so distressed when I see anything that smacks of judgment on this site. These are incredibly hard decisions, and option has a downside (or two or three.)

Well, I'll chime in here after reading most of this thread out of interest and to back up my campaign to get reconstruction on the table for the bc men out there. Men aren't offered reconstruction, and generally live with a scar on one side. Oh, and a hairless square where rads killed the chest hair follicles. It's not a great look, really. OK, men's chests don't have the societal pressures that women's do, and I guess, in clothes, who notices a man without recon? But come summer, well you get a few looks at the beach.

Anyway, I asked a plastic surgeon to write an article on the topic HERE. Time will tell if the situation changes, but it's a debate worth having.

cjs - all silicone implants being currently used are made of cohesive gel, the "gummy bear" implants are the anatomically shaped implants. You may find posts more easily if you type "anatomical" into the search tool, and there are lots of members here with anatomical implants. Anatomicals are slightly firmer, using them can provide a more naturally shaped recon for some, but they lack the same amount of projection that round implants have in the upper pole. Your PS can determine, based on your body type and recon wishes, whether they would be right for you. Also, consider that some PS use drains after placing this type of implant to keep fluid from accumulating in the pocket and causing implant rotation, and require bra wearing, sometimes 24/7 for an initial period, for the same reason.

cjs - do go to the Breast Implant 101 site - link below. If you read the entire header and post the information requested, WhippetMom will give you her thoughts. She is truly an implant guru.

https://community.breastcancer.org/forum/44/topics...

I want to put out there for newbies the idea of Prepectoral, also known as OVER Pectoral Implant Reconstruction. I have a thread discussing this method of Implant Reconstruction. It means that your Pectoral muscle is not cut, and that TE are not painfully stretching the Pectoral muscle, because a TE, then the implant is put on top of the muscle. This is made possible by Acellular Dermal Matrix helping to anchor the implant in place. It is a great method for many women, shorter recovery of strength and decreased pain compared to recovery after traditional under pectoral reconstruction. I have a list of 28 PS's, and counting, across the United States who do Prepectoral Implant Reconstruction, plus links to current research on this method.

EastcoastTS - Is your friend happy with the BMX one-step? I'm assuming that means immediate implant?