Delayed Breast Reconstruction
Hello, I'm currently 34 years old and this July will be 4 years out from surgery. Diagnosed with breast cancer in June 2013, double mastectomy July 2013. I did not do skin sparing. I have a consultation this month and will be asking the surgeon my available courses of action. I had been told previously that if they could slip in the implant (size behind the tight skin, then we'd go that route. If not, while I was under they'd have to put in expanders. Anyone ever had delayed reconstruction after not having a skin sparing mastectomy? What happened? Results? Thank you!
Comments
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Hi, RachelE. I had a mastectomy that removed as much skin as possible in April 2012, since there were breast cancer cells in the skin. My team recommended no expanders be placed at that time. After extensive radiation treatments, I waited until April 2013 to have a DIEP (deep inferior epigastric perforator) flap reconstruction. It was a good choice for me. I wanted to avoid implants, and the DIEP surgery removed a lot of radiation-damaged tissue. Also, the "breasts" are warm, and soft, and there is no worry of capsular contracture, implant rupture, or need for further surgery down the line.
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I also had a DIEP roughly a year after my unilateral mastectomy, with no skin sparing. I was (am) pleased with the results. The recovery was intense (about a month) but as the previous poster said, it's nice to not have to worry about implant issues, especially since we are young and they often only last so long.
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I had implants placed under the pectoral muscle. They look fine but have no bounce or squeaze to them at all. For those who have DIEP do the breasts feel more natural and have more of a squish and bounce?
RachelE, My PS has told me very good stories about reconstruction that is done later. I would have your PS show you pictures of what you can expect. Even though I had immediate reconstruction to be honest I did not find the TE route to be that difficult it was very manageable. I personally do not like the naturelle anatomical implants that they used on me because I would have preferred round to tear shaped but my PS told me the space was so thin that he strongly preferred the thicker anatomical implant so that is what I went with. I would have had to travel for a DIEP and I was not wanting to do that but the tummy tuck and natural feel might have been worth it.
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I can't tell the difference between my DIEP and the natural side, same warmth and squishness. I don't have complete sensation but it keeps getting better with time.
I did not have skin sparing and my mastectomy was done about 5 months before DIEP.
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I had a unilateral non-skin-sparing mastectomy in 2013 (right) and stayed flat on that side.
As I had a new primary in the healthy breast (left) earlier this year I needed another mastectomy. So I decided to also reconstruct my right breast at the same time with a DIEP. My plastic surgeon placed a tissue expander under the skin, above the muscle on the right and expanded the skin for 2 months (this way no belly skin is visible and I just have 1 scar across my breast). After expansion I had a skin-sparing mastectomy on the left and a bilateral DIEP reconstruction of both breast and the expander on the right was removed. I am very happy with the results and my breasts feel warm and soft!
The subcutaneous tissue expander placement requires one additional surgery before the DIEP procedure, but in my opinion it is well worth if you have the time to do it as no DIEP flap-skin is visible and the skin looks more even.
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My unilateral MX was initially intended to be skin sparing, but I ended up losing 1/3 of my breast skin due to the cancer cells extending too close to my skin. I just did the DIEP about 2 weeks after MX. We used the TE to expand my skin for those 2 weeks, then went for the DIEP. I know the patch of abdominal skin on my breast looks a little diffetent, but the new nipple and aereola i will later get will obscure most of the patch. The rest is all lower quadrant, so really I could care less. It won't be seen by anyone other than me and my husband and is hidden in a bathing suit. I could have kept the TE in longer and did more filling /stretching, but there are some risks with that. Plus, I just want to move on. One of my daughters is getting married in May, and I have other things I neef to focus on. I did not want to drag thus on another few months.
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I also will like to knw I'm getting ready to go into surgery 4 my breast reconstruction
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