Help!!! I can't decide and REALLY need some input please.

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Roots
Roots Member Posts: 19
edited March 2018 in Breast Reconstruction

Would anyone be open to sharing their experiences with me around flap (GAP or TUG) or implants immediate reconstruction? Or opinions n the below details. Everyone in my life is giving me their opinions, but I really would love to hear from people who have been through this.


Here's my situation:

I have a doc here in my own city who can perform my DM and there is a plastic surgeon who's just arrived from out of town to set up an immediate reconstruction program here (we previously had to go out of town if we wanted immediate reconstruction). She only does implants with expanders. If I go this route, I would be home, where my family and kids are, rather than 4 hours away, where my other option is. They can also do the surgery in a week and a half.

I also have a referral to a bigger city (Toronto) to a dedicated breast cancer center, where the surgeon specializes in breast cancer, and the plastic surgeon can do 'everything including micro' - which i take to mean flap and implants. I apparent;y do not have enough fat on stomach (I would certainly disagree with that!) so would have to use tissue from my butt if I went the flap route I think. Is it an option to do implants and fat grafting?

I have the surgeon here wanting me to decide by the end of the day if I want to do it here, because they want to book the OR room. I'm tempted because it's close to home, surgery would be soon, the recovery is shorter, and the results seem more predictable.

BUT, Toronto is a dedicated facility, with a more experienced surgeon. Cons are longer recovery (if I go with FLAP), away from my kids, for a week, and no surgery booked yet (it could be soon too, but who knows!?)


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  • Cpeachymom
    Cpeachymom Member Posts: 518
    edited March 2018

    Roots, I haven’t had my recon yet, but I have similar choices. I can have my surgery nearby with implants, or go to Boston for whatever flap or recon I choose. I trust my nearby PS, he has a good reputation and good manner. I don’t want to go the flap route personally because that would just destroy another part of my body. At least with implants, if it fails it comes out and no big loss. I know there are people here who love their flap reconstruction, all natural, warm. But I just can’t see cutting up another body part to make a boob. I would stay half flat first.

    Again with the sucky choices! Cut up our bodies more or fake plastic boobs? In the end we all have to do what we’re comfortable with and hope for the best. We are the ones who have to live with the consequences.

    Wishing you the best with whichever one you choose.

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  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Agree with Cpeachymom, terrible decisions. I am in reconstruction process. We are talking months and years, depending on your situation. I started last June, had expanders, dec exchanged them + fat injections. now is waiting to see a PS to see if I should proceed or not. Tired of the surgeries.

    I chose implant for now, plan B is DIEP, but it sounds less and less appealing as time goes on. if you are doing a double, you don't have to worry about matching, it will match either way (implants and own tissue). Why double btw?

    I heard people say 1 to 2 years to heal with autologous reconstruction. That scared me. I have small kids 5 and 7 and to take 2 years out to heal...Just can't imagine it. I was terrified that my implant would be cold, it's not. It may be a little cooler to the touch. I can't say I love it. Heck no. I can feel it under my pec muscle if I move. There is a certain heaviness from it. PS team told the muscle will strech, the body will accomodate, you will not even notice it later. That did not happen still. I think some people are not in tune with their bodies, so for them maybe.

    I am uncomfortable with it, but I appreciate that I can wear my own regular clothes, I don't have to worry that people can tell it's a prosthesis, it separates from my body or it is so tight on me. I can go to the pool and not worry about it separating from my suit, swimming out of the suit (I do have to wear an orthopedic swimsuit, because of the matching, but that won;t be a problem with double reconstruction). And I know some women do not care about that and I think how cool not to care, but just not right for me right now.


    my understanding that your own tissue may also have pains an aches where the surgery site was or nerve damage. And I just dont know if there is enough information about that. But definitely some women have went that route and loving it. It's never one surgery. It's a long surgery and then smaller surgical procedures to achieve symmetry and correct small imperfections. And depends on your boobs and your age they may end up looking better than before, especially in a bra. And some women get their thighs and bellies reduced and that is desirable. I definitely seen that.

    I hate that you have so little time to make the decision

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  • Lula73
    Lula73 Member Posts: 1,824
    edited March 2018

    roots- have you been able to view the 2 surgeons' Before & after photos of their patients? That's important no matter if you go implant or flap. Make sure you like what you see when you view them, not just look at them and say 'well they look good considering...' did the surgeon in toronto tell you that you didn't have enough tummy tissue for DIEP or did the local doc? Local docs who don't do flap recon are getting a reputation for fibbing to patients that they're not candidates for flap surgeries when they are not qualified to make the assessment. I would see what Toronto doc has to say/recommends. I had BMX with immediate DIEP recon last year in NOLA (5 hrs away by plane, 14 hrs by car) and am thrilled with the results. Traveling for it was not difficult, just have to make sure the kiddos are squared away with their schedules and someone to make sure it all happens (unless you take them with you of course). I actually looked at pics yesterday of before BC and today and I can honestly say that I look far better now (breasts and tummy)than I did then (and I looked pretty good then.) I understand where peachynom is coming from on "cutting up another part of your body" but flap surgery is not disfiguring (equivalent to a tummy tuck or butt lift) and the breasts really do feel natural, soft and warm. I see it as 'i might as well get something out of this'. When you hear someone say 1-2 years to heal from flap surgery it’s not like you’re disabled during that time. It’s more about healing in the first few weeks, going back to work at 6-8 weeks, and then scars fading and getting any muscle strength in your legs/arms back that may have decreased from doing far less activity during those few weeks after surgery. Yes it’s typically 2 surgeries but what do you call mx with expanders and then going bac for exchange months later? Let’s not forget the trips to the doc for fills every week in between. Implants tend to be cold to the outside touch and cold on the chest wall. Implants with mx is VERY different from implants for breast augmentation. Breast tissue goes all the way up to almost the collarbone. That can create divots that implants can't fix. And then there's rippling. Fat grafting is an option but it tends to be reabsorbed especially with implants as the bulk of what's in the breast pocket is implant and not tissue that it can connect to. It's a lot to think about that's for sure. Let me know if you have questions about flap recon.

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  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited March 2018

    I had the same concerns about flap recon - having to do surgery and recovery on another part of my body just to create a not real breast. I opted for implants and was able to go straight to implant (no TE). The implants are above the muscle so no muscle pain or deformity. I was lucky to be able to keep my skin and nipples.

    I could do fat grafting to improve the slight imperfections - some rippling, one indent, a bit of a "step off" even though I have shaped implants - but that would be more surgery to harvest the fat and I'm not up for more anything these days.

    Reconstruction implants do feel cool to the touch being that they are just under the skin - similar to the way that your butt might feel cool after swimming in cold water. They do not feel cold on my chest.

    Unless there is a reason to rush - I would advise taking your time about such an important decision. I weighed all of my options and still had second thoughts later. But, in the end, what was most important to me was to be done with this chapter. I can always go back and do more, but I don't have to.


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  • Runrcrb
    Runrcrb Member Posts: 577
    edited March 2018

    Roots, I understand that with Canada National Health you may be more concerned with scheduling but do not let someone put their deadline on you. This is a big decision that impacts your body and life.

    You need to talk to doctors about the options (be sure that the doctor explaining an option is the same doctor that would perform that surgery) and get pros and cons. My breast surgeon didn’t recommend DIEP because of recovery time - I was out of the hospital in the same time as my mastectomy and back to work one week sooner. My plastic surgeon would have done a unilateral or bilateral mastectomy but did caution that my risk of surgical complications would double with the bilateral. It took me multiple visits, much reading and about five weeks to make my decision and pick my team. And since then I never second guessed it.

    Good luck






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  • Peacetoallcuzweneedit
    Peacetoallcuzweneedit Member Posts: 233
    edited March 2018

    Hi I had double Mx with immediate TEs placed in May 2017. One TE had to be replaced in Aug 2017. Had my implant exchange in Nov 2017 and now nipples most likely in June 2018. Implants are below Pec....in my opinion mine do not feel cold...I am happy with them, but the entire process does have it's ups and downs like everything. I think with both surgeries you have risks of complications - so I think I would try to figure out what is the ultimate outcome/goals and figure it out the path of least resistance that gets you that desired outcome and still meets your goals. I know it all can be overwhelming....I toyed with the idea of a Flap but also was told "do not have enough fat for two"....which I bet I could enough fat for two :-) The surgery time was a drawback as well, plus the hospital stay was longer...every time I researched something and considered recovery - I just always came back to the implants...I know this all can be overwhelming...we never seem to be far from the "next decision."


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