Seeing plastic surgeon today!

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Balance101
Balance101 Member Posts: 29
edited April 2018 in Breast Reconstruction

Hello ladies! This is my first post. I've been reading the forums a bit over the last couple of days and I can't tell you how much the supportive and knowledgeable nature of your posts has calmed me. So, thank you all for your time and compassion. <3

I was diagnosed with Stage 1 invasive lobular carcinoma this week and I am opting for a double mastectomy. I'm seeing the plastic surgeon today. I was wondering if you guys have any suggestions as to what I should ask about. I've read about some having breasts reconstructed from their own abdominal fat, which sounds like a free tummy tuck! (Hey, it would be nice to get something out of this, right?!) I also am interested in silicone, which I've read sounds lighter and more natural feeling than saline. Tissue expanders scare me.It sounds like a long road. Which of these is the easisest in terms of less appointments and revisions, if there is such a thing? Also, what about nipples? I was told by my surgical oncologist that with large breasts you can't keep your nipples and that scares me very much.

I have a lot of questions, sorry this post isn't very concise. I'm feeling a bit overwhelmed right now. Any insight you guys can comment on would be helpful. Thanks in advance!


*Edited to add that I'd like to have reconstruction at the same time as my mastectomies.

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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2018

    Hi Balance, and welcome to Breastcancer.org!

    We know it can certainly be overwhelming trying to make decisions on reconstruction. You're sure to get some great answers from others here soon (hopefully before your appointment today!).

    In the meantime, you may want to check out the main Breastcancer.org site's page on Questions to Ask Your Surgeon About Reconstruction for some good tips on talking with your doctor. Also, the Types of Breast Reconstruction section offers great explanations for all the different options available with you, along with the risks.

    We hope this helps and we look forward to hearing more from you soon!

    --The Mods

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

    Hi Balance- good luck today! If you opted for DIEP flap recon (autologous recon) you may well be able to keep your nipples depending on how much tissue you have available to harvest. Autologous recon is usually 2-3parts: stage 1 is where they do the mx if needed and move the tissue from your tummy to your breasts. Stage 2 is when they “make them pretty” - not that they’re not pretty after stage 1 but this is when they reduce, lift, reposition nipples, shape, etc. Stage 3 is nipple recon and/or nipple tattoos. I know of a few women who were happy with their results after stage 1. Most do a stage 2. Stage 2 is a far easier surgery than stage 1 and recovery time is far less too.

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  • Balance101
    Balance101 Member Posts: 29
    edited March 2018

    Thank you both for the responses! The appointment went well, although my breasts are too large to keep my nipples. I didn't even discuss autologous reconstruction as the paperwork he gave me to look over said it was a week-long hospital stay and I don't want to do that. (We bought a house about 3 days before my diagnosis so lots to do.) I was hoping for implants at the time of my mastectomies, but he said that I needed tissue expenders first. It wasn't what I was hoping for, but it sounds like I'll get the best results this way, so I'm fine with it. Lots of info here for me here to read! :)

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  • Balance101
    Balance101 Member Posts: 29
    edited March 2018

    Thank you both for the responses! The appointment went well, although my breasts are too large to keep my nipples. I didn't even discuss autologous reconstruction as the paperwork he gave me to look over said it was a week-long hospital stay and I don't want to do that. (We bought a house about 3 days before my diagnosis so lots to do.) I was hoping for implants at the time of my mastectomies, but he said that I needed tissue expanders. It sounds like I'll get the best results that way, so I'm fine with it. Thanks again for your help! :)

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

    It would be worthwhile to shop around a bit and get other PS opinions. If you're really fine with this plan, that's great. But most PS tell you about what they do, what they're comfortable with. That doesn't mean someone else can't do what you would like.


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  • Balance101
    Balance101 Member Posts: 29
    edited March 2018

    Thanks for your reply @notverybrave! I honestly liked the plastic surgeon very much and feel as though he'll give me the result I want. I'm just anxious to get through this part of the journey. Thank you for the reminder that I have the right to see other providers though. :)

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

    I only suggested another opinion because in your first post you discussed wanting to keep your nipples, wanting to do all the surgery at once, and wanting to avoid TE's.

    That's not possible for everyone, but it was for me. I had a BMX and had silicone implants placed during the same surgery. I could go back to do fat grafting to improve some areas but don't have to. I was able to save my skin and my nipples.

    Not all surgeons are able and willing to do things this way. And not all patients are candidates, either. I'm not trying to make things harder for you if you're satisfied with how things stand. Just some observations.

    Good luck with the process! None of it's good. 😔


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  • VegGal
    VegGal Member Posts: 507
    edited March 2018

    I agree with Brave. I had fairly big droopy boobs and kept my nipples. My PS recently did immediate implants on a lady who is really big and is obese as well and managed to save her nipples and did a "one and done" surgery. In my experience, almost every doc is nice and personable on the first visit. It doesn't always stay that way and you for sure want to make sure every avenue is explored before cutting.

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  • Balance101
    Balance101 Member Posts: 29
    edited April 2018

    Thanks VegGal for the reply. I'm sorry I didn't respond sooner. I appreciate all of the info you guys have provided me with. Things are just a bit crazy for me right now as we bought a house 2 days before I knew there was anything wrong with my mammogram, so dealing with both inspections, appraisals, packing, etc and cancer appointments. I've decided to stick with what I've planned so far as I'm comfortable with it and my doctor and I really just want to get this over with as quickly as I can. Thank you for reminding me that I do have options. :)

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