Has anyone had a lift and could you share your experience?

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AliceKo
AliceKo Member Posts: 151
edited May 2018 in Breast Reconstruction

Not sure how to proceed, seeing P end of the month. Has anyone decided to operate on the unaffected breast and if you could share your experience?

I had a unilateral skin sparing mastectomy june 2017 with immediate tissue expander reconstruction. Exchange in Dec 2017.

The breasts look good in a bra (thankful for that). Without the bra they look bad. the reconstructed side is up, strange shape, ripppling from my chest muscles, developed a sharp looking protrusion on the lower portion, it's the pocket too big or something. of course they told me that to achieve symmetry, it would be best to remove both breasts and that for unilateral mastectomy autologous transplant would produce a better match. I was not sure I could handle that. The PS plan is to do a small implant on the other breast or at least benelli lift (doughnut hole), nipple reconstruction and tattoo. I am afraid to lose sensation in the other breast if I operate on it, and I really don't want to do an implant. But I would love to be able to look at myself while showering and looking like it's not perfect and real, but somehow ok, It's not ok right now. And I know some women talk about accepting themselves as they are and I applaud them and they do not need no reconstruction or a prosthesis. I am a shallow woman at 42 and I want to look good in clothes and without. I feel like I need to do it for myself, but I also need to do it with minimum damage. I am lucky, my husband completely does not care, told me not to have a reconstruction at all. I struggle with it so much. I was one of these women who actually liked their breasts. They were always perfect size and shape for me, C when I was younger and D after I had my children, no complaints. I actually seen pictures were the breasts after mastectomies looked better! That is no going to be my case

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Comments

  • Runrcrb
    Runrcrb Member Posts: 577
    edited March 2018

    would you consider autologous flap reconstruction?

    When I was making plans after diagnosis, I spoke with several surgeons. The consensus was that implant can match implant, flap can come close to natural and an implant will never match natural.

    I too had unilateral mastectomy. Had my flap reconstruction in December. Very similar in size and feel to my natural breast. My natural breast sits lower without a bra and of course spreads out when I’m reclining. And jiggles more. I see my plastic surgeon next month and will discuss what we can do so that the natural one sits a little higher to match the new one.


  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Runcrb,

    thanks for the quick reply. I am terrified of the autologous reconstruction recovery. I got 2 kids 5 and 7 and there is no way I will not be doing anything for them for the next 12 weeks after surgery. I have spoken to women about DIEPs and not everybody is happy they did it. I would be a candidate for DIEP, other parts are not big enough.

  • nash
    nash Member Posts: 2,600
    edited March 2018

    I had a uni mx with LD flap, and a lollipop lift on the "good" side. The lift was no big deal for me as far as recovery, and the breast looked good. I didn't lose sensation. I've had nothing but trouble with discomfort and pain on the LD flap side, so the lift was a breeze in comparison.

    Unfortunately, in my case, the lift ended up all for naught, b/c within a little over a year, I developed an 8cm new primary in that breast, with lymph node involvement. My tumors are always found on MRI, and my MRI was first delayed due to the lift, then hard to read due to the lift. So the diagnosis of the new primary got delayed. I'm not sure how they managed to miss it during the lift, but that's a whole other issue.

  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Nash, thank you for your reply. What's a lolipop lift?

    . O wow! With missing the primary tumor. I hear it is a big problem with the dense tissue. Are you ok now?

  • nash
    nash Member Posts: 2,600
    edited March 2018

    Here's info on lollipop lifts:

    https://www.pacificplasticsurgery.com/the-lollipop-breast-lift-technique/

    My new primary on the lift side was just diagnosed a couple months ago and I'm on neoadjuvant chemo right now


  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Thank you Nash! I looked it up. I am so not fond of the scars and it sounds like it leaves a long vertical scar.

    I just can't make these decisions anymore. Choosing my surgical team was the worst decision of my life. While I lived and had no infections, the life of chronic never ending pain is not fun. There is still hope, I know my options, medications do not work for me. I am doing alternative treatments before I chose harsh medical interventions - such as destroying the nerves

  • nash
    nash Member Posts: 2,600
    edited March 2018

    Alice I hear ya. I’m in chronic pain from the LD flap and it was the worst decision of my life to trust my PS. And although the lift was easy for me, it masked this new primary. All these decisions are so tough. Good luck with everything

  • strawberrybubblegum
    strawberrybubblegum Member Posts: 8
    edited March 2018

    Hi Alice,

    I, same as you, had unilateral MX and decided to go with exchange surgery on just one side, and leave the other one alone (just talked to the PS TODAY). My PS said he can match the implant side to the natural side pretty well, but deep in my mind I question if he could really do that. After reading your post, I started to wonder if this is the right decision for me. I turn 40 this year. I don't mind that my breasts don't match perfectly, but do they look obviously weird in swimsuit? I'm B cup and perhaps it's easier to match? Another reason to leave the other one along is that I feel it would be much easier to do Mammo or monitor by self-exam without an implant. Thanks for sharing your experience.

  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Hi strawberry, it's interesting that your PS says he can match it with silicone. It just looks different. I had a low profile implant. There are high profile implants, they really stick out. But different surgeons and different women like different things. I am 36 C. Maybe B is easier to match. My breasts look different in the regular swimsuit, one is higher, one is lower, different shapes and missing a nipple. But, I went to dana farber, I am in Boston ma and they had a huge sale on orthopedic swimsuits. I got 4! Like 25$ each. They are usually over 100$ each. I have to say they really do look like regular swimsuits. So, I have accepted the swimsuit situation. Of course I hide as I am changing when I go to swimming pool.

    I am so scared to do anything with the other breast. Just the options available right now seem invasive. I just had my mamogram in dec, it looked clean, surprisingly am not worried.

  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Wow/ I am just like so surprised that medical providers in general do not talk about pain and quality of life after. Yes, getting the cancer is the goal number one, paying attention to the side effects and quality of life issues is also very important. I called up Dana Farber and I told them that I was disappointed about lack of attention (especially from the surgical side!) and options for treatment of the pain

  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Just saw my PS, says check in with me in 3 months. Says maybe the pain and discomfort will decrease. Part of me is glad she is not pushing me to have any surgery. Part of me is so sad looking like this, half done.

  • strawberrybubblegum
    strawberrybubblegum Member Posts: 8
    edited March 2018

    Hi Alice,

    It sounds like you really want to "get it fixed". I saw my PS this week and he said there's no way he can match my MX side to a natural breast "perfectly", but it will be acceptable from doctors' point of view. I then discussed with the nurse who's a woman and can relate how I feel. Anyway, I've decided to put in a small implant in my healthy breast. Period. Exchange surgery is 4/9. To be honest, I'm much happier that I have made up my mind. There're always risks with an implant or not. But I know I'll be happier with slightly bigger breasts and better symmetry. In the end, I'm the one who's gonna face the naked me everyday.

    Alice, it seems like you're not happy.... if the surgery can fix it and make you happier, maybe give it a shot?

    Cheers!

  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Thank you strawberry, you are right it does seem like I want to get fixed. Definitely not happy with the look and the feel when I see myself naked. I am happy in the bra and definitely in clothes. I am glad you made up your mind about the surgery. The ruminations are the worst. I see another PS on the 5th and I looked up a surgeon who used to make breasts completely out of fat injections using the BRAVA medical device, but apparently that device is no longer available. So thinking if I should see him for a consultation.

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

    Alice- for every woman who wishes they hadn’t done DIEP flap there are tens to hundreds more that are thrilled with it. The recovery is about 12 weeks to be at 100%. You’re not totally disabled and unable to do anything for 12 weeks. I was able to be home alone with no assistance for anything at 3 week’s. I was driving at 4 weeks. I was cooking family meals at 4-6 weeks. I was going to ballgames, birthdays, etc with the kids at 3 weeks. I am one of the ones who is thrilled with their DIEP results. I think it also has a lot to do with the skill of the surgeon. So make sure you have one that does DIEP a time least once a week and you like their before & after photos. I went to NOLA for mine. Their photos are available online including women who had implants that were contracting or didn’t look right. Here’s a link:

    www.breastcenter.com


  • AliceKo
    AliceKo Member Posts: 151
    edited March 2018

    Lula, thank you for reply and for sharing, that's real great to hear that you are happy with your DIEP choice. And really no pain and discomfort now? It's all like before. Or it has healed well, but it's not as it was before. I chose my PS because she specialized in DIEP, she is one of the best in Boston who does DIEP. I saw their pictures implants and DIEP. Their implants looked a little better. DIEP still looked good, plus the scar on the abdomen. I don't know how they felt, moved etc. The surgeon and PA told me to do nothing for 12 weeks post op, said one woman was changing sheets and flap failed and they had to race to ER to save it. Spoke with 3 different women about DIEP, 2 were very happy. 2 said 1 year to recover. The younger one said 2 years to recover. I am just not a fast healer and I get miserable. Seriously, 3 weeks for drains to come out!? I hear elderly patients have them out faster. Never had any surgeries before and now 2 since last summer and how many more. Plus, I am size 8, there just not that much tissue to make a C size. That feeling whole sounds real enticing. I don't know what would it take for me to get there, DIEP or symmetry work. The fake nipple sounds interesting, maybe will try that. At least no pain, no surgery, no recovery.

    And the pre-pectoral implant placement is not for me. Said my skin after mastectomy and expansion is real thin.

  • Sweet_Pea
    Sweet_Pea Member Posts: 178
    edited April 2018

    These posts have been so helpful! I'm having a lift and an implant put in for symmetry on my left side at the same time as my exchange surgery on April 24th. The PS says they should look the same in a bra and bikini, but will never look the same naked. So I've been dealing with that and pretty much have it internalized. Right now I have an expander in one side and some days I can see the height difference between that and my real boob, so I change shirts and hope that my lift will correct that at least for a time.

    The other thing he says is that the natural breast with implant will always fall faster than the reconstructed one with time. Seems logical, inevitable. I decided to go for implants instead of flap partly because of recovery time, but also because I don't mind the thought of having two implants.


  • AliceKo
    AliceKo Member Posts: 151
    edited April 2018

    Sweet pea, good luck to you! You will feel better after the expander is out. I also chose implants because of the short recovery time. I hope it works for you. The permanent went in December 2017. Mine look different when naked, but same size when in the bra, no lift, no reduction, no implant on the other side. Waiting to make my decisions

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

    AliceKo- so sorry I'm just responding. Frankly, I feel like I did before BC. That started literally right from the time I woke up after stage 2. I kind of felt like I was in one of those Freaky Friday movies where you change bodies with someone else and then you finally get switched back. Yeah, I got switched back. I kept marveling at the feeling. Now, I did have some pain with my legs/hips from the lipo but that went away and all is good. I'd say it feels like before & it healed well. I also have to credit NOLA & Dr D in particular. Their skill and eye for detail is amazing.

    Everyone's body is different and drains may come out sooner for some & later for others. I was lucky and drains were all out by the time I flew home both times. They say the more active you are the more fluid builds up & then drains. So 1 more reason to take it easy. As far as do nothing for 12 weeks...I went out to lunch on discharge day from stage 1, watched a Mardi gras parade on day 8, ate out several times before leaving NOLA, cooking & driving at week 4, back to work at 8 or 10 weeks (my job requires a lot of lifting, driving and getting in & out of the car all day long). After stage 2, I was eating out in town from the 2nd night after surgery. Didn't miss a beat when I got home. Just couldn't lift anything or return to work for 8 weeks due to hysterectomy I had at the same time. I would agree that it takes about a year to get your stamina back to 100%. It just means you tire a little more quickly and go to bed at 10 instead of 12.

    On the stories...remember that the stories people (Healthcare professionals included) always remember are the bad ones. For every bad/tough story there are likely 10 that went flawlessly. But because the patients that did welljust had regular follow up vs intense multiple visits in a short period of time, they tend to be forgotten.

    When you say your PSs implant photos look better than their DIEP photos, are you talking about breasts or abdomen? How do they compare with NOLA's DIEP photos? How many DIEPs do they do per week/year?

  • AliceKo
    AliceKo Member Posts: 151
    edited April 2018

    Thank you Lula. I do feel like in that movie, my body just does not feel like mine anymore. People are telling me to get used to the "NEW" me, and I am waiting for this to happen and it is just not happening. So I hope that a DIEP maybe an option and I may get my body back when it all heals of course. I emailed my PS questions about APEX, I had never heard her use these words. She is a great PS, just don't know if she is trained in APEX. She does DIEPS at least once a week. Her implant pictures really do look better, less scarring. They look better on the breasts and on the abdomen. The DIEPS, the abdomens look really scarred and sometimes those scars don't look neat and thin, they are like thick and the ends don't look good. I think maybe she used lots of fat injections for the implants and just some women's breasts may have been that shape (the shape of her low profile implants) anyways. I am 42 and I had 2 kids, my boob is a little saggy, but I think it looks pretty good for its age and use, so I don't want to do surgery on it. I am always surprised when women and surgeons describe the implant as a perky 18 year old breast (yuck) and the other breast as an old what ever age it is. And they say it like that, "do you want to have an 18 year old breast?" not me.

    I could not have a nipple sparring mastectomy, so definitely a scar, and the DIEP would add another scar to the breast (to make the sag) and the abdomen. But everything has its pros and cons. I get it. I have never had real surgery before this. And now 2 last year and probably more to go.

  • mitzi458
    mitzi458 Member Posts: 64
    edited April 2018

    I have a question for those who have had a lift done. I am scheduled for a lift on one side and fat grafting on the other. Is a lift painful? How long of a recovery time did you need? I have to go back to work exactly two weeks later and I don’t want to mess anything up by lifting and carrying. I will always ask for help but sometimes there is no help. Unfortunately it’s the only two week stretch I have time off until November.

  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited April 2018

    hi I just read all these posts thought I would tell you about my experience. It is also posted in my profile.


    I was diagnosed in 2014. I had a lumpectomy that couldn’t achieve clear margins and no where else to go with out disfigurement, so Mastectomy of my right side being done followed with a tram flap the following summer I went through recovery with flying colors no set backs and to get most of my range of motion back took about 1 year to 18 months. It was not easy but not unbearable . I have absolutely NO Regrets choosing to do it . I had my lift and reduction on my left breast 6 months later along with nipple recon. They looked beautiful and I felt complete. My PS did a fantastic job. I had little loss of sensation
    At my post op my PS had to tell me though that the pathology report showed in my good breast there was DCIS and we were starting back to step one. I then had A Mastectomy on the left side followed with expansion, implant and nipple recon.

    My breast are symmetrical and my PS did a fantastic job actually an amazing job ! I do not have any sensation now and yes to be honest I do miss it at times but you find a way to confront it, to accept it and to embrace it.

    I know everyone is different and everyone handles and deals with things differently and what is great for one is not always great for others , but for me the lift was The right choice and also a life saver because a 3 D mammogram didn’t find the DCIS just 3 months before.

    But basically what I wanted you to know is the lift will make a huge difference in symmetry and in my experience I didn’t lose sensation.

    I wish you the best in whatever you decide




  • AliceKo
    AliceKo Member Posts: 151
    edited April 2018

    PNWBCHgirl, Thank you for sharing your experience and answering our questions. Do you like the TRAM side or the implant side better? Would you do another autologous reconstruction if you could? Did the nipples change? Especially on the implant side. What size implant?, I understand that the smaller the bra size, the easier it is to tolerate the implant. So many questions, it's just so difficult to make those decisions.

    I got one implant in dec 2017. It's uncomfortable and not looking so good and without the nipple it just looks like some unknown body part, but I know the nipple will change shape and will be something else, the skin is very thin after the expander, 3d tattoo is not an option because the other one sticks out a lot. I am considering converting from implant to DIEP, maybe then I can have an extra piece of skin to make the nipple from and it won't change shape as much.

  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited April 2018

    hi I just read all these posts thought I would tell you about my experience. It is also posted in my profile.

    I was diagnosed in 2014. I had a lumpectomy that couldn't achieve clear margins and no where else to go with out disfigurement, so Mastectomy of my right side being done followed with a tram flap the following summer I went through recovery with flying colors no set backs and to get most of my range of motion back took about 1 year to 18 months. It was not easy but not unbearable . I have absolutely NO Regrets choosing to do it . I had my lift and reduction on my left breast 6 months later along with nipple recon. They looked beautiful and I felt complete. My PS did a fantastic job. I had little loss of sensation

    At my post op my PS had to tell me though that the pathology report showed in my good breast there was DCIS and we were starting back to step one. I then had A Mastectomy on the left side followed with expansion, implant and nipple recon.

    My breast are symmetrical and my PS did a fantastic job actually an amazing job ! I do not have any sensation now and yes to be honest I do miss it at times but you find a way to confront it, to accept it and to embrace it.

    I know everyone is different and everyone handles and deals with things differently and what is great for one is not always great for others , but for me the lift was The right choice and also a life saver because a 3 D mammogram didn't find the DCIS just 3 months before.

    But basically what I wanted you to know is the lift will make a huge difference in symmetry and in my experience I didn't lose sensation.

    I wish you the best in whatever you decide

  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited April 2018

    I’ll try to answer all of this . Yes with out a doubt I would do my tram again the only regret is I did not do both breasts the first time around. My Ps asked if I wanted to so I would never have to worry about it.i had plenty of tissue and just so you know I am not small I am a 36 D and was larger before diagnosis. Since a tram flap is one and done I did not have the option to do it again for the other breast I could have done a lattimus Doris but I would still have needed a implant because of my size.

    I like both. My PS did a Great job and did a lot of fold work to make them match as much as possible and my nipples match pretty close too they are both reconstructed . They are not completely the same but neither were my real ones.My implant is a 410 Natrelle 690cc

  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited April 2018

    I'll try to answer all of this . Yes with out a doubt I would do my tram again the only regret is I did not do both breasts the first time around. My Ps asked if I wanted to so I would never have to worry about it.i had plenty of tissue and just so you know I am not small I am a 36 D and was larger before diagnosis.

    I like both. My PS did a Great job

  • AliceKo
    AliceKo Member Posts: 151
    edited April 2018

    you sound really positive. That's awesome. That you like both the tram and the implant.

  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited April 2018

    @AliceKo I have had a good experience all the way around at times it was hard and I have had my moments , I really cannot complain because everything has turned out very well and I have had really no complications. I did have to have a minor revision to fix a divot but pretty much that was it.


    I am 1year from being completely done ( last surgery the revision was a year ago today) they are part of me. My tram side occasionally reminds me to take it easy when I do yard work or something that takes core and peck muscles since my reconstruction is under the muscle and my breast is made of muscle and tissue from my abs . So I have that reminder as well as the scars but my scars are thin and white.

    I am pretty thankful for the way things turned out especially since I know how much worse it could have been from losing my step mother from stage four metastatic breast cancer back in 1990

  • lifeb4me
    lifeb4me Member Posts: 39
    edited April 2018

    I had a lumpectomy. Unfortunately, I had a terrible experience with my bs. She is very old school and did not tell me there are techniques that hide the scar around the nipple, under the arm or under the breast. She took out a big chunk right in the middle of the breast so now I have a long scar that goes almost side to side of the breast. I also had an infection at the surgical site that made the scar colapse, so it looked like I had a big toothless mouth on top of my breast. Of course she is no longer my bs. I now have a great bs but it’s too late. I found a fantastic ps that I love and have had a scar revision. In some time I hope i wil have just a faded line for a scar. However, after the revision I could look at myself again in the mirror and did not like the assymetry. The girls were no longer twins but distant cousins. My ps suggested a lift to the other breast with fat grafting to restore symmetry. I loved the results. The scar is around the nipple and just one month after the surgery it is already barely visible

  • lifeb4me
    lifeb4me Member Posts: 39
    edited April 2018

    Ah, almost no pain. Back to work and driving in aweek

  • Sweet_Pea
    Sweet_Pea Member Posts: 178
    edited April 2018

    Thanks so much for your input, lifeb4me and PNWBCHgirl. It's so great to hear about other people's experiences and makes me feel better going into my exchange surgery next Tuesday. I'll have a lift and a small implant put in on the healthy side. It's nice to know you both haven't had regrets, despite what might have come later. They will also send the tissue they take out of my healthy breast for biopsy just in case (standard protocol in these cases at my hospital) so that will be setting my mind at ease...or if not, will catch anything ASAP so we can figure out what needs to be done.

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