New reconstruction of breast using mesh sling?
Has anyone had this done? I like this idea of going direct to implant without having to go the TE route behind the pectoral muscle. My breast surgeon said this mesh sling is new and not everyone is a candidate and that risk of infection was higher. On Monday, I will be meeting with a potential plastic surgeon that will be doing my reconstruction so I will be asking him about it then. My breast surgeon is recommending lumpectomy with radiation. My gut is telling me to get a mastectomy. He thinks that is a lot of surgery for something the size of a pea... but I am scared of doing radiation. My oncologist said that you can never lift anything over 10 pounds after a mastectomy?? Is this true?
Comments
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The mesh sling that you are talking about is Alloderm or the like. It's used to help anchor the implant above the muscle. As gross as it sounds, it's made from cadaver tissue that has had all the cells removed. It's like a scaffold for your own body to use. I've never heard of an increased risk of infection.
I had this procedure. My original BS and my oncologist were pretty vocal about being against the choice of mastectomy - even though it is a valid choice. Had my genetic testing come back positive, they would have been recommending it. My second opinion BS was much more accepting of my reasoning and referred me to a PS that she frequently worked with that did this type of reconstruction.
And no - that is not true about lifting restrictions! Only initially after surgery are there any restrictions. At all.
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Sorry, but your oncologist is wrong, wrong, wrong. Lifting can be more difficult if you go the TE route and under the muscle implants because they often cut into the pec muscle to allow room for the TEs and later the implants which can weaken it. But you’re not looking at TE recon... I’d just tell the BS, yeah it is the size of a pea, but a pea that can grow and spread and kill me, so not so small and innocent afterall. And with mx you eliminate the chance of rads permanently damaging your skin and changing the underlying tissue structure which can leave you lopsided and can be painful thank you very much. Immediate recon options that do not require any muscle cutting include direct to implant with the alloderm (implants on top of the muscle) and natural tissue recon using DIEP or SGAP methods.
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The use of allograft material, or dermal matrix, is not new. It has been used for many years for breast reconstruction, whether above the muscle or below. Using allograft with sub-pectoral recon helps strengthen the muscle as it is stretched and helps hold the expander or implant in place. It can be made from human tissue, or cow or pig, and there is also a completely synthetic material called TIGR mesh. The body forms scar tissue around the dermal matrix incorporating it. There is an increased risk of infection with the use of dermal matrix in any type of recon - roughly double the risk compared to reconstruction without it - but still low. Most plastic surgeons use prophylactic antibiotics in an effort to control this.
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You may want to verify whether or not they suspect you'll need radiation. In my case - doing the MX meant that I didn't have to have rads. That's not always the case because it depends on the location of the tumor and status of the lymph nodes.
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I am 3 weeks out from bilateral mastectomy. I was diagnosed with DCIS in left breast only, decided to have both breasts removed. I was so glad I did because “surprise" I had it in the other breast too. I do not need chemo or radiation since I had mastectomy. Have not been told I can't lift anything over 10 pounds, I am a nurse and have to be able to lift 30. I haven't read that in any of the information given to me.
I just joined this group because so many questions I have and don't want to call every time I have one. I am dealing with the fluid from surgery now. Best of luck
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I wasn't super keen on radiation either, but also wanted a smaller surgery with less recovery time. I was able to do accelerated partial breast radiation--only 10 treatments on 5 treatment days. I was part of a study so it was done before surgery and honesty was nothing to fear. Most days between radiation treatments I biked 20 miles and went on a 30 mile bike ride the weekend radiation finished. I'm now one week since surgery and itching to get back to running and biking. I am already walking my large dogs for multiple miles.
So the long story here is I'd recommend talking to the radiation oncologists before ruling out radiation and going to a mastectomy. There are valid reasons for both and if I couldn't have done the accelerated route I might have chosen a mastectomy just for logistical reasons as I was a 90 minute drive to radiation.
Best of luck and speedy healing.
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Dear Marilou07,
Welcome to the BCO community. We are sorry about your diagnosis and surgery but glad that you reached out for support and information. We hope that our members will be a help to you as they share their own experiences. Here is a link to more information about Mastectomy and what to expect afterwards. Let us know what questions you have and we can direct you and better help you to navigate your way around the boards. The Mods
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Thank you everyone. I have decided to take the advise of every doctor I have seen and get the lumpectomy with radiation. I am not looking forward to the radiation treatments but will power through them as best I can and move forward with my life. My surgery will be August 8 or 9th unless they can squeeze me in somewhere sooner.
MaryLou, I am wishing you all the best in your healing. It's a wonderful thing you decided to get bmx! Happy for you that you don't need any further treatments!!
Nat_Blu - Thanks for the encouragement on the rads. I hope mine goes as well as yours did!
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The idea that you can't lift much weight is outdated. Yes, you want do light lifting only while you heal, but after that you can easily build up. The recommendation is to do it slowly with light weights and increasing repetitions, gradually increasing. This is about lymphedema risk, so people may want to read some of the other threads here that are specific to lymphedema risk reduction and exercise.
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