Please help with reconstruction

Hi Bubbly - I am new to implants - I am 7 weeks post-surgery (bmx with dti reconstruction with tearshaped gummies) and I had my ovaries & fallopian tubes out (laparascopically) that same day. Obviously I can't compare firsthand to a flap surgery, but factors that informed my personal decision not to do a flap reconstruction were my aunt and a cousin's experiences and how long the flap surgery would take compared to implants. Being under anesthesia for the estimated 18-20 hours for my total surgery was just too much. My aunt continues to have problems from the muscles cut for her tram flap (balance, strength) and she's 16 years out from surgery. My cousin just curses and was really happy when I chose implants. For me, I decided that the shorter surgery, quicker recovery and less cutting of my body was preferable. So far, I'm ok with how the implants have turned out (cosmetically, in a blouse they're great - naked, I'm still adjusting). They still feel foreign much of the time, but I already have regained a lot of range of motion and am cleared to resume normal activity. I'm sure others will chime in with their experience and hopefully you will have enough to make the choice that's right for you. Good luck!

DIEP flap uses no muscle so not the same as TRAM flap-don’t let anyone do TRAM on you. I did immediate DIEP at same time as mx. I have soft, warm, natural looking and feeling breasts that feel like part of me (because they are!) I’ve been able to look in the mirror since day 1 without having to adjust and today (18 months from stagecoach 1, 9 month some our first ftom stage 2) you can’t even tell I had anything done. I’d have to show you where to look for the scars. With all that being said you need to do your research on the docs that do DIEP and pick the one with the outcomes you want to have for yourself not just the closest or the least amount out of pocket or one that’s in network. I traveled to NOLA for it and have 0 regrets.

Here's a link to their website (keeping in mind very few PSs have results like theirs)band a link to a YouTube video called 'I wish I'd Known' that's very informative (it's all the good stuff the docs tell you before surgery but more importantly it includes the not so good stuff they don't tell you). It can help you make an informed/educated decision.

www.breastcenter.com

https://www.breastcenter.com/2018/05/01/i-wish-id-known-dr-ordonye-speaks-to-ypo-about-modern-breast-cancer-care/

I was pregnant and had small children when diagnosed and my ps recommended implants over diep for that reason, because the diep would have a longer recovery time. He could tell too that I was on the fence. If I felt strongly one way or another he would've gone with it

I will tell you my physical health other than cancer was excellent. I was 53 with no one to take care of my DIEP on left side was easy to recover from. I really wasn't uncomfortable but my mother was doing all the work making food everything. All I did was eat, sleep, talk on the phone and watch movies. She would yell at me if she saw me reach for anything.

No complications healing fine, started driving 1 month after surgery no problems at all. I looked good. Joined LA fitness 6 weeks after surgery started swimming. I also was doing treadmill before diagnosis. After maybe 6 weeks back on the treadmill.

My plastic surgeon said I was on the top of his list as excellent results with no problems. I thought an implant would drive me crazy especially if I could feel or move it. My DIEP breast feels and looks like my real one. I will say there is loss of sensation in the reconstruction but it is still coming back after 7 years.

I had my implant placed before radiation. So I had mx with te, then chemo. 4 weeks later I had the exchange surgery ( plus prophylactic mx on the other side). Another 4 weeks and I started radiation. My ps said if the timing was ok with the oncologists he preferred not to operate on radiated skin due to healing complications. The radiation does not seem to have affected my implant in any noticeable way, tho the risk of capsular contracture is there.

I’m glad you were able to discover the tumor. I was diagnosed a year ago, around 30weeks.It’s so hard with young kids, but it also helps to distract and keep me focused on the future.

that may be your sign to maybe go DIEP flap instead of implants...

Bubblybubbles_1:

I think the radiation will impair healing of any reconstruction.

BS does not make that decision, PS does. If there is one thing I've learned from this journey is that no one except the microsurgeon who does DIEP can tell you if you you're a candidate and in what order they prefer to do the recon. Many microsurgeons prefer to do DIEP prior to rads as the tissue is damaged by rads and tends to have healing issues. They do the big surgery first then you have rads then they fix anything rads damages (which is a much easier surgery). Have you called NOLA by chance? They have hands down the most experience with DIEP pre and post rads and they do an all in one surgery. www.breastcenter.com

Bubbly - Why do they think they need to do full dissection of lymph nodes? Most surgeons start with SNB first and do anything further only if needed.

I had two suspicious nodes upon diagnosis. One was biopsied and found to be negative. The radiologist termed it as "discordant" at the time. But the pathology from the surgery showed no cancer in the SNB nodes and I didn't require radiation with a BMX.