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Margaret Eleanor · 04-22-2011, 03:30 PM

Been lurking a long time, but this is my first post. I am adamant about reconstruction and this topic has over come my superstition to post.

I find your thoughts on reconstruction and the pressure (implied in your message) from your plastic surgeon interesting. Based on inital meetings with my surgical oncologist and my first plastic surgeon, the plan for me was bilateral mastectomy with immediate tissue expander placement (because DIEP would keep me out of commission for so long...my 11 year old daughter plays club soccer, sings and plays piano, and I do not want to miss anything).

I checked in with my plastic surgeon after six months of chemo, and before mastectomy, just like he told me to do. He changed his mind and doesn't do tissue expanders before radiation any more. In fact, his exact words were "I don't know why you're here. You must have slipped through the cracks. I recommended delayed DIEP for you and I will no longer put in tissue expanders before radiation. There's nothing I can do for you. Come back after I get back from my fellowship in July 2011." I was devastated. I cried.

Last week I went to see a different plastic surgeon in the same practice and he refused to even consider putting in tissue expanders and implants since I've had radiation. With ZERO discussion from either him or his partner on DIEP (I cut off DIEP discussion as soon as the original PS told me I'd be in ICU for 4-5 days and overall hospital stay of 5-7 days), he went on to tell me that I have unrealistic expectations of the outcome of DIEP, the extended recovery time of DIEP, and he does not consider me psychologically ready for any type of reconstruction. He says Herceptin has nothing to do with his decision. I was P!$$ed. I threw my purse at the closed door after he left (pretty much cementing, for him anyway, that I'm not psychologically ready). I have a hard time accepting him telling me I'm not ready for reconstruction, but he is the same PS that will do a boob job, lip job, or liposuction on an 18 year old girl for graduation.

I am frustrated and confused! I need some information, education and advise. I do have an appointment with a totally different PS, different practice, everything, in about 10 days. I will bring my purse and try very hard not to throw it.

I'd love to hear from others on reconstruction. Why you did or did not reconstruct. What options your plastic surgeon gave you. What procedure was recommended for you. What you chose to do, etc.

My stats: diagnosed 6-1-2010 @ 48 with IDC 4.5cm multifocal tumor right breast, with 2 positive axillary lymph nodes all ER+1%, PR-, Her2+++; neoadjuvant chemo, 7 treatments with taxol/carboplatin/herceptin 7-12-2010 three weeks on, one week off; then taxol/herceptin 9-13-2010 to 10-11-2010 with no break, 4 dose dense AC 10-25-2010 to 12-6-2010; surgery 1-4-2011 pathology shows nodes pCR and 4mm breast tumor remaining (a satellite of the primary tumor); 30 rads (including 5 boosts) 02-21-2011 to 04-1-2011 (no foolin!) continue Herceptin until Oct. 2011; currently on Arimidex (but not for long...LH and FSH are falling, expect rising estradiol when blood is drawn next week)

04-22-2011, 03:30 PM	#3
Margaret Eleanor Member Join Date: Apr 2011 Location: Phoenix, AZ Posts: 18	Re: Reconstruction Been lurking a long time, but this is my first post. I am adamant about reconstruction and this topic has over come my superstition to post. I find your thoughts on reconstruction and the pressure (implied in your message) from your plastic surgeon interesting. Based on inital meetings with my surgical oncologist and my first plastic surgeon, the plan for me was bilateral mastectomy with immediate tissue expander placement (because DIEP would keep me out of commission for so long...my 11 year old daughter plays club soccer, sings and plays piano, and I do not want to miss anything). I checked in with my plastic surgeon after six months of chemo, and before mastectomy, just like he told me to do. He changed his mind and doesn't do tissue expanders before radiation any more. In fact, his exact words were "I don't know why you're here. You must have slipped through the cracks. I recommended delayed DIEP for you and I will no longer put in tissue expanders before radiation. There's nothing I can do for you. Come back after I get back from my fellowship in July 2011." I was devastated. I cried. Last week I went to see a different plastic surgeon in the same practice and he refused to even consider putting in tissue expanders and implants since I've had radiation. With ZERO discussion from either him or his partner on DIEP (I cut off DIEP discussion as soon as the original PS told me I'd be in ICU for 4-5 days and overall hospital stay of 5-7 days), he went on to tell me that I have unrealistic expectations of the outcome of DIEP, the extended recovery time of DIEP, and he does not consider me psychologically ready for any type of reconstruction. He says Herceptin has nothing to do with his decision. I was P!$$ed. I threw my purse at the closed door after he left (pretty much cementing, for him anyway, that I'm not psychologically ready). I have a hard time accepting him telling me I'm not ready for reconstruction, but he is the same PS that will do a boob job, lip job, or liposuction on an 18 year old girl for graduation. I am frustrated and confused! I need some information, education and advise. I do have an appointment with a totally different PS, different practice, everything, in about 10 days. I will bring my purse and try very hard not to throw it. I'd love to hear from others on reconstruction. Why you did or did not reconstruct. What options your plastic surgeon gave you. What procedure was recommended for you. What you chose to do, etc. My stats: diagnosed 6-1-2010 @ 48 with IDC 4.5cm multifocal tumor right breast, with 2 positive axillary lymph nodes all ER+1%, PR-, Her2+++; neoadjuvant chemo, 7 treatments with taxol/carboplatin/herceptin 7-12-2010 three weeks on, one week off; then taxol/herceptin 9-13-2010 to 10-11-2010 with no break, 4 dose dense AC 10-25-2010 to 12-6-2010; surgery 1-4-2011 pathology shows nodes pCR and 4mm breast tumor remaining (a satellite of the primary tumor); 30 rads (including 5 boosts) 02-21-2011 to 04-1-2011 (no foolin!) continue Herceptin until Oct. 2011; currently on Arimidex (but not for long...LH and FSH are falling, expect rising estradiol when blood is drawn next week)