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Old 09-11-2012, 05:16 PM   #1
valleygirl
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reconstruction

I was wondering if any of you have had successful reconstruction after radiation and if so what type?
I've read on here several different types of surgery.
Thanks
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Old 09-13-2012, 06:23 PM   #2
Mary Jo
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Re: reconstruction

I had successful bilateral DIEP reconstruction after radiation. I was dx in June of 2005.....had surgeries, chemo, herceptin and radiation all ending by October 2006. I had my reconstruction....delayed bilateral DIEP in June 2008. Very successful.

7 year NED survivor and going strong.

Mary Jo
__________________
"Be still and know that I am God." Psalm 46:10

Dx. 6/24/05 age 45 Right Breast IDC
ER/PR. Neg., - Her2+++
RB Mast. - 7/28/05 - 4 cm. tumor
Margins clear - 1 microscopic cell 1 sent. node
No Vasucular Invasion
4 DD A/C - 4 DD Taxol & Herceptin
1 full year of Herceptin received every 3 weeks
28 rads
prophylactic Mast. 3/2/06

17 Years NED

<>< Romans 8:28
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Old 09-13-2012, 11:06 PM   #3
Pray
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Re: reconstruction

Did you have reconstruction and did it go well?
__________________
dx 11/12/09 IDCI
Stage 3a
ER 98% PR 80%
Her2 +3
4/12 nodes
6 rounds TCH
Herceptin 12 months 3weeks
Rad. 30 tx
Tamoxifin 6 months stopped
Arimedex stopped 9/12 (side effects)
Aromasin 10/12
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Old 09-14-2012, 07:11 AM   #4
snolan
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Re: reconstruction

I had my reconstruction in Dec along with all the other proceedures (nipple, and tatoo). I did latissimus dorsi flap and love the results. I tell everyone my new boobies are better then the old ones. Recovery is a little tougher as you have two incision sites had to do some physical therapy to work on scar tissue and range of motion.
__________________
dx: DCIS 6/8/10, HER 2+ 7/26/10; Stage I Age 41
Double mast w reconstruction
6 TCH w 1yr herceptin
Tamox.
25 radiation tx
Removal of expander on L due to infection. Tried to save it had 3 bouts of antibiotics and went to see plastic surgeon 2-3x wk to get drained. Saving it was my idea not his. But lost it anyway.
Reconstruction set for December 21st,2011
Finished chemo 12/2010
Finished Herceptin 8/26/11
Reconstruction 12/21/11
Expanders exchanged for silicon 3/19/12
Nipple reconstruction 5/18/12
Nipple tatooing- 7/9/12- All done yay!
11/22/12-Went back to get scar tissue stretched to even the outside of breast, didn't work due to it being radiated skin.
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Old 09-14-2012, 04:40 PM   #5
valleygirl
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Re: reconstruction

I did have an expander in and a implant on my non-cancer side but I couldn't take the pain and had them removed not long after they were put in. I was thinking I might have better luck the second time around. I really think they weren't put in correctly because the pain was horrible.
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Old 09-15-2012, 12:36 PM   #6
chekmark
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Re: reconstruction

I didn't have radiation but I also had reconstruction and I found the expander very uncomfortabe and hated the fills, it got more comfortable with time, once it was removed it all went well. I just got my nipple yesterday and everything looks pretty good. I thought that I was the only one that experienced the pain with the expander since no one really ever complained. It was horrible for about 10 days. The implants are something I had to get used to. Did you talk to your surgeon about other options? My surgeon explained all the procedures to me and I went with the less recovery time. Its a personal decision, I hope things work out fpr you.
__________________
DX Sept 30 2010 at the age of 49. Oh crap! 1.5 cm idc, stage 1 grade 3 er/pr+, her2+ no lymph nodes, mastectomy Oct/10. Started 6 rounds of TCH Dec/10 and will continue herceptin until Nov /11 and just started femara.
Stray kitten found my lump while I was playing with it. It is now my pet and my dog is not real happy about that.
Mammo good
last herceptin 11/21/11 YAY
reconstruction 12/09/11
Chapter closed 12/10/11, hopefully, fingers crossed
Bone scan, chest xray, clear
04/27/12 Expander removed, implant put in, ahh sigh of relief, much more comfortable
Sept 30, 2014, 4 years NED
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Old 09-19-2012, 11:34 PM   #7
harrie
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Re: reconstruction

I had bilateral radiation and then 7 yrs later had stage I with mastectomy and DIEP (bilata) It made the surgery a bit more difficult, but my surgeon did very well and I am very happy.
__________________
*** MARYANNE *** aka HARRIECANARIE

1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen

2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy

2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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Old 10-19-2012, 04:38 PM   #8
Westcoastgirl
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Re: reconstruction

I had bilateral reconstruction after radiation. I was not willing to do anything else to upset/scar my body so would only opt for silicone implants. I knew that implants were not recommended after radiation but I had had skin sparing mastectomies, took really good care of my skin during all my treatments, and waited a year after radiation to go directly to implants, no expanders. I had been a C cup and was happy to go with A cups to make the surgery less difficult. I have now had nipples created and am happy with the whole result. My ps said there are often problems when trying to use tissue grafts to create two mounds so I think he was relieved when I said I wanted only to try for implant reconstruction. I had my ps promise me that if the surgery did not work out then he would return me to my previous flat chested state. The radiated side is an adequate breast and the other breast is lovely so I am probably no different than a woman that had a lumpectomy done. I am probably overly critical and my very wise husband tells me both breasts are lovely. All the best, Carolyn
__________________
12/17/08 biopsy after two 6 mos mammo recalls
12/30/08 diagnosed high grade IDC & DCIS
ER/PR +, Her2 (+++) post menopausal/age 57
1/15/09 double mastectomy/skin sparing; no evidence of vascular/lymphatic invasion, 8neg/8 nodes (tumor 8.0mm)
2/16/09 given portacath/removed 4/30/10
2/18/09 "surprise" 2.0mm tumor/positive borders~
completed 28 rads 10/09.
2/23/09 until 4/19/10~treatments every 3wks (4 Cytoxan + Adriamycin, 4 Taxol + Herceptin, 13 Herceptin alone)
8/09 osteoporosis diagnosis/Zometa 3 yrs of 1x/6 months
Chemo side effects; Deafness, kidney function loss
11/09 began Aromatase Inhibitor (Femara)/Feb2014, stopped Femara early/after 3 mos began Tamoxifen for 8 mos to complete 5 years
11/10 Reconstruction, directly to silicone implants
12/11 nipples by skin graft/Right breast size reduced

I have heard th
ere are troubles of more than one kind

Some come from ahead and some come from behind.
But I've bought a big bat. I'm all ready you see.
Now my troubles are going to have trouble with me!
Dr. Seuss
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Old 10-19-2012, 08:23 PM   #9
Cure4Cat
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Re: reconstruction

I am not sure how to start my own thread so I am tagging along with this one since my question is pretty much the same. Has anyone been successful at expander/implant reconstruction after radiation? I am going to have my exchange surgery in November and I am terrified that it is not going to work. I have taken really good care of my skin and I have not expanded that much. I only know a few women who have done this route after radiation and theirs all failed after the exchange surgery. I would just like some hope!
__________________
Dx Her2+, ER+, PR-, stage 2b/3 July 2010
Chemo Sept-Dec 2010
(Pertuzumab during last 3 rounds of chemo)
Surgery Jan 2011
25 Rads March 2011
Herceptin started during chemo and continued every 3 weeks for 1 year
Started Tamoxifen for 5 years

Looking for a vaccine trial
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Old 10-20-2012, 02:46 PM   #10
roz123
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Re: reconstruction

i just had a bmsx 6 days ago. I had a lump and rads 6 months ago. I have expanders with a lat dorsi flap on the radiated side. I was told i had to do the flap procedure b/c of damage to the rads side. Recovery has been really really tough. But i have to say the pain in the front is worse then the excision on my back. I thought it would be the reverse. I have been filled to 160cc already and the pain has become more of a tight sensation. My PS has done hundreds of these and tells me the failure rate after the implants go in is very low b/c the flap has created a proper sling for the implant
__________________
diagnosed aug/11
right breast IDC 2.2 cm LVI
neoadjuvant fecx3, tax and her x3
surgery -pCR 0/2 nodes
25 rads
herceptin x18
tamox
prophy bi-msx with TE's oct 15/12
LD flap reconstruction (PM me if you want the details)
zoladex shots monthly until SOFT studies come out
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Old 10-21-2012, 11:33 AM   #11
julieta
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Smile Re: reconstruction

Hello:
I had a mastectomy, chemo and radiation in 2009.
This wednesday I'll have an appointment with the surgical dr.
I want to know what is the best reconstruction, and how is the recovery if is a flap.
__________________
10/1/2008
IDC, IIB
ER+PR+ Her2+
Taxotere/Carboplatin/Herceptin
Mastectomy left breast
1/29 node+
33 radiation
Arimidex
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Old 10-22-2012, 06:59 PM   #12
Ruth
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Re: reconstruction

I had reconstruction on radiated side after surgery. I waited almost two years before starting. I have silicone implants and it worked out fine. My skin proved to be healthy enough to try it. Most PS don't want to try it. I'm happy with the results.
__________________
[/SIGPIC]~~~~~~~~~~~~~~~~~~~~~~~~~~~

Diagnosed 6/03 nursing daughter
Dose dense A/C 4x
Modified rad mast 8/03
IDC; 3 cm; 10+/16 nodes; ER/PR-; Her2+++
Weekly taxol w/Herceptin (off label) 12x's
40 weeks Herceptin
Radiation 33x
Reconstruction w/ implants 05 & 07
NED
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Old 10-22-2012, 08:43 PM   #13
julieta
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Red face Re: reconstruction

Thank you Ruth!!
That's great, I'll ask about implants..
__________________
10/1/2008
IDC, IIB
ER+PR+ Her2+
Taxotere/Carboplatin/Herceptin
Mastectomy left breast
1/29 node+
33 radiation
Arimidex
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Old 10-22-2012, 09:42 PM   #14
candlegranny
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Re: reconstruction

I just had reconstruction. I only lost one breast. Radiation was strong and hard. My scar was pretty bad. I had D.I.E.P. tram flap. They took fat, skin, and blood vessels from my stomach...no muscle involved so pain was minimal....I have a beautiful breast..I call it my belly boob causebthevskin is from my belly. I gota nice tummy tuck. Because of the radiation the doctor could not use the blood vessels in my chest so he had to reroute the blood vessels in my lymphedema arm to my chest. I am back with my therapist to get my arm back in check and doing well. On my natural breast he will do a lift and implant. This doctor is awesome....this type of reconstruction is notbdobe everywhere but definetly good for those with radiation scars. Life is good.
__________________
Mammogram Sep 21, 2009 everything good and clear
DX jan 19,2010 Invasive Ductal Carcinoma, Grade 2 Age 56
modified radical masectomy on LEFT side 29 Jan 2010
2.7 cm 18/31 nodes
mets to just above collar bone ( 2 nodes showed in PET)
ER- PR - / Her2 +++ (IHC) Stage 111 C
ki-67 60% nottingham score 7
A/C chemo mar 22,2010 DD
herceptin & taxotere DD june 1,2010
finished taxotere july 12, 2010
finished herceptin 16 May 2011
PET Scan 9 Aug 10, cancer in neck is gone! NED
33 Rads completed 1 Oct 2010
PET/CT Scan 6 Jan 2011 NED
PET/CT Scan 3 Aug 2011
MUGA 59% 3/22/10 -63% 9/23/10 - 51% 1/4/11 - 55% 2/17/11 - 50% 8/3/11
26 Aug 2011 NED
20 Feb 2012 NED
5 Mar 2012 PORT OUT
12 July 2012 DIEP breast reconstruction
23 Aug 2012 NED
15 Nov 2012 new breast tweeked and natural breast uplifted and implant added
17 Feb 2013 NED
27 mar 2013 lipo suction to add fat cells to new breast in hopes for needed adjustment.


"Don't spend your time worrying about when or how you are going to die, spend your time figuring out how you are going to live today". ~Elizabeth Edwards.
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Old 10-23-2012, 01:22 PM   #15
julieta
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Wink Re: reconstruction

Thank you Candlegranny!!!!
__________________
10/1/2008
IDC, IIB
ER+PR+ Her2+
Taxotere/Carboplatin/Herceptin
Mastectomy left breast
1/29 node+
33 radiation
Arimidex
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Old 10-23-2012, 02:28 PM   #16
norkdo
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Re: reconstruction

Julieta, would it be callous of me to say you look absolutely gorgeous on your pic? I have NEVER (okay, maybe 25 yrs ago....in a one-piece) looked as sexy as you do in your bikini top pic?
My plastic surgeon is kind of a boy wonder genius guy with an awesomely great reputation. I was asking the same question you are asking when I was referred to him by another doctor with the rave reviews.
You will find all my posts here somewhere when I was asking same questions you are right now.

So. I went to him last May. I had finished 30 rads in April.
here is what I learned. By the way I continue to have faith in my excellent Plastic Surgeon.

1. Six months is needed after last radiation as rads continue to work deep inside and might destroy the new breast. (ironically he did mine 5 mos after instead of 6).

2. I asked "diep or tramflap or silicone or salt water or....." and the answer was this:
(which i think is awesome and shows how smart and experienced he is

3. "If you look at the research, some recons fail. (result of radiation still working, or infection, or skin being too thin to regenerate after infection...etc etc) Statistically. A Plastic Surgeon has to therefore keep in mind these potential failures which X percentage of the time (twenty? can't recall, but high enough) occur. I have to therefore leave in the future an operation which can be done after the potential failure. In your case, the tramflap or diep...the abdomen muscle etc is an operation I do not wish to COMMENCE reconstructing you with, but is an op i wish to leave on reserve in case the first operation fails. If I start with it, we cannot do the silicone/salt water afterwards. If I start with expander (salt water)/changed up to silicone implant, then afterwards, if that fails, we can always do the diep/tramflap. Not the other way round. If the tramflap is the first operation and fails....you're screwed."

4. By the way, people here like Chrisy? (forgive if wrong) told me you can just leave your expanders in for life and never swap em up for silicone. You do not have to decide before the surgery.

5. My PS (plastic surgeon) did not give me an option (thankfully as he had a brilliant plan to prevent further problems in his head) about choosing the size of implant. He chose an implant on my skin-sparing, non cancerous, alternate breast side HALF THE SIZE OF MY OLD REAL BREAST. On the morning of surgery he was drawing on it, showing the senior resident what kind of wrapping of the silicone implant he was going to do. Turns out he CHOSE THE HALF SIZE IMPLANT so he could double wrap it in skin~. The reason is that if the skin dies off from the frequent post-reconstruction infections that occur, THERE IS STILL ANOTHER WRAP OF SKIN AROUND THE NEW SILICONE!!

So consider asking for a double wrapping of your skin around the new silicone if that is what you are getting.

Also, if choosing skin-sparing on your "good" side, consider nipple sparing too. My nipple, on my non-cancerous side, where i still had a breast, a year after the mastectomy of my cancerous breast, was not aesthetically, at 52 years of age and me being overweight and all something I wished to duplicate. I simply asked the PS what he would recommend, and he said "I will give you far better looking nipples than you had before" so I take him at his word.

Somebody on here recommended a thread on the sadness pre-recon of losing breast sensation, not necessarily as a woman having a sexual partner, but even if you are celibate, the sadness of losing nipple sensation altogether while you sleep ...the sheets giving you nice dreams etc...and that is an excellent thread to read. Yes you will have to grieve that ahead of time, so start that early cos I did and I got that out of the way, and am seriously no longer in any grief about that at all, but you need to go through it before you come out of it i think. the thread can be found on breastcancer.org and you can search "nipples" there. It is completely frank about a taboo topic. helps tho. I am just saying I do not know if by doing a nipple-sparing op on your single existing breast you will have any sensation or not. I was offered one on the morning of my surgery by the surgeon that does the digging out of breast tissue on the good breast. The Plastic Surgeon (the one you go find and meet with several times prior to the operation) is the one I consulted about this offer given by the other.
__________________
fall 2008: mammo of rt breast worrisome so am asked to redo mammo and have ultrasound of rt breast.I delay it til january 2009 and the results are "no cancer in rt breast. phew."
found plum sized lump in right breast the day before my dad died: April 17th 2011. saw it in mirror, while i was wearing a top, examining my figure after losing 10 lbs on dr. bernstein diet.
diagnosed may 10 2011

mast/lymphectomy: june 7 2011, 5/20 cancerous nodes. stage 3a before radiation oncologist during our first mtg on july 15th says he found cancer on the lymph node of my breast bone. Now stage 3b.
her2+++, EN-, PN-. Rt brst tumors:3 at onset, 4.5 cm was the big one
chemos: 3fec's followed by 3 taxotere, total of 18 wks chemo. sept: halfway thru chemo the mastectomy scar decides to open and ooze pus. (not healed before chemo) eventually with canasten powder sent by friend in ny (illegal in canada) it heals.
radiations:although scheduled to begin 25 january 2012, I am so terrified by it (rads cause other cancers) I don't start til february, miss a bunch, reschedule them all and finally finish 35 rads mid april. reason for 7 extra atop the 28 scheduled is that when i first met my rads oncologist he said he saw a tumor on the lymph node of my breastbone. extra 7 are special kind of beam used for that lymphnode. rads onc tells me nobody ever took so long to do rads so he cannot speak for effectiveness. trials had been done only on consecutive days so......we'll see.....
10 mos of herceptin started 6 wks into chemo. canadian onc says 10 mos is just as effective as the full yr recommended by dr. slamon......so we'll see..completed july 2012.
Sept 18 2012: reconstruction and 3 drains. fails. i wear antibiotic pouch on my job for two months and have 60 consecutive days visiting a nursing centre where they apply burn victims' silver paper and clean the oozing infection daily. silicone leaks out daily. plastic surgeon in caribbean. emergency dept wont remove "his" work. He finally appears and orders me in into an emergency removal of implant. I make him promise no drains and I get my way. No infection as a result. Chest looks like a map of Brazil. Had a perfectly good left breast on Sept 17th but surgeon wanted to "save another woman an operation" ? so he had crashed two operations together on my left breast, foregoing the intermediary operation where you install an expander. the first surgeon a year earlier had flat out refused to waste five hours on his feet taking both boobs. flat out refusal. between the canadian health system saving money and both these asses, I got screwed. who knows when i can next get enough time off work (i work for myself and have no substitute when my husband is on contract) to get boobs again. arrrgh.


I have a blog where I document this trip and vent.
www.nora'scancerblog.blogspot.com . I stopped the blog before radiation. I think the steroids made me more angry and depressed and i just hated reading it anymore
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Old 10-23-2012, 07:49 PM   #17
julieta
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Re: reconstruction

Thank you Norkdo.
You are very helpful.
Tomorrow is the appointment with the PS.


PS; the picture is 2 month before de Dx in 2008. Now I have 30 pound over.
__________________
10/1/2008
IDC, IIB
ER+PR+ Her2+
Taxotere/Carboplatin/Herceptin
Mastectomy left breast
1/29 node+
33 radiation
Arimidex
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Old 10-24-2012, 07:26 AM   #18
norkdo
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Re: reconstruction

please let us all know here how it goes!!
__________________
fall 2008: mammo of rt breast worrisome so am asked to redo mammo and have ultrasound of rt breast.I delay it til january 2009 and the results are "no cancer in rt breast. phew."
found plum sized lump in right breast the day before my dad died: April 17th 2011. saw it in mirror, while i was wearing a top, examining my figure after losing 10 lbs on dr. bernstein diet.
diagnosed may 10 2011

mast/lymphectomy: june 7 2011, 5/20 cancerous nodes. stage 3a before radiation oncologist during our first mtg on july 15th says he found cancer on the lymph node of my breast bone. Now stage 3b.
her2+++, EN-, PN-. Rt brst tumors:3 at onset, 4.5 cm was the big one
chemos: 3fec's followed by 3 taxotere, total of 18 wks chemo. sept: halfway thru chemo the mastectomy scar decides to open and ooze pus. (not healed before chemo) eventually with canasten powder sent by friend in ny (illegal in canada) it heals.
radiations:although scheduled to begin 25 january 2012, I am so terrified by it (rads cause other cancers) I don't start til february, miss a bunch, reschedule them all and finally finish 35 rads mid april. reason for 7 extra atop the 28 scheduled is that when i first met my rads oncologist he said he saw a tumor on the lymph node of my breastbone. extra 7 are special kind of beam used for that lymphnode. rads onc tells me nobody ever took so long to do rads so he cannot speak for effectiveness. trials had been done only on consecutive days so......we'll see.....
10 mos of herceptin started 6 wks into chemo. canadian onc says 10 mos is just as effective as the full yr recommended by dr. slamon......so we'll see..completed july 2012.
Sept 18 2012: reconstruction and 3 drains. fails. i wear antibiotic pouch on my job for two months and have 60 consecutive days visiting a nursing centre where they apply burn victims' silver paper and clean the oozing infection daily. silicone leaks out daily. plastic surgeon in caribbean. emergency dept wont remove "his" work. He finally appears and orders me in into an emergency removal of implant. I make him promise no drains and I get my way. No infection as a result. Chest looks like a map of Brazil. Had a perfectly good left breast on Sept 17th but surgeon wanted to "save another woman an operation" ? so he had crashed two operations together on my left breast, foregoing the intermediary operation where you install an expander. the first surgeon a year earlier had flat out refused to waste five hours on his feet taking both boobs. flat out refusal. between the canadian health system saving money and both these asses, I got screwed. who knows when i can next get enough time off work (i work for myself and have no substitute when my husband is on contract) to get boobs again. arrrgh.


I have a blog where I document this trip and vent.
www.nora'scancerblog.blogspot.com . I stopped the blog before radiation. I think the steroids made me more angry and depressed and i just hated reading it anymore
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Old 10-24-2012, 01:11 PM   #19
Deb33
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Posts: 133
Re: reconstruction

My surgeon did a beautiful job in just using expanders then implants, fat transfer and some kind of matrix stuff that provides internal support. 4 weeks later I developed a bad infection between the implant and my chest wall of the radiated side and had to remove the implant. My body just had a tougher time healing there. I am waiting for a few months and believe we will go the flap direction to increase healthy tissue and blood flow. My doc said he has good results trying things the way we did but my research shows the best results for success are using the flap - either belly or back.
Good Luck.
__________________
11/19/10 Identified swollen lymph node
1/24/11 Mammogram showed microcalcifications - no mass
2/4/11 Diagnosed ER/PR- HER2+++
2/23/11 Began TCH protocol every 21 days 6x
5/23/11 Ultrasound of originally diseased lymph node shows normal
7/25/11 Lymph node dissection - 8 of 14 show disease
7/29/11 Double mastectomy with reconstruction (expanders)
8/29/11 Begin follow up chemo - Adriamycin 4 treatments every 2 weeks and Xeloda. Self inject Nupogen shots
1/6/12 6 weeks of Radiation finished
2/13/12 Last Herceptin/remove port
3/27/12 PET/Brain Scan NED :)
8/15/12 Final reconstruction - hello nipples, good bye expanders
9/14/12 Rejected implant/infection. Implant removed
5/6/13 Latissumis Dorsi surgery left side with expander

PS - my photo was taken 5 days after my double mastectomy surgery and 6 weeks after my TCH was completed
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Old 10-25-2012, 07:36 PM   #20
julieta
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Re: reconstruction

Hello Deb.
The dr. told me the best way for me is the diep flap. No implant or expanders.
I'll wait for the next year. It's about deductible.
Thank you Deb
__________________
10/1/2008
IDC, IIB
ER+PR+ Her2+
Taxotere/Carboplatin/Herceptin
Mastectomy left breast
1/29 node+
33 radiation
Arimidex
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