CONFUSED ABOUT RECONSTRUCTION

[KRISTEN]

YESTERDAY I SAW 2 PLASTIC SURGEONS, ONE WOULD DO A LATISSIMAS DORSI TRAM AND LIFT THE OTHER ONE, BUT ON ALL THE PICTURES I SAW, THERE WAS THIS WHITE ROUND OVAL SHAPE THAT THEY SAID WAS DUE TO NOT HAVING ENOUGH SKIN TO COVER. BOOKED IT FOR THE END OF AUGUST. NOW WILL SEE SOME OTHERS DRS. BUT HAS ANY OF YOU HAD THIS TYPE OF PROCEDURE AND HAVE IT NOT COVERED? THE SECOND GUY WANTED TO PUT IN IMPLANTS BUT ONLY ON ONE SIDE, HE SAID I DIDN'T NEED A LIFT ON THE OTHER SIDE. ALL THE PIC I SAW ONE BREAST HUNG DOWN LOWER THAN THE OTHER. HE SAID A BRA WOULD BRING THEM UP TO MATCH. WASN'T REAL THRILLED. BUT WHAT INTERESTED ME WITH HIM, IS THAT SINCE I HAD GONE THROUGH RADIATION, ENDED JUNE 1, HE WANTED TO TAKE IT VERY SLOW BECAUSE THE EFFECTS OF RADS WAS STILL WORKING. NOW MY DOCTORS HAVE OK THE SURGERY. BUT I AM WONDERING IF THERE IS SOME TRUTH TO HAVING RADS STILL WORKING. ANY THOUGHTS ABOUT HOW LONG TO WAIT? WHAT TO ASK? I AM IN NO HURRY AND CAN SEE OTHER DOCTORS BUT IT IS SO CONFUSING. I NEVER MINDED LOOSING THE BREAST, I WANTED IT OFF, BUT THE LOOKS OF THE NEW ONES DON'T REALLY STATISFY ME. IS THAT JUST HOW IT IS, OR CAN I FIND A DOCTOR WHO CAN DO IT ALL. THANK YOU FOR YOUR GUIDANCE. KRISTEN

[eleanor]

Hi Kristin,
I don't know about the rads still working but my surgeon wanted me to wait so that this skin would have time to heal. He said that radiation can cause the skin to lose its elasticity and to give it time so that he would have a better idea of how much "give" there would be in that area.
el

[Vicki Z]

Hi Kristen,

I had a lat flap with a saline implant immediately after my right breast mastectomy. However, I didn't have radiation so can't address that. My plastic surgeon is going to put in an implant on my left side, because he is a perfectionist and wants it to look perfect. Since I had Paget's, he'll also do a "nipple" from the inner thigh. Good luck in your search for a good plastic surgeon. They're out there.

Vicki

[Ruth S]

Hi Kristin - I was told by my radiation onc. that I must wait 9 months before considering plastic surgery. I don't know about the radiation still working but he did say that it would take months for my skin and cells to heal themselves. I still haven't had surgery and I completed 30 rounds in Jan.
Gook Luck! Ruth

[Lyn]

Hi there, don't settle for second best with your reconstruction. I have been going to have my reconstruction for months but due to other health problems it was put off. I was to have a DEIP which is better than the TRAM flap, because I had the chest muscle and pectoral muscle removed along with 156 lymph glands. The radiaiton continues to burt for up to 6 weeks after if not longer. Radiation peaks at day 10 after finalisiation, I know this for certain because I just finished another round of radiation to my neck which I was coping with until about day 10 when it appeared like a 3rd degree burn on my neck, painful and tight. My plastics guy is going to make me a B cup, and reduce the other to match about 6 weeks after so he can get them both to look the same, give me a new nipple and belly button. HE said he could not make my new breast as big as my other, so I told him I hope not it is big and hanging so I said I want a perky pair, now I just have to get my chemo under control so I can rebook my surgery. The radiation does damage the skin tissue and that is why it is coming from my stomach, all the fat is removed and just enough used for the new breast, hopefully my skin will heal. Hope this helps.

Lyn

[chris]

Hi there
My oncologist and radilogist both told me I had to wait at least 6 to 9 months before reconstruction. I finished rads in October of 03 and am going in for surgery on the 7th of July!!!! Finally. I also had nodes removed(21 all but 1 positive)which was another factor in why I had to wait so long. I am having aTRAM done on the left and then a lift and reduction on the right but not for a couple months after to insure that the swelling has gone down. I wanted a DIEP but there are no surgeons around here that can perform this and my insurance does not allow me to travel outside of the state. Hope this helps!!! Feel free to email me. Stay well
Chris

[Linda in Calif.]

Hi Kristen: I had expanders (which stretch the chest skin) placed after a mastectomy on one side and a prophylactic breast removal on the other. It took about 6 months to stretch the skin to the proper size. This was at the same time I was doing chemo therapy. I then had radiation to the side that had the cancer. My plastic surg. wanted to wait for at least nine months after radiation to perform the surgery to replace the expanders with saline implants. I had what they call a very "brisk" reaction (think "burned to a crisp!!!) to the radiation so the skin on one side was very damaged. I was originally a size "C" but didn't have enough healthy skin left after the radiation for that size so now I am a size "B". I had to have the surgery done a second time because of scarring internally around the one implant because of radiation damage and because the breasts wheren't the same size or even. The final results are OK....nothing to write home about. The breasts are still a little off in size and location but not noticable when I have clothes on. My plastic surg. is willing to give it another try but I've had it with surgery. I'm lucky that it doesn't matter that much to me or my significant other. One thing I did want to tell you about though is that it feels like you are wearing a tight bra 7/24. I went with this proceedure because it was the least invasive and least damaging to my body. I have heard from physical therapists that TRAM flaps can cause back problems because it takes away the support your body needs. There have been some new proceedures developed that claim not to have some of these problems but I am not familiar enough with them to talk about them. Hope this helps. Take Care, Linda