After all this time (well I guess it's only been a couple of years) I have finally started to entertain the possibility of reconstruction.
In January of 2009, I had a bilateral mastectomy. I couldn't consider reconstruction at the time because of radiation. I also felt like I'd had enough with the surgeries. And that reconstruction was capitulating to the notion that I needed breasts to be a worthwhile female.
I have prosthetics, but I don't wear them. In fact, I don't like them at all. But clothes don't fit me right and every darned day I look in the mirror and can't help but feel sadness for what I have lost. So I thought I'd meet with a plastic surgeon, just to see what's available.
That's what I did yesterday. The way she sees it, I have two options.
1) Lat Flap reconstruction -- Using the latissumus dorsi muscle in the back. You can read all about it here, but they basically remove muscle and skin from your back to make a pouch and put tissue expanders inside. They fill the expanders over the course of a couple of months, then remove them and put in an implant. The pros of that are that it's a relatively short set of procedures and recovery time is not terrible. The cons are that I'd have an implant. Not only can any variety of things happen to it, it's not permanent and would have to be replaced like every 10 years or so. Plus, I'd lose a back muscle and with it, 8% of my shoulder strength.2) DIEP flap reconstruction (read here) -- Uses abdominal tissue to create a breast. It's a very complicated surgery that takes like 12 hours and involves a week in the hospital. There are veins and arteries that have to be attached to the sternum. The big pro is that there is no implant.
Of course, Option 3 is to do nothing.
I don't know what to do, but I'm all over the place with this decision. I know some of you have opinions and I'd love to hear them!!
10 comments:
Katie, I really feel for you, and I know what it's like to weigh all this out. Ultimately you have to choose what's best for you personally. I did have a lat flap - from a top surgeon of lat flaps - and I sincerely regret it. I'd say 8% is inaccurate - my range of motion was compromised to the point where I ended up with frozen shoulders - extremely painful - and to this day I can't hold my shoulders back without lots of effort. Also, the front of me will always 'flex' in an unnatural way. You can send me a Twitter DM if you'd like. Hugs!
I had bilateral DIEP surgery in 2006 and love the results. Obviously this is an individual choice, but since you asked :) my advice is to avoid any procedure that tampers with a muscle if at all possible. If you want more info about my DIEP experience you may ask me directly, and/or read about it on my website stayinthepink.com/
I'm glad you're talking about it and writing it.
I was able to avoid radiation by having the double mastectomy so I know that opened up options for me that you may/do not have. I have silicone implants (had expanders and all of the procedures associated with that process). I don't mind having implants, I'm not worried about leaks; had MRI at 3 yrs to check for that and swapping every 10 years or so doesn't faze me because that surgery is a piece of cake compared to the lat flap and DIEP. Those are MAJOR surgeries, you should talk to women who have had positive and negative experiences. Have heard many stories, some of them definitely enough to be serious cautionary tales.
I think the recovery, weakness, chance of complication are major with the 2 operations you are considering. Depending on what your daily life is like and how much time you can take off it would affect how likely you are to risk having one of these done. Even when everything goes smoothly these are big.
Perhaps asking your surgeon for names of women who have had them might give you some added perspective. You can try to find women your age who have similar daily lives and see how much they are affected. I talk to women all the time about reconstruction surgery and it's usually helpful. Your surgeon should have names of women willing to share their ideas (and even see what their final result looks like).
I wish you the best, it's hard to make these decisions but important to feel comfortable in the skin you are in.
Katie,
I agree with Lisa, I would get references/talk to women who have been through it and it also wouldn't hurt to ask to see pictures of the results. My plastic surgeon has a photo gallery.
I have not had either of those surgeries so I can't offer an opinion. I had a single mastectomy followed with immediate reconstruction with an expander/implant. I wasn't concerned about implants. I opted for silicone because it feels more natural. The saline expander fill kind of felt like a baseball. My plastic surgeon said leaking isn't an issue because it's like a gummy bear and none of his patients have had problems. I also had an implant/lift on the other breast for better symmetry. I am really happy with the results.
It sounds like you have been unhappy with the way you look so reconstruction might be helpful even though they sound like pretty significant surgeries. You're not a shallow person for wanting to have your female shape back. Feeling good about yourself is worth it.
Best of luck to you as you decide!
A tough decision, to be sure. If you're curious to read about my experiences with reconstruction after radiation, check out my blog under the tag "reconstruction." The long and short of my decision to have an implant put in (instead of using autologous tissue) was based on two primary concerns: 1) if the tissue transfer failed there was no "plan b"--so I went the implant route and, if that fails, autologous tissue is the back-up plan, and 2) fear of the long recovery and double the risk of complications (e.g. two incision sites, two sets of drains, etc.). I go in for my exchange surgery in a few weeks and hope my radiated skin cooperates with the surgeon and heals nicely for the long term. Good luck in making your decision.
Hmm, I used to hold a serious grudge against my prosthesis, but then bought some lovely post-surgery bras and essentially just got used to wearing it around. (I have certain shirts to wear sans-prosthesis, and certain outfits that demand a boob-like bump on my chest.) Maybe before you decide on the surgery you might want to try your prosthetics for like, a week? Just to see? It might help finalize your decision.
Good luck in your decision. It's a big one for sure.
Hmm, I used to hold a serious grudge against my prosthesis, but then bought some lovely post-surgery bras and essentially just got used to wearing it around. (I have certain shirts to wear sans-prosthesis, and certain outfits that demand a boob-like bump on my chest.) Maybe before you decide on the surgery you might want to try your prosthetics for like, a week? Just to see? It might help finalize your decision.
Good luck in your decision. It's a big one for sure.
Hi Katie,
I totally empathize with your decision. I had a DIEP and despite the hellish recovery, it's so nice not to have anything foreign inside of my breasts. I still have to wear a prosthesis on the breast that had cancer because it is a tad smaller due to radiation damage and multiple prior surgeries.
Good luck with your decision. I can relate.
I also understand the difficulty with this decision. You made the right move by asking around first. At the very least, you'd have some idea of what you are potentially getting yourself into.
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