Breast Reconstruction Options

Hello, I am under a prostate cancer watch and utilize these boards.  My Wife was diagniosed with aggresive breast cancer two months ago.  She is depressed and not proactive towards researching the web.  Our insurance company will pay for reconstruction .  She wants the reconstruction and i am interested in learning her options and what others here have received with the least amount of complications and good cosmetic results..  Any recommendations and information would be greatly appreciated.. thanks in advance, philip

Hello Philip

 you asked about breast reconstruction for your wife.

 I know when I went through breast rreconstruction 15 years ago, it was a very good thing for me.

However, in retrospect, had I known, I would have insisted on silicone implants, rather than saline, as they have become rather 'ridgey'.

But despite that the result has been good and at 65 I am reluctant to undergo more surgery.

 For my procedure a muscle was moved from my back to form the support for the implant.  The op was long and recovery uncomfortable, in that one feels very 'tight' and can't move much for a few days.

But WELL WORTH it!!

 I wish your wife well

God bless

Jacqueline

 

however in

 

On 7/7/2009 TRAUMER wrote:

Hello, I am under a prostate cancer watch and utilize these boards.  My Wife was diagniosed with aggresive breast cancer two months ago.  She is depressed and not proactive towards researching the web.  Our insurance company will pay for reconstruction .  She wants the reconstruction and i am interested in learning her options and what others here have received with the least amount of complications and good cosmetic results..  Any recommendations and information would be greatly appreciated.. thanks in advance, philip

 

Find out all your options before chossing the one best for you. I knew nothing and followed my surgeon's reconstruction partner and had expanders put in prior to implants which were to be exchanged 6 months after radiation was over.

What my surgeon did not tell me was that there was another option and in fact, for patients who have had radiation is a better alternative. It is the SIEA Tram or DIEP Tram. This procedure builds breasts from the patients own skin. The results are incredible and they look real!

If your wife is having radiation, what can happen is that the skin becomes brittle and cannot support the implants. As a result, the implants lay on the rib cage wall and cause Post Mascetomy Pain Sydrome. I developed this and had to go on massive pain meds just to function each day. After many consults with Plastic Surgeons, I made the decision to have the implants (which look like rocks and do not resemble real breasts at all) replaced and have the Tram.

There are only a handful of surgeons trained in this procedure. Do your research. My doctor has the reputaiton of being "The Fixer"...he fixes the "mess" other doctors did. I found him through recommendation. His name kept coming up as the one to go to.

I wish you and your wife a safe and smooth journey.

I am so happy and pain free. The reason my origial doctor did not recommend this alternative was that he was not trained to do the procedure and did not want to loose the patient.

I wanted the bilateral mastectomy with immediate DIEP free-flap reconstruction. Unfortunately, the world-reknowned hospital in Baltimore wouldn't do it all in one procedure as they said they they would when I made my appointment. They placed tissue expanders, I got a pseudomonas infection around a week after surgery in one...I was very ill.

 I was directed to Cleveland Clinic about 9 months later by a neighbor who had the bilateral mastectomy with immediate DIEP free-flap reconstruction...her results were awesome! I cried, because that's what I had been seeking.

I since have had MY bilateral DIEP free-flap reconstruction by Dr. Bernard at Cleveland Clinic. It was a 14+ hour surgery, I was in the hospital 3 days (usually a week is standard). I love my breasts...they are warm and comfortable...my clothes fit...I have a cleavage! I since have met another woman in my town who had hers done at Cleveland Clinic, and is also very happy with her results. Have also met a woman who went the implant route. She wishes she had gone for the DIEP...she says her implants are "ok" but they are kind of cold feeling on her chest. Mine are warm and comfortable. I am having my nipples "done" this September.

That's just my story in a nutshell. DIEP free-flap is state-of-the-art, but not everyone does them, or does them well, even if they say they do.

Prayers for your wife, and blessings for your journey!

Hello Phillip,

I just want to tell let you know about my reconstructive surgery.  I too had chemo and radiation.  Because of the radiation, I did not qualify for implants (which I knew I did not want in the first place).  I had a DIEP free-flap, which is different from the TRAM free flap.  The DIEP does not take the muscle, they only use tissue and fat.  The TRAM free-flap uses muscle, which has it's own complications.  I am very very pleased with my results and would recommend a DIEP over implants to anyone who has the availability of a qualified surgeon to do the proceedure.  I also had a friend who had a DIEP at UCLA.  Her results were completely different from mine.  I am so thankful that I went to my surgeon and not UCLA.  The results are like night and day.  My surgeon is also a professor at UCLA but has a private practice.

Like the previous response above, do your research and ask a lot of questions.  Ask to speak to patients who have had the proceedure, I did this, it not only will put your wife at ease but it will help her feel more confident when it comes time for the surgery. 

Best of luck to both you and your wife.

Teresa 

I am another satisfied DIEP customer -- had unilateral immediate DIEP.   It is a long, tough surgery and the recovery takes a good 6-8 weeks, but it is worth it.   Once it is done, it's done -- and the results are good.

Do your research though and make sure you get a really experienced plastic surgeon -- one who has done hundreds of these operations -- if a doctor tells you it's not a good option, they probably are not experienced enough to do it -- so keep looking.

I found these sites very useful in explaining the recontruction options in detail, and they lined up well with what our plastic surgeon told us.  Hope they help:

http://www.networkofstrength.org/programs/sharering/transcri



http://www.breastcenter.com/procedures/procedures.php



http://www.optionsforbreastreconstruction.com