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Immediate Breast Reconstruction

Immediate Breast Reconstruction

Posted by Buffythevampire on Feb 7, 2019 10:46 pm

Why do they tell you it's immediate reconstruction when it's not immediate? I wanted to go in for a mastectomy and come out with a reconstructed breast. Instead I go in for a mastectomy and they immediately start the reconstruction surgery procedure. I didn't want to wake up with no breast. What has to happen is they are removing the breast and putting in a balloon and filling it with air until they put the replacement in place.
Immediate means immediate. Now I am angry and upset all at the same time.

Re: Immediate Breast Reconstruction

Posted by Dielle on Feb 8, 2019 7:55 pm

Hi Buffythevampire‍, I can understand that you must be disappointed, upset and angry.  Thats how a lot of us feel when facing cancer and surgery.  And then to have this thrown into the mix - it must have been such a letdown.

I know you wanted to have a reconstruction with tissue and not implants.  Is that what you are having?   Did they explain to you why they want to do a 2-stage reconstruction?

I had a 2-stage reconstruction with the tissue expander and then an implant.  I still thought of it as immediate reconstruction, although I do understand your point.  I thought of it as immediate because when I woke up from the surgery I did have a breast.  True, it did look a little different in shape but it was recognizably my own skin and nipple.  I understand that you may feel differently but I thought I would share this with you.

I also found it helped to remember that the plastic surgeon really wanted to be able to make my breasts look as good as possible and that was behind the advice she was giving.  

Take care,

Re: Immediate Breast Reconstruction

Posted by Buffythevampire on Feb 9, 2019 11:21 am

Dielle‍  I mostly wanted to go in for a mastectomy and come out with my new breast. I know they will use my skin but I lose the nipple. But also found out from the plastic surgeon that part of the skin can't be used because of the lumpectomy surgery I had. And by using the expander I have allergy concerns which I told him. To get it inflated I have to drive an hour from my home to get it done. I was told they could still be able to use my tissue to make the new breast but I would need to lose 10-15 lbs. Telling him that I will be losing the weight from my breast but that doesn't count. Has to do with the blood flow. So now I have to go on a diet.
I didn't want the flat look. I am scared of the flat look. I don't know if I can look at myself that way let alone let anyone else see me that way.
I am also large breasted and the reconstruction one will be smaller. So at some point they will have to make the other breast smaller. So another operation. And at some point I have to decide about my missing nipple. It just seems like it's going to take forever to get back to 2 same size breasts. More questions arose as it is starting out different then I expected.  

Re: Immediate Breast Reconstruction

Posted by Lauren55 on Feb 9, 2019 6:41 pm

Buffythevampire‍   I too wanted to come out with breasts and not be flat.  I had a bilateral masectomy and wanted a chest when I woke up.  It was explained to me that I would need expanders and then reconstruction.  I had the expanders put in 2017.  The actual implants were put in June 2018.  My one side capsulated so I am currently waiting for a third surgery sometime in 2019 to remove the scar tissue and correct the implant.  I don't like going almost flat in some situations so I have a set of false boobs to wear.  

This past January I had my foobs in my travel bag in my car.  Sometimes the bra is uncomfortable and I take it off when I can.  Someone broke the window in my car that night and stole my travel bag.  Now I have no bra or foobs.  That was close to $900 and my self esteem that got stolen along with all the other stuff on my bag.  I wish the people that stole my bag had been kind enough to return my personal clothing items.  

What I am trying to say is, flat is not the end of the world.  I will have new foobs in April.  Until then I am what I am.  And most importantly I am alive.  I am looking forward to the final outcome but I don't want to rush my plastic surgeon.  


Re: Immediate Breast Reconstruction

Posted by Dielle on Feb 10, 2019 1:55 pm

Buffythevampire‍ Thank you for explaining more about your circumstances.  Yes, it is a long road, especially when you are at the beginning and wondering if you will ever feel 'normal' again and sometimes it can seem as if nothing is going right especially when you have to deal with the idea of surgery, treatment and just the fact of having cancer all at once.  It can be overwhelming.  All I can tell you is that it usually does get easier and the thought of being flat may become less terrifying as you get used to the changes.  But for now, its okay to feel grief, anger, fear or whatever.

Lauren55‍ I'm sorry to hear your implant encapsulated.  .  And that some low-life jerk stole your bra and foobs.  👿  I imagine they ended up in a dumpster somewhere - I can't imagine there's much of a black market there.  I just had my exchange surgery two weeks ago so I'm crossing my fingers (and doing the massage) to try to make things go smoothly.


Re: Immediate Breast Reconstruction

Posted by Lauren55 on Feb 10, 2019 2:39 pm

Dielle‍ no I don't think there would be too much resale value there lol.  So pissed they would violate my property like that.  I do get a bit of a chuckle when I think about their face when they pulled the bra with the foobs in it out of the bag, hee hee.  Oh well, I can get new ones and the car can be fixed.  I really don't want to go back to work flat though.  I do have a set of knitted knockers and they may have to do until my insurance will replace my real ones.  

please, please do your exercises religiously.  I didn't and now I am paying the price.  I wish they had stressed the possible outcome of not doing all the exercises.

I did the massage, maybe not all the time.  It seemed to be encapsulated pretty much from the beginning.  Something about radiated skin being like old leather.  My plastic surgeon seems to act like everything is going as he anticipated.  Not at all like I did.  I wanted it to be fixed 2hen I woke from the first surgery.  I have met one girl where it was done all in one surgery.  She looks fabulous.  With me though the surgery was a lot more extensive and a lot less skin to work with.  Now I have come to an understanding that for anything good it will take time.

Re: Immediate Breast Reconstruction

Posted by Buffythevampire on Feb 10, 2019 3:33 pm

Lauren55‍ More and more crime seems to be happening and it would make me so angry if I had any of my stuff stolen. There was one time I had my purse stolen. It was recovered with everything except for the cash. I carry less cash with me now. But to lose what you lost (your fake boobs), I would be so angry. Thankfully you had insurance.

Dielle‍ I felt rushed at the appointment with the plastic surgeon. I was the last appointment and only had about 15 minutes to ask questions. And I had prepared my questions based on immediate reconstruction. When it wasn't going to be what I thought was immediate, I lost my focus and train of thought. No, I wasn't explained why it has to be done this way. I don't know whether it's because of my situation or if it's the plastic surgeon's preferred method. Now I have to make a list of more questions based on a different surgery. And it's more surgeries then I wanted. And more time off of work then I wanted. I am the only income. I still don't have a surgery date yet.
And since I learned about the mastectomy I am having aches in my body on one side that I am pretty sure is just tension/stress related. My mind doesn't seem to shut down either.

Re: Immediate Breast Reconstruction

Posted by Lauren55 on Feb 10, 2019 4:32 pm

 Buffythevampire‍ I found my plastic surgeon was very quick with answers and time too.  I phoned his nurse and after each appointment I would discuss what I thought he had said.  If she was not sure of an answer she would get him to come back and clarify.  

any aches and pains are worthy of further investigation.  If there is nothing wrong then your fears would be alleviated.  Through my journey I learned one thing, Always ask questions.  No question is a dumb question.


Re: Immediate Breast Reconstruction

Posted by Naan on Feb 11, 2019 1:01 pm

I had immediate reconstruction, it’s called DIEP. It was a 13 hour surgery, one surgeon did my bilateral mastectomy and then the plastic surgeon did the reconstruction using tissue from my belly! Breasts are about the same size as I was before.
have to have some minor filling for spots that flattened out after swelling went down, but other than that it was a one and done procedure!

Re: Immediate Breast Reconstruction

Posted by Dielle on Feb 12, 2019 12:23 pm

Buffythevampire‍, I have that problem too.  If something doesn't go according to plan I can't think quickly enough to come up with the questions I should ask.  And for the first several weeks after being diagnosed I could barely think at all.  It is too bad that when the stats say 1 out 8 women will get breast cancer that there is not more general knowledge about the surgery options before we have to make the decision.  All I knew about reconstruction was what I had seen on TV (not the most reliable source).  Of course trying to educate yourself beforehand and decide how you would feel about losing your breasts is probably not something that a lot of us would do unless we had a family history of breast cancer.  

Lauren55‍ I was warned about the radiation damage as well.  There are just a certain number of cases where the damage is too much and they have to fix it.  We can do everything right but luck also plays a certain role.  That is why part of my plan is to keep my fingers crossed, lol.  😁

Naan‍ That is wonderful that you are pleased with your results.  I think that might be the procedure that Buffy wanted but unfortunately not everyone is a candidate.

Re: Immediate Breast Reconstruction

Posted by Naan on Feb 12, 2019 1:02 pm

No, unfortunately they have certain criteria to meet for this surgery to happen. Thankfully I did.

Re: Immediate Breast Reconstruction

Posted by Buffythevampire on Feb 12, 2019 7:45 pm

I called the plastic surgeon's office today and said I had more questions from the last appointment. She read me the Dr. notes. If he had told me what was in his notes some of my questions would have been answered. Turns out I don't qualify for the procedure that I was hoping I was getting. She was able to answer a few of the other questions that I had also. Still disappointing it didn't go the way I had hoped though.
Found out also that I am taken on as a patient even though I am not in their catchment.
Dielle‍ I too did some research before going to my appointments. The internet has so much information but it's hard to distinguish which is Canadian. I have joined a couple of facebook groups that deal with my particular cancer but you still have to filter stuff out to get to the Canadian information.

Re: Immediate Breast Reconstruction

Posted by Dielle on Feb 14, 2019 2:25 pm

Buffythevampire‍, I'm glad you were able to get the extra information about your situation.  Its too bad that your surgeon didn't take the time to explain it all.

Its great that you are finding some helpful facebook groups.  To deal specifically with the Canadian system I found The Intelliget Patient's Guide to Breast Cancer to be really helpful.  It is written in BC (I"m not sure where you are?) and while I think some things are a bit different in other provinces  I think it is closer than some of the books written in the U.S.  And of course cancer.ca is always my first stop.

Take care,


Re: Immediate Breast Reconstruction

Posted by Buffythevampire on Feb 15, 2019 6:47 pm

Dielle‍ The book you mentioned I have looked at. It's on loan to me from a local Doctor's office. Yes I am from BC.

Re: Immediate Breast Reconstruction

Posted by snowflake45 on Mar 24, 2019 1:08 pm

I had BMX with tissue expanders on March 7. Sometimes the tissue expanders are very uncomfortable to the point of pain. They feel like they are sliding around when I turn or bend, such a weird feeling! I am getting injected on Tuesday and am concerned it will cause more pain. 
Reading through your posts, I see many of you are doing exercise and massage, I have not been told to do this but have been carefully stretching to improve tightness. What exercises or massages were recommended to you?

Re: Immediate Breast Reconstruction

Posted by Quinn on Mar 29, 2019 5:17 pm

Hi, I have had my single mastectomy several weeks ago and into recovery for 6 weeks, and currently going for appointments to see my plastic surgeon for "Expander", where the fluid is injected to form a breast like size.

I am still "a student", learning everything that I can, and hope that I have back my breasts where I should have looked to feel a whole. 2nd time I saw the plastic surgeon, he says for me to start stretch exercises slowing to reduce the tightness in my left side. I started to stretch and hope that stinging/ jab pain goes away! Patience, I TRY...I am still confused with the Breast Reconstruction Issue. I may go for 2nd operation to have the fluid removed, and implant put in and less ugly scarring, I dread the outcome, like friends may nip at me like it's not safe with the Silicone implant, as they hear through the internet and news. All that I can hope is that silicone implants are safe, but results are remained to be seen. I guess every women is different. I also agree, there's the "anger" because of going through so much after surgery, and not feeling/ looking the best...I TRY to keep my anger in check, but it's still there and avoid people until I have it in control. I find that I have difficulty explaining my mood swings to friends, and often I am misunderstood, and try to keep things simple and not want arguements...Does everyone understand what I try to say...?

Wow, just learned something from everyone here. It helps to learn from each person and their experience, so I can know what to expect...Hopefully someone can drop more hints and tips here, that would help a lot.

Enjoy your Spring weekend, HOPEFULLY - Sunshine!

Re: Immediate Breast Reconstruction

Posted by Naan on Mar 30, 2019 8:58 am

Quinn, only those of us going through this or have gone through this truly understand. Emotions are all over the board but you finally make the decisions you need to make that are best for you. No judgement here, just support and encouragement. 💕💕

Re: Immediate Breast Reconstruction

Posted by Minus2 on Mar 30, 2019 9:21 am

Hi Quinn‍,
I am very glad to hear your recovery is progressing, but you are right that you need to be patient.  It's a heck of a shock to learn we have limits and cannot just go and go and go.  Who knew!?  Stretching exercises can produce some discomfort.  My surgeon told me persistence was the key and that I should not be pushing myself until I had significant pain, but rather baby steps were the goal in regaining my mobility.  I followed his advice and have full range of motion and no discomfort. 
Your post resonated with me because we share some similarities.  I was diagnosed with DCIS and Stage 1 IDC in May 2016 and was recommended to have bilateral skin and nipple sparing mastectomies followed by immediate implant reconstruction - no expanders or middle steps - it was one stop shopping!  I was not a candidate for reconstruction using my own tissue, so I chose saline implants and I am very happy with the results.  There is some rippling, but again, it's not visible in clothes, and because they are placed under the muscle, it looks very strange if I flex, so I don't do that.  I have a 5" scar under each breast; the scars are white, very flat, and you really need to look for them because of their position.  But it took a year for them to fade in colour, so again, patience is key.  My new breasts are round, not tear drop shaped, but that's okay - nobody sees them except my husband and I.  My plastic surgeon was very good about providing realistic expectations that reconstruction is designed to help us look good in clothes.  And my friends, families, and co-workers tell me every day that I look really good - and of course, they only see me in clothes!  As for looking good naked - well, I am a 57 year old woman who has had two children. Enough said!
The decision to have reconstruction performed is very personal.  And the procedure and materials used are also specific to your desires and your body.  Like I said, I couldn't have the DIEP flap reconstruction - too skinny - so it was implants or no reconstruction.  Friends and family will express opinions without understanding because until they have their own diagnosis and are faced with the decisions that accompany it, they simply will not get it.  As for what you hear in the media - good journalists are very interested in telling the truth without bias, but most news stations are seeking ratings so doom and gloom and shock value are the strategies employed.  Go to reputable sources for information like your Dr. and this site and divert the conversation if people make you angry or upset.  I have become much more straightforward in telling people when a conversation is not helpful and asking that we change the topic.  And there are some conversations and people I avoid, even on this site, because opinions are so strong they undermine the work I have had to do to develop and maintain a confident, positive mindset about my choices.  What you can live with following your diagnosis and procedures is unique and specific to you, nobody else.
Several weeks following my surgery, I went and talked to a social worker at my regional cancer centre.  She helped give me the words to deal with difficult people and situations as well as helped me see things from a variety of perspectives.  I am glad I went and it's something you may want to think about if you find you are feeling angry and upset more often than not.
This post is much longer than planned - sorry!  Keep moving forward, things will get better every day.  And no, I do not have sunshine today - grey skies and rain, sigh.