Last day of chemo. Breast reconstruction?

By Racuh Monday, December 14, 2009

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I'm done tomorrow! Hopefully forever. I've made 2 cakes. One for the oncologist and one for the chemo nurses in the infusion room. I'm outta there.

New boobs time.

Well, It's nearly been a year since I've had my left breast cut off. I've endured 2 rounds of adiramycin, simple mastectomy to the left breast, 38 rounds of radiation, and 12 rounds of Taxol. If that doesn't beat the hell out of my angiosarcoma I'm not meant to live. If it comes back I'll chalk it up to inferior genetics, bad luck... and wander off into the Mojave desert to die. No joke.

I can get reconstruction (implant) in February. Huzzah! So here is my question... I've actually found very little information about implants post radiation. Evidently a lot of doctors say no. I understand that the musculature and skin is less elastic and has fibrous banding making implants do crazy things... from capsular contracture to actually being pushed through the chest wall (OMG!). I'd love to hear from anyone who's had the experience (good or bad) of implant reconstruction post radiation.

I really want to ditch the breast form. I also don't need more body drama... If its more trouble than it's worth I can wait 2 years for a TRAM flap... though honestly that sounds pretty nuts too.

Thoughts?

-Trace

OUCH! and an MRI update.

Comments (11) | Add comment

Phyllis Johnson, Health Guide

12/14/09 7:09pm

My radiated skin turned out to be too inelastic for an implant. But only your own plastic surgeon can evaluate your skin. Lots of people who've had radiation do just fine with implants.

I'm so pleased to hear that you are finished with this stage of treatment and can move on to new things. Best wishes as you move on.

PJ Hamel, Health Guide

12/14/09 8:30pm

Trace, I can speak to a TRAM flap. Love mine, pure and simple. It hangs right, bounces right; not much sensation, but hey, in my clothes, you'd never be able to tell. And even naked it does pretty well. With the lights off - only the nipple gives it away. Bottom line - it worked for me. Good luck with your decision. And CONGRATS on being done! I'm sending you healing energy FOREVER. XXX PJH

Baileysgirl22

12/15/09 8:30am

Hey pretty lady!!! Woo Hoo your done! Onto better things. I havent heard anyone having reconstruction after radiation but Im sure somewhere someone has had it and it turned out just fine. So I say try it and go for it. Im sure ditchin that Breast form will feel awesome! I am now still getting expanded every week. This past expansion is quiet uncomfortable. My boobie skin was only so big to begin with and its stretched pretty far and were only half way done of the expansion process. Yikes.... Well I hope your holidays are the best. I thought I sent u a pic of the new puppy Justin got me. Hes so cute. Def takes my mind off of things about me which is nice. Plus Justin is just happy Ive stopped crying. So it works for both of us. Well Im sure Ill talk to you before Christmas. Im sure your decision will work out perfectly for you. Good lucks gotta start sometime!!

Best wishes,

Nicole :)

Jennifer

12/17/09 4:24pm

Hiya!

I just recently had recon post-radiation on my right side. I had a lumpectomy, but the tissue continued to shrink for about 3 years after rads were done, so the right breast ended up being significantly smaller than the left (non-cancer) breast. Sooo...even in working with all of my original breast tissue, minus what they took out for the lumpectomy, I have had *some* issues, albeit not necessarily bad ones. What has happened is that while the non-cancer side (which they had to amend to match the recon side) has dropped into a very natural position since the surgery-related swelling subsided, the right side has not. The implant has remained very high, leaving the effect that I'm wearing a super-duper push-up padded bra on one side and not the other. :-/ Part of the problem is that I *did* experience capsular contracture, which is VERY common in post rad recon. The other issue is taht the skin just isn;t all that elastic on that side, thus keeping the implant from freely "hanging" like it does on the non-cancer side. At this point, the plan is to swap out the silicone implants I have for the gummy-bear teardrop-shape ones available, which will somewhat force the cancer side to take on a more natural, less pushed-up shape. The capsule (contracture) will be removed and the new implant placed, hopefully with a better result.

Racuh

12/17/09 4:36pm

Hmmm. Yeah I need to talk to plastics still. I will do that in February. I'm doubtful that I'll get okay'd to do anything but TRAM or like procedure. I was a little different. Most breast cancer patients get the skin sparing mastectomy stuff and I couldn't because the cancer I had was cutaneous to some extent. So they took a LOT of skin. so my chest is slick with just a horizontal flat scar. No puckering anywhere. I don't think that they'd have enough tissue to expand for the implants. I'm a little scared about TRAM though (which I can't have for 2 years anyway because of reoccurance risk) I'm 26... I don't want to have back or hernia issues on TOP of crazy cancer. I just don't know what to do. Im also pretty thin. I don't have that much belly tissue to make a new boob out of either. Crap. I really don't wanna go through life with one boobie. There needs to be a guest plastic surgeon on this site that I can bug.

Thanks so much for your reply though!

Tami

12/17/09 4:49pm

I have not had reconstructive surgery yet, but I have done my homework. Google Dr. Glen Bolitho, La Jolla, California. Many years ago I wrote to him and he wrote back to me. He might be able to answer your questions.

Beach Babe

12/18/09 8:14pm

I am with PJ, very happy with my muscle sparing diep. I did it after my masectomy and other than no nipple, my breast looks quite real. It's firmer than my other breast, but hey, not bad for a new boob. I am thin, too, but I had a baby a year before diagnosis and am only a B cup, so needless to say, I has just enough to spare. A doctor can also take skin/fat from other areas, too. I know of a lady who is very thin and wanted a DIEP, so for a month she ate more fattening foods to build up her belly. The reason I chose not to do implants is because eventually you have to replace them and there's the possibility of leaks, etc. I was not crazy of more future surgeries! Also, you will not get a hernia; you're too strong for that. If you are interested in another opinion from a reconstructive surgeon, Joan Lipa at UCLA is excellent. She's my doctor and I love her. Intelligent, warm, very experienced - she's attractive and understands a woman's perspective regarding body image. Good luck!

Racuh

12/23/09 1:48am

Thanks! All of my treatments have been done at UCLA. My doctors are William Tap (hemotology/oncology) and Fredric Eilber (surgical oncology). They're pretty awesome. I've been happy so far. I was very lucky to have been living in LA with one of the best sarcoma teams in the US. If it hadn't been for them I'd be going to MD Anderson in TX for treatments. Spooky thought. I'll check out the doc you suggested. I know that my surgeon reccomended someone on staff at UCLA that WILL do an implant post radiation. Gotta find out who they are. Thanks for commenting!

a 2-year survivor

12/23/09 12:10am

I had a double mastectomy followed by adriamyacin, cytoxin, taxol chemo and then radiation. Initially the plan was to have implants. But my surgeon told me that because of the radiation, I was no longer a candidate. I was not interested in having the tram flap because I didn't want my stomach muscles removed. I had read about too many awful side effects - difficulty sitting up, hernias... Then I learned about the DIEP flap procedure and I was lucky enough to have Drs. Levine and Allen perform the reconstruction. That was the only viable solution for me.

Racuh

12/23/09 1:44am

Thanks for the info. In all probablity I'll have to wait my 2 years until I am deemed out of the woods by my sarcoma oncologists. Goodie. Until then, fake boobie and lame bras it is. My surgical oncologist did say that one of the plastic surgeons at UCLA (where I have to get all of my treatment) WILL do implants post radiation. I guess next stop is a consultation with THAT guy. Im sort of preparing myself for a Cancun vacation in May sans tits. Where the hell does a one breasted girl find a damn bikini!?

Debi Friedlander

1/14/10 4:17pm

Heh. At this point I am embracing my asymmetry. Maybe someday I will be willing to face more surgery. If so, I'm pretty sure the muscle sparing stacked flap is my best choice.. but that decision can wait. I don't mind being unique. Unless something changes my mind, I plan to design a lovely tattoo and wear my skin proudly.

There's not much to a bikini.. maybe you or a friend can sew or alter the top to fit both sides? I believe there are forms specifically designed for swimsuits. A pouch should be able to be added to a bikini to slip it in and keep it from floating away. Lots of options, I suspect.

My surgeon told me "There is no right answer, only the answer that is right for you." Have fun finding that right answer!

Debi

Last day of chemo. Breast reconstruction?

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