Written by
TO: Natalia Hernandez
There are a lot of drawbacks to TRAM flap surgery for breast reconstructions after a mastectomy.
I had a TRAM flap, and the doctor did not bother to tell me all the drawbacks -- a major one being a huge risk of hernia. I ended up having hernia surgery about 6 months after the TRAM flap.
So talk in detail to someone who has had TRAM flap, and be sure you understand ALL the drawbacks, as well as understanding the cosmetic advantages.
Hi Natalia. I just ran into your story and I must say, you are amazing! I too have breast cancer. I had a mascetomy with an immediate rebuild. The doctor actually took my latisimus muscle from my back to do the rebuild along with a silicone implant. There isn't as many complications as if you could experience with the stomach one. You may want to check into that. I am very happy with my results.
Hi, my name is Kris. I just saw my plastic surgeon last Thursday and she suggested the latisimus muscle surgery for me as well. I would be really interested in all the details of your surgery and recovery. How is everything healing up? Are you happy with it now? Is your breast the same size as the other one? Any problems? Please let me know as I'm trying to decide what to do.
Someone in my family had this done, at the same time of the mastectomy. She is very very happy with the results - a totally natural looking breast opposed to what happens with traditional reconstruction.
Check out website of Dr. Lujean Feng for photos and more info.
Hi Natalie and all,
I just wanted to add a comment on the reconstruction options. I am a 3 yr bilateral mastectomy breast cancer survivor. I am also a nurse anesthetist so I had a little bit of advantage in doing research on reconstruction options. About a year ago I underwent a "staged" reconstruction (done in 3 stages, 2 are actual surgeries). I had DIEP flaps which sounds like what you may be looking into. Ths involves taking belly fat and using it to reconstruct the breast. Honestly, I couldn't be happier with the results! (they actually look better than my original breasts and feel totally natural ,too! Who would guess!) Anyway, a similar procedure exists for patients who are thin, using butt fat, because almost everyone has some to spare there! The other procedures people mentioned, the tram flaps and lat (lattismus) flaps use muscle, rather than fat for the reconstruction. One of the complications of muscle flaps can be hernias and some loss of function from the muscles that were used, although they are usually succesful. I would HIGHLY recommend you not only investigate your options, but also which surgeon(s) you have doing the procedure. I ended up going to New Orleans (accross the country from me) to the Center for Restorative Breast Surgery (www.breastcenter.com) . Drs. Dellacroce, Sullivan and Trahan operate this clinic that does NOTHING ELSE but breast reconstruction and have an entire staff dedicated to helping you with every aspect of the reconstruction, from insurance to traveling to help with finances for those who need it. If nothing else, look at their website so you can get information and lots of great before and after pictures.
Good luck to you!
Jayne
Thanks for sharing this info. I have looked everywhere for info on reconstruction after radiation, but it just isn't out there. Please keep me informed. I finished radiation in March and can't wait for my reconstruction, but I want the best possible results. No one in my town has worked with skin that has been radiated. Who is your doctor and where is he located?
Thanks, Cathy
I had a right complete mastectomy on 7/8/08 and will be doing 7 weeks of radiation. I am looking into breast reconsturction just as you discribe. I can't bookmark this page for some rease. Please keep me posted and good luck and God bless you through this process.
Gail Killough gkillough@comcast.net
A reoccurance recently after 11 yrs. On Arimidex. Implants not possible due to radiation. I was told. I have plenty of fatty skin around the surgical area and my arms BUT I could not do implants/reconstruction now because I had a tummy tuck back in 85. The cost I have not looked in to because I'm too old....68. BUT I am an active (or was) senior. This "losing your breasts" has devestated me but I carry on....alone.
I found out my cancer returned in the midst of breast reconstruction surgery, when my plastic surgeon was placing larger tissue expanders. Once the path came back, the reconstruction was put on pause while I had my affected chest wall area removed (since I had a modified radical mastectomy in 2005 I had little mucle to remove.)
I just finished 7 weeks of radiaiton, and while I am a little red, my plastic surgeon has absolutely no concerns about my skin - saying that I am young enough for it to bounce back - I am 34. I spoke with him regarding this post and he told me that there is no reason I wouldn't be able to get implants underneath my little muscle strip with radiated skin. I told him I wouldn't mind him using tissue, skin and muscle from other areas of my body, but he said that likely won't be needed, because my skin will bounce back. At the end of the month I move on to chemo for 2 months then I will continue on with my reconstruction efforts.
No one's cancer, treatment, or side effects are the same. Everyone is different and each treatment and cancer is as unique as the individual who has it.
Angi
Cancer is NOT a DEATH sentence
I know this post was a year ago... but I have a strange situation. I had a very rare cancer called angiosarcoma. It showed up in my breast (its unrelated to breast cancer though the end result looks the same) and I've had 8 weeks of radiation in addition to a simple mastectomy and a lot of chemotherapy. Since my particular cancer is so aggressive it usually comes back within the first 2 years. My doctors at UCLA will not allow me to have a TRAM or any other reconstructive surgery that will have to be undone if the cancer comes back... so my only option IS an implant. I keep hearing all of these horrible things about implants post radiation and I was just wondering if you ever had the implant and how it looks and if you've had issues. Im 26 so this is particularly hard as I had this idea that your body is supposed to be whole and beautiful when you're young. Guess not! Cancer sucks.
Hi! I had a right lumpectomy following chemo to shrink the tumor and then 26 radiation treatments in 2006. I had a recurrence in February 2008. I had a mastectomy and expander placed on May 2, 2008. I have been going through the process of having my expander filled and have one more visit to make 700 ml. I will have to wait a few weeks for my implant to be placed. This has not been an easy experience. The chest becomes very tight and painful. My plastic surgeon is not crazy about my irradiated skin but he is going to cut out as must as possible. It sounds like you may have had a TRAM flap. I didn't want that option because of the longer healing time, but now I wish I had considered it. I really can't comment about my end result. I am planning on having my left breast lifted and have an implant placed next spring. This has all been a very slow process for me. The expander causes my skin to bulge out from my chest from right beneath my clavicle (collar bone). My main concern is that my general surgeon did a skin sparing mastectomy and my plastic surgery didn't want that "cooked" skin. They even discussed my case prior to surgery...I haven't been able to find any cases of mastectomies where the patient previously had radiation and went with expanders. We'll see how things go! Therese
Thank you so much for your article. I was wondering exactly what all was involved. I had like 12 weeks of radiation and was thinking of breat reconstruction. I wondered about the dark burnt skin . I had asked my radiation oncologist about it and he said it would eventually go away. But how can something go away if it is destroyed. Thank you so very much and good luck. Your young so I would defenitely do the reconstruction. However, I am 56 and suffer a lot of infections so I will definitely get several opinions. God Bless!
well, i am sorry to have to use this channel to get to you, but here is the thing;
i live in chile, south america now, and a few months ago i heard that an old friend of mine had cancer, i have tried to get in touch with her (you) but i´ve had no luck untill now, may be you dont remember me, well, my name is al carrasco, i am rauls brother, and son of rosario (charo) and raul. i hope i finnally get lucky and find who i am looking for, im not reallysure it is you, if you dont remember me yet, and you are not sure it is you i am looking for, let me check if i am right, youhave two brothers, fico and diego, and your dad´s name is victor, and your mom´s ely............
if i got lucky and really found you, please let me know, i would love to hear how you are doing now, well, AL.CARRASCO@HOTMAIL.COM thats my email, fell free to write when ever you can, and if i was not lucky (again) please, let me know.
bueno, eso seria todo por ahora, te deseo la mejor de las suertes en todo, seas quien busco o no lo seas, por favor, dime si te encontre o no, te dejo muchos besos, abrazos y bendiciones, bye
I wish I had read your story first - I had 6 months chemo and 7 weeks of radiation. My plastic surgeon convinced me the best way was to put expanders in right at the double mastechomy. BIG MISTAKE!! the right side/cancer couldn't expand to a C cup - I didn't mind, but DR said it would expand over time. 2nd BIG MISTAKE! By the time my treatment was over, the right 'bump' had moved up and was as hard as a rock. Then that DR left town and another took over. When the reconstruction was done and implants were put in the burned skin open up and started oozing - it took 5 months for that to heal and 2 types of medication. Not only that but it is still about 2" higher than the left and flat on tip because the skin is so damaged. DR won't touch it again as he says it's too damaged. Can't even get a bra to fit right because of the diference in shape and height. What a mess - Just wanted to let others know that it doesn't always turn out the way you want and surviving is the most important goal - not trying to look like you did before cancer -
thanks for letting me vent...
Hi Natalia, I was diagnosed in January of this year and had a mastectomy in February followed by 6 chemo treatments - I have been really looking forward to reconstruction. I had a consultation with my radiation oncologist yesterday and she scarred the crap out of me!!! She told me I would 30 treatments, not be able to have an inplant due to the radiation, my breasts will not be the same size and that I would end up with scar tissue on my lungs but that if I choose not to go through with radiation I have a 25% chance of a reocurrance. Yikes! I am on a waiting list to speak with a plastic surgeon in my area who comes very highly recomended and specializes in breast reconstruction. Thank you so much for your story... I will be checking back on your progress. Best of luck to you!!!
I am 28 and I have had radiation and double mastectomy. I was just told that reconstruction may not be possible. Can I please talk to you to see what you actually done on your reconstruction. I can be reached at rwood@wrmc.com. Thank you so much!
Hi there! I am wondering how your reconstruction turned out. I finished 8 weeks of radiation a few months ago and now am looking into reconstruction. I was hoping I could just do expanders and implants because that is the easiest surgery and has the least amount of scars but my doctor said I can't do that because of the radiation. So it looks like my options are some kind of flap and if I want to go bigger, I can also get an implant.
Your response would be greatly appreciated. It is so hard to find someone young who has done reconstruction after radiation.
Amy
AMY I JUST DID MY SURGERY IN OCT. I DID THE TRAM FLAP & GOT A WONDERFUL TUMMY TUCK THEY JUST DID THE BLOOD SUPPLY INCORRECTLY & THE TISSUE DIED & I WAS LEFT WITH A MASSIVE MESS!!! 4 MONTHS INTO IT I AM SECHEDULED FOR MY 4TH SURGERY IN AS MANY MONTHS TO NOW REMOVE THE MUSCLE FROM THE BACK & FILL IN THE 3RD HOLE LEFT FROM THE 3RD SURGERY. THIS HAS BEEN THE WORST ROLLER COASTER OF A RIDE & I LOVE ME SOME ROLLER COASTERS!!!! IM ONLY 41 & WAS DIAGANOSED @ 39 JUST MAKE SURE YOU HAVE A GOOD DR & YOU FIND OTHER PATIENCE THAT HAVE USED HIM.
Hey Guys: I liked the results the nurse was talking about, she loved hers. Hey I would be willing to donate some of MY BELLY FAT for the skinny women who don't have body fat! I got plenty and for the skinny women who have breast cancer. I also have an entertainer friend that can help us raise some money for those who can't afford it. Get back with me and let's make this happen captain!!!
Yes it's me again Philly1994, if you like the idea of helping our woman let me know about the fundraiser. I also want to comment about something else. Has anyone has Panoramic pictures taken at the dentist. A camera moves on the outside of the mouth (x-rays) why can't they make a machine like that when we need a mamogram? Also do you think the guy who invented it hated his mother. Lovebuggums1994@cox.net. Ciao
UR SO FUNNY!!! ALL MY FRIENDS WERE WILLING TO DO THAT FOR ME!!! YOU NEVER KNOW HOW MANY "REAL" FRIENDS YOU HAVE UNTIL YOU HAVE CANCER!! ALL MINE WERE SO WILLING TO GIVE UP THEIR BELLY FAT FOR ME BC I DIDNT HAVE ALL THAT MUCH!!!! BUT THEY WERE ABLE TO MAKE A NICE MOUND FOR ME FOR ABT 24 HRS & THAN IT WENT HAYWIRE!!!! I'M WKIN ON MY 4TH SURGERY TO CORRECT THE BAD RECONSTRUCTION I HAD!!! THE SHAPE WAS PERFECT THE BLOOD SUPPLY JUST WAS NOT DONE CORRECTLY. I HAD RADIATION & I WAITED 11 MONTHS AFTER TO DO THE RECONSTRUCTION WHICH I THOUGHT WAS AMPLE AMOUNT OF TIME I WANTED MY SKIN TO BE GOOD & RESTORED FOR THE SURGERY.
WELL I JUST WENT THRU THIS SURGERY & I'M A VERY STONG PERSON WHO USED NO PAIN MEDS AFTER THIS SURGERY!!!! UNFORTUNATELY I HAD ALOT OF COMPLICATIONS I HAVE HAD 3 LARGE HOLES IN MY CHEST FOR ALMOST 4 MONTHS!!! THEY DID NOT DO THE RIGHT BLOOD SUPPLY WHEN THEY ATTATCHED THE NEW TISSUE! I HAVE HAD 3 SURGERIES THE 1ST WAS THE TRAM FLAP WHICH CAME OUT BEAUTIFULLY FOR ABT 24 HRS THEN IT ALL WENT SOUR THE TISSUE STARTED TO DIE IT WAS A TERRIBLE MESS. I WAS TAKING CARE OF THE BREAST BY MYSELF. THE 2ND WAS TO CLEAN ALL THE BAD TISSUE OUT & PUT A WOUND VAC ON WHICH I HAD AN REACTION TO & MY CHEST BLISTERED UP. THE 3RD WAS TO CLOSE THE 2 HOLES WICH I COULD PUT 2 FINGERS THREW THEM. WELL AFTER THAT SURGERY ANOTHER HOLE APPEARED WHICH IVE HAD FOR 2 MONTHS NOW. WELL I GOT SMART & GOT ANOTHER SURGEON WHO TOLD ME THAT IT WAS DONE INCORRECTLY & IM GOING FOR THE 4TH SURGERY THIS MONTH & NOW I GET TO HAVE THE NICE SCAR ON MY BACK BECAUSE THEY HAVE TO USE THAT SKIN & MUSCLE TO REAPIR THE FUBAR FROM THE 1ST DR!!!! THAN I HAVE TO LET THAT HEAL & GO & HAVE THE OTHER BREAST DONE TO MATCH & THAN THE NIPPLE & AREOLA AFTER THAT HEALS!!! SO BY THE TIME IM DONE ITS A YR OF MY LIFE IN RECONSTRUCTION. I DID TAKE LOTS OF PICS WITH MY CELL FONE TO DOCCUMENT IT ALL ITS VERY GRAPHIC & VERY PAINFUL!!!!
THANK YOU SO MUCH FOR YOUR CONCERN!!! THAT WASN'T EVEN THE HALF OF IT!!! I AM VERY THANKFUL THAT I AM STILL ABLE TO FUNCTION!!! I LOVE THE TUMMY TUCK I REC'D SHE DID A GOO JOB WITH THAT!! I JUST WONDER IF THERE ARE WOMAN OUT THERE WHO EXPERIENCED THE TRUMA THAT I HAVE BEEN THRU!!!! I'M ONLY 41 SO I HAVE YOUTH ON MY SIDE!!!MY NEW DOCTOR IS VERY WELL KNOWN IN MY AREA & HAS DONE MANY GOOD THINGS SO I AM VERY HAPPY THAT I WAS ABLE TO FIND HIM & HE CAN FIX THIS!!!
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Hi Natalia, isn't it great that you're now thinking of reconstruction when once all you could think about was how to get through the day after diagnosis? I'm very happy for you!
Sounds like you're going to get a TRAM flap or DIEP surgery? It's what PJ and so many others did too and it's what I plan to do sometime in the near future. One of those rare times it actually helps to have some fat in the belly.
Would really appreciate your posting the process. Thanks for reminding everyone that whatever process you chose to have, step number one is choosing the best qualified doctor.
Thanks as always, Natalia!