Ihad invasive ductal carcinoma in the L breast and decided to have R mastectomy done due to family history. This was March 2008. Had tissue expanders put in during surgery. Despite nearly begging for nipple saving surgery it was not offered and my scars look like the areola was cut out then sewed shut. I had chemo and radiation on the L side only. The L expander is very high and the R is looserand sort of under my arm. I saw my ps in October after the radiation was over to start the reconstruction process. He told me to come back in Aug 09. It has been so long since my consultation, I barely remember what he told me about my choices - except that if we did a TRAM flat for both breasts he could only guarantee an A cup. I still don't know where he came up with that as I am 5' and weigh 190. Guess where it sits? Yeah, in my belly! I have also found out about a bunch of different options on this site. I don't really want to go with implants, but I feel like that is where he is directing me. I don't want to sound like a ninny when I go back, but I really want to go over my options with more detail. Is this unusual, the waiting period and my ambivalence about asking for more info?
- Resources
Q: Is it unusual to not start reconstruction process for over a year?
Hi Dee - I don't think it's unusual to wait that long for reconstruction; some women don't actually have it till years after their mastectomy. And it's certainly not unusual to be ambivalent - I've just spend 2 hours with a woman who just can't make up her mind of she wants reconstruction or not... It's pretty major surgery, no doubt about it; and it had big implicaiton on how you look and feel, so of course you're going to think long and hard.
If you feel like your surgeon is pushing you in a certain direction, rather than providing information on all your options, I'd suggest you find another surgeon. I'm not sure why he'd guarantee an A cup from a tram flap if you weigh 190 lb.; maybe something to do with your previous surgery for implants? At any rate, get another opinion, especially about a tram flap, as that would give you a tummy tuck along with new breasts. You need complete informaiton - as much as you can get - to make this important decision. Good luck - PJH
I did send the e-mail, and even though he didn't read it, he answered all the questions I had. I took a friend and she wrote down his answers then made sure he touched on all of my concerns. He walked in thinking tram flap and free flap as the proceedures we were going to use and implants only as a last resort. This is what I had figured out that I wanted and was thrilled that we were in agreement. 
I'm not sure where the whole A cup thing came from, today it was if you want a D then no way but B/C shouldn't be a problem. So despite being very nervous, I now have a surgery date (Oct 19) and some idea of the recovery time line. Thanks for a wonderful site, for letting me vent and reminding me that if I don't stand up for myself, no one will.
Radiation damage to the skin can affect reconstruction, so that might be the reason that the plastic surgeon wanted you to wait a year. I agree with PJ that you should get a second opinion and maybe do a little doctor shopping to find a plastic surgeon who will listen to you and work with you to find the best surgery for what you want. There are risks and benefits to either type of surgery and it's important that you have all the information to decide which is best for you.
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I've never had implants, but did have 2 C-section births, plus the stomach muscles split during the 1st pregnancy. I have had these stupid expanders since the surgery in March 08 and am heartily sick of them. At the time of the first consultation I am sure I was tired of surgery and pain and feeling helpless, so may have indicated that I would go with the implants. Of course a year out I am not feeling exactly the same and after having dealt with the expanders, implants don't seem like such a great idea. In all likelihood if it had been done then, I would be thrilled and not going through this whole soul searching. Everyone I have spoken with says my p/s is one of the top in Dallas and he is more like an artist than a surgeon. I will be sending his office an e-mail today with questions and letting them know that I expect complete explinations and answers when I have my next appointment on Thursday.
Thanks for getting back to me.