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Old 08-11-2011, 04:14 AM   #121
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And Nemo, guys get breast cancer too, just not so frequently as girls.
Uh, uh..............about 8 years ago I felt a lump while showering.....hopped on my bike and cycled to the hospital......doctor, who immediately recognized my fears, told me it was just a subcutaneous cyst, which would, and did, disappear within a couple weeks.
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Old 08-11-2011, 06:01 AM   #122
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Originally Posted by omni550 View Post
Here's a youtube video on this procedure for breast augmentation...

(One of the posted comments beneath the vid is by a lady who had breast cancer and states that she had just had this procedure done the prior day.)

SG - I agree with the OPs comments, there's probably no need to rush into this decision, although it's good to know that there are 'natural' options.

Wishing you a very successful outcome,

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Yes omni, that appears to be the same procedure I described in #4. I believe it started out for augmentation, but now is also being used for complete reconstruction. It is still a relatively new procedure, but it holds promise in that it does not involve implants and the surgery/recovery is much less intense than with a flap procedure (that involves cutting out a chunk of skin/fat with it's blood supply from elsewhere in the body and then via microsurgery attaching the blood supply to breast arteries - a 6 to 8 hour surgery, if I understand correctly). I still have reservations about long term results/side effects and will discuss further with my PS today to get his opinion. Also concerned about traveling for surgery. This is the clinic I am looking at - several of the women at breastcancer.org have been here: Breast Reconstruction & Augmentation Fat Transfer Miami Breast Center
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Old 08-11-2011, 08:58 AM   #123
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Sorry for the additional bad news/stress, simple girl. Rest assured that Dallas is full of women with, shall we say, enhanced bosoms, and most seem to be doing okay.
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Old 08-12-2011, 12:24 PM   #124
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SimpleGirl, that is just too much, all at once, for anybody. It is awful when you think you've already gotten the bad news, and then more bad news gets revealed. Like being kicked when you're down.

I can't add anything to the wisdom others have already expressed, but I admire and thank you for sharing everything so candidly and in such detail. We'll be with you as you go through what you must, a step at a time.

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Old 08-12-2011, 12:45 PM   #125
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SimpleGirl, that is just too much, all at once, for anybody. It is awful when you think you've already gotten the bad news, and then more bad news gets revealed. Like being kicked when you're down.

I can't add anything to the wisdom others have already expressed, but I admire and thank you for sharing everything so candidly and in such detail. We'll be with you as you go through what you must, a step at a time.

Amethyst
Thank you Amethyst. Yes it is quite, quite overwhelming. I think I've had a headache for almost a week continuously now. I'm glad you appreciate my candidness. Sharing my story openly with others is therapeutic for me, but I also am hoping something good will come from it - maybe it will help someone else going through this in the future.
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Old 08-12-2011, 01:01 PM   #126
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Plastic Surgeon Visit
Yesterday was a LONG day at the PS's office. Overall, I will say that the surgeon was AMAZING. He spent well over a solid HOUR with us - just talking, talking, talking to us - counseling us on how to make a decision on this, but not pushy AT ALL about any one particular technique. He was so kind, gentle, and empathetic.

Despite how wonderful he was, we did not come away with a good feeling about my options for recon:-(((( And let me just say I am still heeding Rich's advice to slow this down - still considering delaying recon until I have time to process all of what is happening to me.

I'm going to detail this all out, you can read on or not - up to you. Writing this all out helps me to process my options and see the pro's/cons more clearly. If you find the nitty gritty interesting, read on.

Essentially, I can have either implants placed or a tissue flap harvested from elsewhere on my body, or a combination of both. There is one other option that is a new procedure - microfat grafting - but I would have to fly to Miami for treatment multiple times over the next year or so...

Implants
This is the easiest procedure to go through in terms of initial surgery. However, neither of us is keen on the idea of implants. First off, hate the idea of a foreign object in my body. Secondly, they have to cut the pectoralis major muscle and put the implants under the muscle. This area has to be stretched out by internal expanders (filled progressively with fluid) before your final exchange surgery is done. While I know many women have implants placed, the procedure has more incidence of complications for those who have had a mastectomy - a 30 to 50% chance of capsular contracture (scar tissue around the implant) and ongoing chronic pain and tightness/restriction of shoulder motion. Also, ALL implants leak eventually - doc said it is not a matter of if, it is WHEN. Usually in about 10 to 15 years you have to have them switched out. So outpatient surgery is necessary several times over your lifetime. Implants also look unnatural as you age - your body sags, but the foobs ("fake boobs", LOL) don't.

Tissue Flap
This was what I was hoping to do, b/c the result is much more natural with less long term complications. However, because I don't have a lot of body fat, my options are limited. Most women can do a flap from their stomach, essentially getting a "tummy tuck" at the same time. Not me. Doc says he could do a flap from my inferior gluteal region (IGAP procedure: Options for Breast Reconstruction).

However, there are several disadvantages:

1) It requires a significant amount of tissue to be taken. If I only have a unilat mast, he will need to lipo the other side of the gluteal region and inject it into the harvested side to try and make the sides match. Still, most likely it would not be a perfect match. So there would be a defect left in that area. The scar is also supposed to be hidden, but when we looked at his photos, we saw that the scar extends out quite farther from the gluteal fold and was pretty bad. If I have to be bilat, then less assymetry will be noted at the harvest site, but I will still have 2 nasty scars. And, who knows how this will affect my comfort level with sitting, since your "sit bones" are right there. This could be especially problematic as I age and lose muscle mass. Also, I have a history with sciatic nerve issues, and this could flare that chronic pain problem - no way to predict that for sure...but it is a possibility.

2) My surgeon only does about 6 of these types of flaps per year. He is most experienced in doing the abdominal flaps (which, as I said, are easier to do and more common). The IGAP's are more technically difficult to perform and also have a slightly higher failure rate.

3) Length of surgery - I would be under the knife for 8 to 10 HOURS. This is no small surgery. I would be in the hospital for 2 to 3 days afterwards. Oh, and he can only do one flap at a time, due to the length of the surgery. If I ended up needing bilat, I would have to have one surgery, wait 6 wks, then go through it all over again for another 6 wks.

Microfat Grafting
This is a new procedure developed by a doctor in Miami. See Breast Reconstruction & Augmentation Fat Transfer Miami Breast Center
for a description. He has been doing it only about 8 years now. I was skeptical of this being legitimate, but many women on the breast cancer boards have been raving about the results, so I asked my PS his opinion. He actually said he is familiar with Dr. Khouri's work and that he is a well respected PS. He said that the procedure is very promising and certainly is MUCH less invasive. The drawbacks are that the patient has to be highly committed b/c it is a lot to go through - you have to wear a device (Brava external expander - see the website) for something like 10 to 12 hours/day for a month or so, have a lipo procedure, then rinse and repeat for however many procedures are needed to get your final result. Typically, women need 3 or 4 treatments. So, if I did this, it could mean over a year long commitment of repeat trips to Miami for surgeries (which are much less invasive, but still not a picnic) and wearing this device every day for a LONG time (yes, I think some do sleep in it, so that would be good if I could handle that). My doctor said if I am willing to take that on, it looks like a safe, good option for me - but to remember there are no studies yet on long-term results, since the procedure is so new. He also said he would have no problem following my care if I pursue this - if I have any complications he will work with Dr. Khouri to treat me here between Miami visits. I wish he could do this procedure himself, but he is not trained in it yet. I asked about other docs in Atlanta or New Orleans that are starting to do it - but he cautioned me that he would not recommend anyone other than Dr. Khouri yet, since it is so new.

That's it.
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Old 08-12-2011, 01:22 PM   #127
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Plastic Surgeon Visit
Yesterday was a LONG day at the PS's office. Overall, I will say that the surgeon was AMAZING. He spent well over a solid HOUR with us - just talking, talking, talking to us - counseling us on how to make a decision on this, but not pushy
Wow - lots of options.

It would be interesting and maybe helpful to you to add one more section to your very well-written summary: no reconstruction with a 1 year deferral as noted earlier. The side-by-side may give you insights into your priorities and preferences. In any event, the more choices the better.
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Old 08-12-2011, 01:30 PM   #128
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It would be interesting and maybe helpful to you to add one more section to your very well-written summary: no reconstruction with a 1 year deferral as noted earlier. The side-by-side may give you insights into your priorities and preferences. In any event, the more choices the better.
+1

Plus, as I'm sure you have probably already considered, the relatively new microfat grafting option will have another year of track record - and perhaps additional PC's in your area skilled in the procedure.
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Old 08-12-2011, 01:55 PM   #129
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Wow - lots of options.

It would be interesting and maybe helpful to you to add one more section to your very well-written summary: no reconstruction with a 1 year deferral as noted earlier. The side-by-side may give you insights into your priorities and preferences. In any event, the more choices the better.
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+1

Plus, as I'm sure you have probably already considered, the relatively new microfat grafting option will have another year of track record - and perhaps additional PC's in your area skilled in the procedure.
I'm thinking hard about that. I need to find out if I can still have a skin sparing mast (SSM) (which gives better cosmetic outcome) along with delaying recon. I don't know if you can walk around with a SSM for a year without all the tissue contracting/adhering. I also need to consider that we will definitely meet our deductible this year and financially it might be a better move to get as much done this year as possible. Of course that isn't my biggest concern, but it is a factor.
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Old 08-12-2011, 02:26 PM   #130
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simple girl.......Sorry to her of your rain of bad news. DW had a DCIS
diagnosis many years ago. She decided on a masectomy because we didn't
have confidence that they could remove all of the bad stuff with the localized lump treatment. I apologize in advance if this is not an apt or appropriate analogy but I liken it to local treatment for dry wood termites vs tenting and fumigation.

She had reconstructive surgery w/ implants which went fine for some number of years. The first one then leaked. She had it replaced but there was some kind of complication (forget what it was). The doctor replaced the replacement for free but again something wasn't quite right. This combination of events plus the fact that even if everything went well,
there would have to be replacements ever N yrs, as you mentioned, got her fed up so she told the doctor to just get rid of the implants.

Today, many yrs later, life is normal. Yesterday she finished her club's golf season and expects to take the most improved golfer prize so life does
go on and may even get better. I think the major annoyance now is the
airport screening through those new scanners where we still have to perfect a process to deal w/ TSA. They think she's carrying suspicious substances in the prosthesis.

Good luck with your decisions ahead. Just wanted to give you some encouragement.
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Old 08-12-2011, 02:36 PM   #131
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simple girl.......Sorry to her of your rain of bad news. DW had a DCIS
diagnosis many years ago. She decided on a masectomy because we didn't
have confidence that they could remove all of the bad stuff with the localized lump treatment. I apologize in advance if this is not an apt or appropriate analogy but I liken it to local treatment for dry wood termites vs tenting and fumigation.

She had reconstructive surgery w/ implants which went fine for some number of years. The first one then leaked. She had it replaced but there was some kind of complication (forget what it was). The doctor replaced the replacement for free but again something wasn't quite right. This combination of events plus the fact that even if everything went well,
there would have to be replacements ever N yrs, as you mentioned, got her fed up so she told the doctor to just get rid of the implants.

Today, many yrs later, life is normal. Yesterday she finished her club's golf season and expects to take the most improved golfer prize so life does
go on and may even get better. I think the major annoyance now is the
airport screening through those new scanners where we still have to perfect a process to deal w/ TSA. They think she's carrying suspicious substances in the padded bra.

Good luck with your decisions ahead. Just wanted to give you some encouragement.
Thank you so much for sharing your story! It is indeed encouraging...can't wait to get back to my normal, happy self!
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Old 08-12-2011, 07:08 PM   #132
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+1

Plus, as I'm sure you have probably already considered, the relatively new microfat grafting option will have another year of track record - and perhaps additional PC's in your area skilled in the procedure.
Great thing to consider ! Take care !
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Old 08-12-2011, 07:21 PM   #133
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SG, what a lot of factors to consider. Being a medical person yourself, you obviously understand the pro's and con's of treatments much better than the average person might. For example, at first I was thinking, "Not enough fat? Maybe she can just gain some fat that the surgeon can harvest," and then I read further. Nothing is ever simple.

I pledge to send at least one good thought your way every day until your ordeal is over.

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Old 08-14-2011, 10:18 AM   #134
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Simple girl, sorry to hear of your news. Me and my wife went through this 4 years ago she had a double mastectomy and recon was with implants. It was a tough 1st year and she is tight on the side from radiation. But now she golfs, rides snowmobile. We are back living life. Good lick
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Old 08-21-2011, 08:28 PM   #135
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simple girl, I haven't posted for quite a while but have been reading everything. Mainly because I'm at a loss for words. DW and I went through this in the 80's and 90's. She's a survivor. Had the double mastectomy in 1986, they took all the lymph nodes and she never had chemo. Surgeon told her to wait about reconstruction, because the type cancer she had was very possible to return. She waited 10 years to have reconstruction. However, those ten years took a toll on her. After reconstruction, the stretching of the chest skin to accept the implants left her in pain. She opted for the size she was prior to the surgery which was a mistake. She looked great but was in pain. Two years later she had more surgery to reduce the cup size. She's really happy now and is glad she went for the reduction. Her goal was to fill out clothes, not to look great in a bikini.

Hope everything works out for you and that you have a successful treatment plan. DW sends her best also. Our prayers are with you.
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Old 08-21-2011, 09:24 PM   #136
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Hi everyone - I've sent private thanks, but I just wanted to send another note to all to thank each one of you for your ongoing support.

I'm nearing the time to make the final call on some big decisions. I'm much more comfortable with my recon decision now - have decided to proceed with the microfat grafting. I went to Miami this past week and had consults with the surgeons. I have strongly considered delaying recon as was suggested, but every time I think of that, I have a meltdown. I have to have something to hope for. Can't do it. I appreciate the advise so much, but it's not right for my personality to delay reconstruction. If it was medically necessary, I would somehow find the strength to do that.

The next big decision for me is whether to have a prophylactic mast on the unaffected side. I'm talking with my docs and reading lots to determine my risk to develop a new cancer on the other side at some point in my life.

We will be setting a surgery date fairly soon.
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Old 08-21-2011, 10:25 PM   #137
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Old 08-21-2011, 11:45 PM   #138
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Simple Girl,

Your strength and courage in the handling of this matter is an encouragement to all of us who have read this thread, I'm sure.

I can only hope that should I ever be faced with a very difficult and life changing situation, that I may be able to handle it as well as you have.

Remembering you in my prayers.

C
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Old 08-22-2011, 12:08 AM   #139
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I am reading and trying to catch up on your thread simple girl. I'm glad to read you are going a different route than the implants. I just sent a message to a friend of mine for her website (that I think moved). She has been on the forefront and created a support web site many years ago for hundreds (if not thousands) of women made sick by the implants - yes saline as well as the silicone ones. Many of the woman on there testified before the FDA. Good, factual and documented information. I'm sorry my post is a little late. Am glad you have made a decision! Hugs to you.!
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Old 08-22-2011, 09:17 AM   #140
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I have to have something to hope for. Can't do it. I appreciate the advise so much, but it's not right for my personality to delay reconstruction. If it was medically necessary, I would somehow find the strength to do that.

The most important thing is that you are comfortable with your decision. It is nice to have something to look forward to .
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