As a naive and very scared 26 year old in the world of breast reconstruction I was clueless. I was incredibly lucky to end up with a fantastic surgeon who did a great job. However having done this blog I now know this isn’t the case for hundreds of women.
For those who haven’t gone through with the surgery yet my main advice is take your time doing plenty of research and finding a surgeon who you have faith in and they make you feel comfortable. I have spoken to ladies who have left appointments in tears because the surgeon just didn’t give them that confidence. Its a good idea to know yourself what you think would suit you best before you see somebody. Everybody deserves to be happy with their surgeon and have a great big smile on their face like I did when the ordeal is over.
One interesting fact that is that as a patient your are eligible to go to any surgeon in the UK to find the treatment that suits you. You aren’t pinned down to your area just because you live there. You can be referred anywhere.
When I went to see my breast care nurse she had a gallery of photos on an iPad which were separated into specific techniques. This was really useful but I still think a bit of research done at home and speaking to others is really important. There are various forums on the internet where you can speak to other women going through the same thing.
One forum which is very useful is : BRCA umbrella
This resource is specific to those carrying a BRCA mutation such as myself. It is very confidential and you must be able to prove your joining for genuine reasons. This makes women comfortable such as myself in opening up and posting photos of your journey knowing they will remain confidential. There is also a gallery of reconstruction for you to browse through.
Another great website is ABC After Breast Cancer DiagnosisThis website is brilliant and is trying to focus on bringing together all the relevant info for women going through this process. Including which surgeon offers which reconstruction etc, it is all done from the writers personal experience which I think is so important and valuable to other women.
Some patients if they are having radiation or chemo may not be able to have reconstruction at the time due to the integrity of their skin.
Flap reconstruction- tissue used from another part of your body.
With most surgeries you are able to decide if you want to keep your nipples. Keeping the nipple adds on about a 1% risk of getting breast cancer. My surgeon had not seen a case of BC appear in this site after such surgery (which doesn’t mean it doesn’t happen) but this assured me slightly so I decided to keep mine.
A Nipple sparing mastectomy is what I went for. There breast tissue is scraped away very closely behind it and the nipple itself remains.
Nipple reconstruction is also an option. Nipple reconstruction is done after the reconstructed breast has had time to heal — at least 3 or 4 months after reconstruction surgery.The surgeon makes small incisions and then elevates the tissue into position, forming and shaping it into a living tissue projection that mimics the natural nipple.The new nipple can then be tattooed to add color and create the areola around the nipple.
A nipple tattoo. Instead of using tissue to rebuild a nipple, some women choose to have a nipple tattooed on the reconstructed breast. Some women decide to have a star, a heart, or another meaningful image tattooed on the reconstructed breast instead of a nipple. I have seen some of these and they look amazing!!!
A breast cancer survivor has recently been in the papers with her floral nipples.
More info on nipple reconstruction/sparring/tattoos can be found here Nipple options
When you are in the room with the consultant you kind of go blank, and you know they are the expert and just go along with what they say. Don’t get me wrong the main aim of this op is to reduce your risk of breast cancer/remove your cancer, however the reconstruction part is still a HUGE part for a women.
I am not an expert but from my research the main techniques I’m aware of are……
DTI (direct to implant) This is what I had and it requires only one operation as your breast tissue is replaced with a silicone implant. This was then secured with strattice which is a piece of pig skin which acts like a sling to support the implant. As far as I am aware you can’t go bigger with this, but I wasn’t bothered at all about this. This surgery has the quickest recovery time, but as always has its risks.
Read more: implant reconstruction
Photos can be found here : implant reconstruction
LD Flap– In a latissimus dorsi flap procedure, an oval flap of skin, fat, muscle, and blood vessels from your upper back is used to reconstruct the breast. This flap is moved under your skin around to your chest to rebuild your breast. The blood vessels (artery and vein) of the flap are left attached to their original blood supply in your backIn most cases, a breast implant has to be placed under the flap to achieve the desired shape, size, and projection. A latissimus dorsi flap procedure leaves a scar on your back, but most surgeons try to place the incision so the scar is covered by your bra strap. This type of surgery can leave you with some weakness in certain movements so isn’t suited to everybody.
Read more : LD flap reconstruction
Photos can be found here :LD flap reconstruction
TRAM- This stands for transverse rectus abdominis, the muscle in your lower abdomen between your waist and your pubic bone. A flap of this skin, fat, and all or part of the underlying rectus abdominus (“6-pack”) muscle are used to reconstruct the breast in a TRAM flap procedure. This is a very common technique however I feel the down sides are two sets of “open wounds” and it leaves a big scar. I could not have this type of reconstruction as I already have a scar going across my abdomen and have had 7 surgeries here due to bowel perforations, so it is a no go area.
Read more : TRAM
Photos can be found here: TRAM reconstruction
There are also other reconstructive techniques which I am not too sure about but there is lots of info here Breast reconstruction
I hope this helps anyone going through this decision at the moment or considering it soon