Direct to Implant and Reconstruction Same Day

Posted by toomey79 @toomey79, Jun 28, 2023

My daughter is 43 years old and has the BRCA2 gene. She was just diagnosed with Stage III Invasive Ductal Carcinoma(Breast Cancer). She is a professor at Temple University and lives by herself in Philadelphia. We(her parents), live in Ohio. She does not want to do radiation or chemotherapy. Neither she nor us are in a good financial situation. We are right at that lower middle class line. She has been checking around and is set on a surgeon and plastic surgeon in Beverly Hills, California. We would have to fly out, have someone take care of our two dogs, get a hotel, Uber back and forth to the hospital and of course, eat. We would have to take a loan out for $60,000. We are in our 60’s and I am disabled. The financial burden alone is immense. The place in Beverly Hills is called Cassileth Plastic Surgery. The surgeons name is Dr. Mensick. My question is; does the Mayo Clinic do direct to implant surgery all in one day, and is it safe? Any suggestions for a worried parent who doesn’t know what to do and if it’s the right and safe thing to let her do. She has big breasts with dense tissue and with the BRACA2 gene, both of which make the surgery and follow-up more concerning.

Interested in more discussions like this? Go to the Breast Cancer Support Group.

I am a Mayo patient and was given this as an option. However, it is not as simple as “one-and-done”. Implants are placed same day but there are follow-up surgeries to fine tune size and so-forth. I was discouraged from this plan due to my age and low grade diagnosis along with high rate of complications with the reconstruction. Mostly infections. I chose lumpectomy because of this but will always wonder if it was the right choice. I also have dense, heavy breasts. Discomfort is due to movement of these heavy (and age-sagging) breasts. Have purchased upward of 20 bras to try and find wireless, supportive one. I’ve found a few now that will work but not ideal. Time will tell. Get a second or third opinion if necessary. Godspeed ti you all.

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Good morning, and big hugs to you very caring and worried parents💕 I just underwent a double mastectomy 9 days ago at the Mayo Clinic in Phoenix, and I had the “direct to implant, nipple sparing reconstruction.” I am a smaller person with smaller breasts, and my area of concern was too large to do a lumpectomy. I reported to the hospital at 5:30am, surgery started at 8 and was completed by 12:30, and I was leaving the hospital by 3:30pm. All went very smoothly, and my follow up appt a week later showed everything is healing nicely.😊 I still have drain tubes, and pain level has been very manageable. I never had to take the strong pain med (Oxycodone) they sent home with me at all. Just tylenol, ibuprofen, a muscle relaxer, and an antibiotic. Im so sorry your daughter is battling cancer and facing these big decisions, but it sounds like you are there for her with support and encouragement, and having people in her corner can make a wonderful difference💕

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I had two lumpectomies and the surgeon couldn’t get clear margins so I had to have a mastectomy. I had two great surgeons and they did the mastectomy and reconstruction at the same time. I had one more surgery to remove the expander the plastic surgeon placed. The expander was uncomfortable)not gonna lie). But I am so glad I did it. The important thing is have a really great plastic surgeon and I was so fortunate to have him. And he is one of the kindest people I’ve ever met. Godspeed ❤️

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Please take my comments as my own - I don't wish to disrespect anyone that has chosen to have implants or their reasons for having them. I'm older - had my children - have a solid stable relationship with my husband and my answers would be different if I were younger, hadn't had my children or wasn't in a solid stable relationship with my husband.

I had double mastectomy, (I'm Triple Negative and also BRCA2+) and was given the option for implants. Just as a side note - I had chemo before surgery and was told that IF I had "clear margins" there would be no need for radiation - I did not have "clear margins" - so radiation was done. The recommendation for chemo and radiation my be out of her hands once surgery is performed - but the final decision will be hers. For implants, I was told I would have to heal before they could implant the expanders, then it would require several visits for the expanders to be filled with the solution, then it would require another surgery to remove the expanders to have the implants inserted. If there was a one-and-done method I would have taken that option, so long as it didn't require lots of follow-up visits and additional surgeries. My concern with traveling so far away to have the procedure is all follow-up appointments that may also require travel unless you're going to take up residence in the area for the duration of the procedure to be completed and to receive full release from the surgeon.

From your message - I take it you have several concerns. Part of this is the financial impact to you and your family for your daughter to have the procedure so far away from where everyone currently reside - and how do you support her during this time. If the support you provide is only for the duration of her recovery that might only be about 2-3 weeks. I know after my surgery it was difficult to raise my arms and required usage of step stools to grab things that were able shoulder height.

When my husband and I have supported our daughter during procedures she's had (she lives in North Carolina and we live in California); only one of us goes to help her. It was financially prohibitive for both of us to go at the same time. Since my husband and I still work - currently remotely we have worked reduced hours while there. We're both fortunate to have positions that allow for this.

Has your daughter even met with the surgeon in California to see whether it's possible to have the procedure done there? Have you asked her why she feels this is the best place to have the procedure performed; does this place specialize in cancer patient breast reconstruction or are they just a highly regarded plastic surgeon? It might be helpful to discuss with your daughter to ask her to see what type of support she feels she would need from you and for you to let her know what you're comfortable providing. This is only my opinion, (I'm in a different mental stage - getting ready to retire and will have a significantly reduced income) - but I would probably spend whatever I could for the life of my child - but I'm not sure I would place that same financial worth for her to have breasts (I'm not sure I'd take out a $60,000 loan for her to have breast surgery). My first concern would be the breast cancer surgery and then being a good plastic surgeon - for me would be secondary. I'd want to make sure the breast cancer surgery was of paramount concern.

I wish you the best in which ever way you decide to your daughter during this challenging time and in how you support her during her upcoming procedure(s).

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@sblair

I am a Mayo patient and was given this as an option. However, it is not as simple as “one-and-done”. Implants are placed same day but there are follow-up surgeries to fine tune size and so-forth. I was discouraged from this plan due to my age and low grade diagnosis along with high rate of complications with the reconstruction. Mostly infections. I chose lumpectomy because of this but will always wonder if it was the right choice. I also have dense, heavy breasts. Discomfort is due to movement of these heavy (and age-sagging) breasts. Have purchased upward of 20 bras to try and find wireless, supportive one. I’ve found a few now that will work but not ideal. Time will tell. Get a second or third opinion if necessary. Godspeed ti you all.

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Thank you. It’s such BS a hard decision for my daughter. And with her not trusting Philly hospitals, some terrible reviews at places and wanting the quick and perfect scenario I don’t know what advice to give her. Thank you for sharing your experience. What stage were you when diagnosed if you don’t mind me asking?

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I believe your question is directed at me so I will answer. I was stage 0 DCIS and I am 64 years old. Lumpectomy was done 3 weeks ago. I begin radiation in a few weeks. I have a good prognosis and am blessed that all is well so far. I apologize to everyone for whining about trying to find a bra that fits. It is so minor compared to what so many experience. I can’t believe I actually wrote that on here!

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Has your daughter not looked into plastic surgeons closer by? I ended up purely by chance getting a super fantastic plastic surgeon here. Also her surgery should be covered by insurance, any breast surgery by law for breast cancer is covered by insurance. I hate to be so suspicious this but is the surgeon in "beverly hills" a scam? Almost every Dr. will do their best to get a procedure pre-approved.
If this were my child I would be more than happy to help take are of my daughter's physical/emotional needs however I would not borrow money to pay for something that is covered by insurance.

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I had a lumpectomy with sentinel lymph node removal 2 weeks ago. Stage 1 invasive ductal. I had a lift with implants placed during the 5 hr. surgery. I’m not sure if I made the right decisions. It’s been a whirlwind since I was diagnosed in April. I feel lost and unlike myself. I’ll have radiation for sure and still waiting on tissue results. I was told the breast that receives radiation will harden and shrink. This is the least of my worries because obviously my health is top priority. Has anyone experienced this. I’m new here. I’m terrified. I will pray for your daughter.

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First God bless all of you in your journeys!!!! I am having surgery July 18. I have ILC with another spot of ADH. I M having Double mastectomy and implant. My surgeon decided that he’d rather use implants to save me from numerous surgeries. I thank God for that but am sincerely nervous.

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@jamilee414

Good morning, and big hugs to you very caring and worried parents💕 I just underwent a double mastectomy 9 days ago at the Mayo Clinic in Phoenix, and I had the “direct to implant, nipple sparing reconstruction.” I am a smaller person with smaller breasts, and my area of concern was too large to do a lumpectomy. I reported to the hospital at 5:30am, surgery started at 8 and was completed by 12:30, and I was leaving the hospital by 3:30pm. All went very smoothly, and my follow up appt a week later showed everything is healing nicely.😊 I still have drain tubes, and pain level has been very manageable. I never had to take the strong pain med (Oxycodone) they sent home with me at all. Just tylenol, ibuprofen, a muscle relaxer, and an antibiotic. Im so sorry your daughter is battling cancer and facing these big decisions, but it sounds like you are there for her with support and encouragement, and having people in her corner can make a wonderful difference💕

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Hello,

So with your diagnosis did you skip chemo all together? I have been told that my cancer HER2 + was too large to do lumpectomy or anything else and that we needed to shrink it first. I am only going into my 2nd treatment now, the first treatment it was super bad for about 7 days with severe bone pain, fever and excruciating headache. Next chemo is on monday and not looking forward to it. I would have loved to have had my breast removed but this was not given to me as a good option. As I understand I will still need to take Herceptin and Pergeta for a year after my lumpectomy and reconstructive surgery,

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