Anyone decide not to do reconstruction after getting the expander in?

I have HER2 breast cancer and I had a double mastectomy at Mayo, they got everything and I and have expanders. I completed 5 weeks of radiation and I am recovering.
The skin does change and processes of skin flap or implants are discussed.
I will have implants and first surgery on reconstruction will be in August and completion in December.
I trust my plastic doctor - and understand what limits I have for size after radiation.
I am in remission and have a bit to go with my treatment plan and chemo.
Excited for my future!!

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At age 45, I had a lumpectomy, chemo (2000) and 6.5 weeks of radiation on left breast for hormone-positive breast cancer (2001). In late 2014, in the same breast, mammogram found another mass in that breast and biopsy confirmed cancer. Had a double mastectomy—pathology on lump showed triple-negative cancer in left breast and DCIS was found in tissue of removed right breast as well. Had tissue expanders placed at time of double mastectomy. Had 5.5 months Adriamycin (four sessions) and Taxol (12 sessions) chemo in 2015.

I opted for breast implants instead of any type of flap, or tummy tissue surgery; I did NOT want large implants (are about a C cup; am a plus-size woman). I was prepared for the rebuilt breasts to not look "real" as my nipples could not be spared and implants would be used. Although it had been 14 years since the left side was irradiated, I've had a lot of problems with the rebuilt breast on that side—it's fallen to the left, it had a bleed behind it that caused it to develop capsular contracture necessitating replacement and currently, it sits much lower than the right.

When I HAD to have the left one removed November 2020 because of the capsular contracture (the implant became very hard and moved waaay up on my chest), my surgeon had to remove a LOT of tissue, scar tissue and skin—which meant using a tissue expander again to create room to put the implant in and growing more skin to cover it—which meant I had to have yet another surgery to place the new implant in April 2021. At the time of the capsular contracture, I considered not putting implants back in; my plastic surgeon said I would feel "maimed" if I opted to "go flat." Honestly, unclothed my "breasts" look awful, so not sure surgeon should be throwing the word “maimed” around; my oncologist (who has practiced 30 years and seen a lot of breast cancer patients) said mine looked pretty much like others he's seen (made me feel better about mine, but sad for all of us who reconstructed).

When I decided on the double mastectomy, I wanted reconstruction so that I’d look “normal” and opted for implants because I did NOT want a lot of surgeries, additional scars and the long recovery time associated with transplanting my own tissue from other areas of my body. So far, I have had 7–8 surgeries to fix various issues and the fake boobs (foobs) if unclothed would fool no one and do not "match" in shape, nor sit at the same level. Every subsequent surgery has cost me thousands of dollars (even with health insurance), taken weeks to heal and caused more scarring and a significant loss of tissue in my left armpit (I am lucky that I don't have lymphedema and that I have full range of motion in both arms). I don't know if going the "own tissue" route would have ultimately been less trouble and given me a better result, or not. I don’t know if the left breast having been irradiated meant no matter what surgery I chose would have led to less-than-desirable outcomes. If I had known then, what I know now and if I have to have more surgery, I will take the implants OUT and “go flat.”

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Thank you for sharing. I’m 68 and having a double mastectomy in 10 days. I elected not to go with reconstruction and hoping I made the right decision. I just didn’t want to have more surgery…

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At age 45, I had a lumpectomy, chemo (2000) and 6.5 weeks of radiation on left breast for hormone-positive breast cancer (2001). In late 2014, in the same breast, mammogram found another mass in that breast and biopsy confirmed cancer. Had a double mastectomy—pathology on lump showed triple-negative cancer in left breast and DCIS was found in tissue of removed right breast as well. Had tissue expanders placed at time of double mastectomy. Had 5.5 months Adriamycin (four sessions) and Taxol (12 sessions) chemo in 2015.

I opted for breast implants instead of any type of flap, or tummy tissue surgery; I did NOT want large implants (are about a C cup; am a plus-size woman). I was prepared for the rebuilt breasts to not look "real" as my nipples could not be spared and implants would be used. Although it had been 14 years since the left side was irradiated, I've had a lot of problems with the rebuilt breast on that side—it's fallen to the left, it had a bleed behind it that caused it to develop capsular contracture necessitating replacement and currently, it sits much lower than the right.

When I HAD to have the left one removed November 2020 because of the capsular contracture (the implant became very hard and moved waaay up on my chest), my surgeon had to remove a LOT of tissue, scar tissue and skin—which meant using a tissue expander again to create room to put the implant in and growing more skin to cover it—which meant I had to have yet another surgery to place the new implant in April 2021. At the time of the capsular contracture, I considered not putting implants back in; my plastic surgeon said I would feel "maimed" if I opted to "go flat." Honestly, unclothed my "breasts" look awful, so not sure surgeon should be throwing the word “maimed” around; my oncologist (who has practiced 30 years and seen a lot of breast cancer patients) said mine looked pretty much like others he's seen (made me feel better about mine, but sad for all of us who reconstructed).

When I decided on the double mastectomy, I wanted reconstruction so that I’d look “normal” and opted for implants because I did NOT want a lot of surgeries, additional scars and the long recovery time associated with transplanting my own tissue from other areas of my body. So far, I have had 7–8 surgeries to fix various issues and the fake boobs (foobs) if unclothed would fool no one and do not "match" in shape, nor sit at the same level. Every subsequent surgery has cost me thousands of dollars (even with health insurance), taken weeks to heal and caused more scarring and a significant loss of tissue in my left armpit (I am lucky that I don't have lymphedema and that I have full range of motion in both arms). I don't know if going the "own tissue" route would have ultimately been less trouble and given me a better result, or not. I don’t know if the left breast having been irradiated meant no matter what surgery I chose would have led to less-than-desirable outcomes. If I had known then, what I know now and if I have to have more surgery, I will take the implants OUT and “go flat.”

Jump to this post

Thank you for sharing. I’m 68 and having a double mastectomy in 10 days. I elected not to go with reconstruction and hoping I made the right decision. I just didn’t want to have more surgery…

Jump to this post

I have HER2 breast cancer and I had a double mastectomy at Mayo, they got everything and I and have expanders. I completed 5 weeks of radiation and I am recovering.
The skin does change and processes of skin flap or implants are discussed.
I will have implants and first surgery on reconstruction will be in August and completion in December.
I trust my plastic doctor - and understand what limits I have for size after radiation.
I am in remission and have a bit to go with my treatment plan and chemo.
Excited for my future!!

Jump to this post