Surgery Types Available
Whilst researching my mastectomy options I learnt so much and put so much work in I thought it might be helpful to write up a cheat sheet for people to refer to in the future re options available.
*PLEASE DOUBLE CHECK EVERYTHING ON HERE WITH YOUR SURGEON, THIS IS MEANT AS A GENERAL GUIDE AND KEEP IN MIND I GOT MY INFORMATION FROM THE INTERNET!! ALTHOUGH I NOW HAVE FIRST HAND EXPERIENCE WITH THE DIEP*
That said, this is what I found out.....
That said, this is what I found out.....
Reconstruction Options:
Immediate Reconstruction
They do the mastectomy and reconstruction all in one operation, generally with 2 surgeons, an oncology surgeon and a plastic surgeon. In other words you will be put under anesthetic with a breast and wake up with a breast.
They do the mastectomy and reconstruction all in one operation, generally with 2 surgeons, an oncology surgeon and a plastic surgeon. In other words you will be put under anesthetic with a breast and wake up with a breast.
Delayed Reconstruction
You will wake up flat and after a period of time you will then have a reconstruction (or not depending on your choice).
You will wake up flat and after a period of time you will then have a reconstruction (or not depending on your choice).
Mastectomy Types:
Nipple Sparing
You will get to keep your nipples
You will get to keep your nipples
Non Nipple Sparing
You will lose your nipples
You will lose your nipples
Skin Sparing
This is generally only offered with an immediate reconstruction, it means that your new breast will have the same skin that your old breast had. There may be exceptions to this.
This is generally only offered with an immediate reconstruction, it means that your new breast will have the same skin that your old breast had. There may be exceptions to this.
Non Skin Sparing
This is the option given for a delayed reconstruction, it means your new breast will not have the same skin as your original breast (I *think* there are options for the skin to be saved for later on your chest wall with this but please check with your surgeon). Skin sparing will be aesthetically the most similar to your original breast as the skin is simply 'repacked'.
This is the option given for a delayed reconstruction, it means your new breast will not have the same skin as your original breast (I *think* there are options for the skin to be saved for later on your chest wall with this but please check with your surgeon). Skin sparing will be aesthetically the most similar to your original breast as the skin is simply 'repacked'.
Surgery Options:
Diep flap (2 part operation)
Operation 1: An orange peel segment shaped piece of fat and skin from your stomach (between the belly button and pubic line) from hip bone to hip bone is cut out and used to make a new breast. This operation is an average of 8-10 hours long with a weeks stay in hospital and approx a 6-12 week recovery period in total. Don't forget you will be getting progressively stronger as you near the end of the recovery period, you will not be bed bound that entire time. The reason the operation takes so long is the blood vessels need to be disconnected from your stomach and reconnected to your new breast. The stomach part of the operation is more or less the same as a tummy tuck and will be a side benefit. A diep is only available if you have enough stomach fat to make a new breast(s)
Operation 1: An orange peel segment shaped piece of fat and skin from your stomach (between the belly button and pubic line) from hip bone to hip bone is cut out and used to make a new breast. This operation is an average of 8-10 hours long with a weeks stay in hospital and approx a 6-12 week recovery period in total. Don't forget you will be getting progressively stronger as you near the end of the recovery period, you will not be bed bound that entire time. The reason the operation takes so long is the blood vessels need to be disconnected from your stomach and reconnected to your new breast. The stomach part of the operation is more or less the same as a tummy tuck and will be a side benefit. A diep is only available if you have enough stomach fat to make a new breast(s)
Operation 2: this is where the breasts are made symmetrical if needed and a nipple is made from your own tissue if needed / required. This is done around 3 months after operation 1 so the new breast has settled, it is usually a small operation done in a day under general anesthetic. This was just what I was advised personally, it sounds like there are different timings depending on surgeons and what needs doing.
If you are having a diep as a result of a delayed reconstruction it will have a slight patchwork effect because the skin could not be spared and the stomach tissue is stitched onto the outside of chest to create a new breast.
If you are having a diep with an immediate reconstruction the tissue will be hidden inside your own skin
Diep patients tend not to need any more surgery once complete.
Implants
Something called an expander (a bag that gets filled gradually with saline) is placed under the skin and slowly inflated over a period of weeks to stretch the skin to the size of the implant required. Expanders are generally only used for delayed reconstructions to stretch the skin as there may not be enough left to host an implant. There may be exceptions to this that I am not aware of. If you are having implants with an immediate reconstruction then something called Dermal Matrix may be used (pig skin) to help keep the implant in position. Scar tissue can form around the implants making them hard or uncomforatable but I do not know if this is the 'norm'. Again please check with your surgeon, this is just my internet research, however my surgeon said to me that a diep can be more comfortable in the long terms.
Something called an expander (a bag that gets filled gradually with saline) is placed under the skin and slowly inflated over a period of weeks to stretch the skin to the size of the implant required. Expanders are generally only used for delayed reconstructions to stretch the skin as there may not be enough left to host an implant. There may be exceptions to this that I am not aware of. If you are having implants with an immediate reconstruction then something called Dermal Matrix may be used (pig skin) to help keep the implant in position. Scar tissue can form around the implants making them hard or uncomforatable but I do not know if this is the 'norm'. Again please check with your surgeon, this is just my internet research, however my surgeon said to me that a diep can be more comfortable in the long terms.
Latissimus dorsi (LD) flap
A muscle and some fat is taken from your back and pivoted round to make a breast. From my research and speaking with surgeons it sounds like this operation is being phased out in favour of the Diep flap. Also a lot of the time implants are used with an LD flap if there is not enough fat to create a breast(s).
A muscle and some fat is taken from your back and pivoted round to make a breast. From my research and speaking with surgeons it sounds like this operation is being phased out in favour of the Diep flap. Also a lot of the time implants are used with an LD flap if there is not enough fat to create a breast(s).
No reconstruction
Self explanatory
Self explanatory
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