breast reconstruction

[Jaquta]

I'm struggling  with the decision whether to have breast reconstruction or not.

I thought that I would be more comfortable with immediate breast reconstruction but ... I didn't like the surgeon.  I didn't feel that he listened to me.  And I didn't like what he had to say.

I am against having implants but the doctor said that I don't have enough belly fat and that the best option was the back flap with an implant.

I'm thinking that if I were to choose to have an implant then I wouldn't bother to have the muscle taken and just have it placed behind my chest muscle.  Was wondering what it felt like just to have an implant.  Does it feel different/ weird?

Are also wondering what it feels like just to have a straight mastectomy without any reconstruction.

Is a hard call.  I think the thought of implants is steering me towards having no reconstruction at all.

[bluebutterfly2222]

Yes, I realized my suggestions were of no value to you after I saw mention (in a different thread) that you reside in NZ. That is why I aplologized, in my last post, for offerering what turned out to be useless suggestions. :-(

I am glad you have come up with a plan, and hope all goes well for you.

Best wishes,
bb

[Jaquta]

Have consented to have the modified radical mastectomy without reconstruction.  Just waiting for an appt for the pre-op assessment and a surgical date.

Centres in the States don't really help me here in NZ.  I'm in the public health system here where you basically get what is available.

[bluebutterfly2222]

p.s. Sorry--my suggestion about contacting a particular center in the USA isn't helpful. :-(

I didn't know you reside in  NZ until I read one of your posts in  another thread.

bb

[bluebutterfly2222]

I don't know if you have the financial resources to consider going to a top center?

The doctor told you you don't have enough belly fat for the DIEP, but do you have fat anywhere else? Some reconstructive surgeons also use fat from the back or thighs, I believe. Perhaps if you contacted a plastic and reconstructive surguty center with doctors highly experienced in that procedure, someone on the staff could tell you about more options.

I think SueYoung 55 has posted the Web site for the place she went and was highly satisfied. Check out the link zouzi provided above to SueYoung55's excellent thread on all types of breast reconstruction.

I agree with you about avoiding the surgery that takes an abdominal muscle.We have had endless posts by members who have had long-term complications from that procedure!

bb

[Jaquta]

I would like reconstruction but I don't like the options (using my back muscle and the implant.  Other options are unavailable).

I don't want to have no breast form and I don't want the hassle of a prothesis but ... again I don't want implants (foreign material or risk). Don't want major scarring either.

Seems so trivial but I keep getting stuck on it.

[bluebutterfly2222]

Actually, in making any decision, it's not really heart versus mind (although it's common to express it that way), it is one set of thoughts that leads us in one direction and other sets of thoughts that lead us in other directions.

In trying to make a decision, we keep adding information (practical considerations, factual data, opinions gathered from others, research, ones psychological perspective, etc.) to each set of thoughts (which could be labeled Plan A, Plan B, etc.).  Then as we weigh one against the other, at some point the scale usually tips in favor of one.

If they are so close we can't decide, one "trick" is to conclude if they are that close, it really doesn't matter which we choose, and resort to a coin toss to see which one wins..........then see if we feel okay with the result! (If we don't, it probably means they really aren't were't that close, but for some reason we  haven't admitted to ourself which one we truly prefer.)

Another technique is to "choose" Plan A and then spend a period of time, perhaps a whole day or longer, "living with that decision" (in your mind, but thinking  constantly as though it were a done deal). Then for another period of time "choose" Plan B, and "live" with that decision, and so forth, if there are additional possibilities.

This gives us an opportunity to totally concentrate on one set of thoughts at a time, and fully evaluate our reaction to it, rather than bouncing back and forth from one to the other until we are dizzy and all the more confused. And if we feel really uncomfortable, or even panicky while "living" with any of the plans, that signals us to explore what we didn't like about it, or seek more information if it raised unanswered questions.

Also, keep in mind that not making a decision is also making a decision. (For example, if you "can't decide" whether to leave a job for another one and end up staying, you have actually decided in favor of the original one. Or if you can't decide if you want to marry someone and he finally gives up and moves on, at some level, you actually had decided not to marry him.)

I don't know if any of this will be of any value to you, but it is a commonly used psychological approach recommended for making a decision when someone feels at an impasse.

bb  

[Jaquta]

Thanks!  What if the information tells you one thing but your heart tells you another?

My heart tells me that reconstruction is best but my head tells me otherwise.  At the moment I don't think I could stand behind either decision.  Not sure what will happen later if I still can't make up my mind.

[zouzi]

You welcome jaquta...

I fully agree with bb..It's always so important to seek a second opinion  when you  are a little confused on what to do.When you are well informed I am sure that you'll feel  much more confident about the decision you'll be making.

Good luck to you!

[bluebutterfly2222]

I understand your discomfort about seeking a 2nd opinion, but try to keep in mind that we never need to feel embarrassed about taking steps to obtain all the information we need to make important health decisions.

Most doctors today are very used to patients taking this step, and some insurance companies prefer, or even require, that patients get another opinion before undergoing some surgeries.

If both surgeons'  recommendations agree, you could still have the first "best in the area" surgeon handle your case, or if you choose to work with someone with whom you feel a lot more comfortable, that could also be part of your decision.

bb

[Jaquta]

Thank you both for your responses.

I spoke to a woman tonight who had a delayed reconstruction and whose sister had a back flap operation.  She also suggested I ask for a second opinion.  I feel embarrassed asking to speak to another surgeon when the surgeon I saw was suppose to be the best in the area.  I guess the main problem was the lack of communication and empathy.

It's going to be a difficult decision.

[bluebutterfly2222]

Hi,

Since you did not like/did not feel listened to by the surgreon, perhaps a 2nd opinion with another surgeon would be of value?

Best wishes,
bluebutterfly

[zouzi]

Hi jaquta,
I know that you are going through a tough time,but I sincerely hope that you are doing well under the circumstances.
The decision to have or not to have breast reconstruction is really up to you and you alone.Breast reconstruction could be a bit complicated as there are so many pros and cons and options to consider.
I have added for you a link where Sue Young,one of our dear members, has given valuable information regarding breast reconstruction.

http://www.medhelp.org/posts/Breast-Cancer/Trans-flap-vs-implants/show/1308880?personal_page_id=384050

This additional link below,(Sue Young) also gives important suggestions compiled from posts on pre and post-surgery preparations

http://www.medhelp.org/posts/Breast-Cancer/How-can-I--prepare-for-my-bilateral-mastectomy/show/1227057?personal_page_id=384050#post_5678838

I really hope that this will help a little and I wish you the best and good luck on whatever you decide.