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Failed reconstruction
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DancinDiamondGirl posted:
Has anyone had a hard time with breast reconstruction after bilateral mastectomy? I had two infections in my right expander, 2 and 3 months after my surgery in April '10. The first we conquered with antibiotics; the 2nd we did not, and I had to have it removed in August. I spent the last 5 months healing from that, and just last week had the expander replaced. Hoping for the best this time! But there is significant skin loss on my right side, and my surgeon wonders if there will be enough stretch to accommodate saline fills to match my other side. And of course we all wonder if THIS expander will behave itself and not get infected. Has anyone had this experience, or one similar? Thanks.
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kiwiallright responded:
Why don't you go with the DIEP Flap procedure - they use the fat and skin from your abodemen area - I have had no problems from this procedure and I have heard of a couple of people who have had issues with infection with the expanders. Find yourself a Plastic Surgeon who does the DIEP Flap procedure - not sure where you are but Beverly Chang in Salt Lake City, UT performed my procedure and she was great -

Good Luck
 
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hort11 responded:
also had a bilateral mastectomy but had to wait 2 years before reconstruction. I also had the expanders but had no problems, maybe it was too soon after your surgery. I would not recommend a tran flap ,it just sounds like an awful surgery.
 
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kiwiallright replied to hort11's response:
there is a difference between and DIEP Flap and a trans flap.
The DIEP Flap they only take the fat and skin from your abdomen nothing else - they find a good blood supply at the reconstruction site.
The Trans Flap is they take your stomach muscle and pull it up through to the breast cavity and also bring the fat and skin from the abdomen area. I for sure was glad that I did not do the Trans Flap.

Also the Dr is June Chen not Beverly Chang sorry.
 
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Lanter4 replied to kiwiallright's response:
The free TRAM flap sacrifices a portion of the transrectus abdominus muscle (hence the acronymTRAM) but doesn't tunnel it up through the abdomen. The DIEP flap does not use any of that muscle to transfer the blood supply to the reconstruction site. A skilled microsurgeon with fellowship training in muscle sparing free flap reconstruction provides a permanent reconstruction option with a successful DIEP without sacrificing needed abdominal musculature. There is ALOT of great information on the web about this and what questions you should ask to make sure you are choosing a microsurgical team who has the experience and at least a 98% success rate. Talk to ladies who have had DIEP, GAP, HIP, SIEA flaps ( but not TRAM, it's not the same) and see what kind of downtime they have had, you'll probably find it similar to the amount you have had with the repeated implant/expander problems. Best wishes on your research and recovery.
 
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Doris042 replied to kiwiallright's response:
Hi, Kiwiallright I am going to have that proceedure in about a month due to having radiation before the reconst, I had my implant removed and at same time he started the tram flap he took the artery but I am having problems finding video's of that surgery to understand it better do you know of any or any info regarding that surgery would be great ...
 
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kayjoedwards replied to Doris042's response:
Doris,
Check out the resources section of this site. I posted a link to a great video of the DIEP reconstruction procedure.
kayjo
 
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kiwiallright replied to Doris042's response:
Doris,

Good luck with the surgery, I was off work for six weeks, I probably could have gone back after three but I wanted and needed the extra time to recoup from the last year and a half There is a post on here somewhere where they show the DIEP procedure - I do not think I would want to watch it - I have seen some cable shows showing reconstruction and plastic surgery work and thought I am not watching that. I am glad that I was knocked out cold.

Good luck, also even though I have never had expanders or silcone, those who have had issues with the expanders and gone with the DIEP say it is so much more natural
 
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Kimoh responded:
Hey DDG, I also had a bilateral mastectomy last April 10. I had reconstruction with expanders. About 2-3 weeks into the expansion, the left one got infected and so I told them to take both out. It took 2 months and 2 surgerys to get rid of the infection. The Dr said it was from the hospital, but not MRSA. So now, almost a year later, I had them put in again in Jan, 2011. So far so good and now just waiting my 3 mo to put the inserts in. The difference is I opted to have it done at the outpatient surgery center versus the hospital because there is so much infection at the hospitals now days. Best of luck to you, but it does happen more than people know. They say now, that it is just like a car accident, someone is going to get in one, it is just in the numbers. So, my motto is never give up and achieve all your goals and dreams!
 
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DancinDiamondGirl replied to Kimoh's response:
Hey Kimoh, thanks for your reply! Your situation sounds very similar to mine, including the dates! I do believe that about infections in hospitals.... but strangely, my infection came along 7 weeks after my mastectomy when I was nowhere near a hospital. I'm wondering if it was caused by the saline injections during the weekly expansion process in my PS's office. But yes I believe it's a numbers game, and being diabetic puts me in a higher risk category, so there ya go. I did the outpatient center for my expander replacement 3 weeks ago too. How's your recovery so far? I'm hoping to get my drain out tomorrow...
 
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An_188712 replied to Kimoh's response:
Apparently if you had this done twice I guess it is not too bad of a procedure. I am thinking of having it done but am afraid Can you help me with a few words of the discomfort involved?
 
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mariamaria2011 responded:
Just has the same thing happen to my left expander three wks after bilateral mastectomy. Staph and mrsa man was i sick and in pain. Now i am in waiting for five months to try again. Is the replacement surgery as painful as first.one? Hope everything goes well with you this time, you have been through enough... MARIA
 
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DancinDiamondGirl replied to mariamaria2011's response:
Hi Maria,
No, the replacement surgery is NOT as bad, I promise! The recovery is much quicker. I waited 5-1/2 months to have my right expander replaced (after infection) and it was the best thing I ever did, because I was able to regain my strength and stamina during that time. It's now been 2 months since I had it replaced and I'm doing GREAT. I just got my exchange surgery date, June 1st, to get these puppies out and finally have my implants! So far so good... the right expander is now fully expanded and is behaving itself. My tendency is to do too much; I'm one of those "can't say no" kinda girls. But I've changed my ways, and I'm still trying to treat myself better... rest more... eat better... exercise regularly but in moderation... drink more water... get massages... and I think it's helped alot. Hang in there, I promise you there's light at the end of the tunnel! Thanks for sharing and keep in touch!
Rhonda
diamond2dance@aol.com
 
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bcdevil replied to DancinDiamondGirl's response:
Rhonda,
I'm just beginning the fill process and was wondering if you knew what the normal time frame is from last expansion till implant swap? Hoping all goes great for you this time !!! Glad you learned to take good care of yourself. I worry that i'm already doing too much 3 wks post bi lateral mast. Your post truly gives me hope and is telling me to slow down!! Thank you for being so bright and cheery!! You Rock!!
hugs
Sandy
 
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0910faith replied to bcdevil's response:
Rhonda,
Your words of encouragment are good to hear.
I'm getting ready to Bi-Mast. We all need your
positive words.
thank you
faith


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