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ToTheNines
Nov. 13, 2009, 07:17 AM
Anyone gone through this? Need a plastic surgeon that understands that my end goal is to be as active as before, not big cleavage!

shea'smom
Nov. 13, 2009, 07:55 AM
When I was worrying about this particular aspect of the whole stinkin' business, I went on line and found some pictures of some brave women who were willing to share what they looked like after reconstruction.
I recommend that. It helped me decide what was right for me.
There are definitely some methods that I felt would interfere with my rapid return to the saddle. I was able to ride 10 days after my surgery, which was very important to me.
Good luck. PM me if there is anything else or you need any support. You will get plenty here.
Kathi

izzy
Nov. 13, 2009, 08:28 AM
Oh boy do I ever. I've had three plastic surgeons for three different reconstructions starting at an early age. Did not get it right until the third, the first two definitely had an agenda and one look at the photos of their wives told me all that I needed to know.

What kind of reconstruction are you considering? I've had implants, and a DIEP flap.

If you feel more comfortable feel free to PM me. I'm a physician as well as two time cancer survivor

ToTheNines
Nov. 13, 2009, 09:44 AM
I am a candidate (according to my second surgeon's opinion but not my first) for one step implant. That is what I am planning right now. Would love any comments on that procedure.

This is my second time around with BC. I had a lumpectomy with radiation in 1996. The lumpectomy was no big deal, but the radiation wears you out.

Second tumor, same breast, in 2009, which is why surgeon is saying mastectomy. Already had tumor removed as outpatient, went home, took nap, put on two bras, and went riding. But now I am being strongly urged to get mastectomy. They will not do radiation a second time on same side.

I love hearing about the quick recoveries... so would love any such tales. But I need to hear the bad too I guess. I have a good BC forum, but I really want to hear from horse folks.

Equibrit
Nov. 13, 2009, 12:32 PM
I have been through it and found my best solution was to seek out a lady plastic surgeon. I had all lady doctors and found them to be very sympathetic/understanding and a lot easier to talk to. I was a big girl and couldn't believe that I was going to be able to shed chest poundage and make riding more comfortable! I now have little perky ones! I would recommend that you check out Dr Susan Love's book or website for information on options and straight poop on the disease. http://www.dslrf.org/
I was determined to be back riding quickly and had no real problem doing it, but with some pain. I had the implant put in at the same time as the mastectomy and it was gradually inflated over the course of a few months. This was, in my view the quickest way for me to be rid of the whole experience. The gradual stretching of the muscle over the implant was what caused the pain, and I would have had to endure it, had I ridden or not. So - I rode and made myself feel better for a bit. I made the choice to not compromise my pelvic muscles by having flap reconstruction . Anyway good luck to you, and make sure you learn a lot about the possible treatment options and do what YOU WANT TO DO even if it means changing doctors etc..

sickofcollege
Nov. 13, 2009, 01:47 PM
I see that you're in Texas! My BF's mom had breast cancer and they did a complete mastectomy. She went to a Dr. in Fort Worth who did an AMAZING job with the reconstruction. Minimal scarring, etc. She looks awesome now!

PM me if you want the Dr's name.

gingerbread
Nov. 20, 2009, 07:57 PM
Yes, I have gone through this experience. I chose the saline implant because recovery time was quick, and it didn't compromise my abdominal area(flap method)---with riding, you need your core! My reasoning was--why mess with a healthy area of my body (abdomen)for cosmetic reasons?
I did the one-step procedure, where they start the implant process at the time of the mastectomy--there's one less anesthesia involved this way.
Be clear with your plastic surgeon about who you are and what you want.
Good luck! Feel free to e-mail me privately if you want.

Hampton Bay
Nov. 20, 2009, 10:50 PM
I am interested in hearing these responses too. I have a very strong family history of BC (mom, grandma twice, great-grandma, and aunts are younger but one has already had some issues). It has been recommended to me that after I have children, I have a double mastectomy and reconstruction to minimize the risk I will ever get BC.

What's this flap thing about?

Outyougo
Nov. 20, 2009, 11:07 PM
I am much like Equibrit had a lumpectomy/radiation Then 9 years later there was a re-occurrance in the scar line.

This time I had to do the chemo and mastecomy. i felt that my breast bas a bad actor and willing to just be an Amazon. But after riding for 6 months i found that I was sitting crooked and protecting myself when riding--not too effective. Then when giving a leg up to another rider I got kicked in the chest hey with no padding that hurt. SO after consulting 2 surgeons I got an implant. OK it is not perfect but it is numb and has a nice tattoo on it. My docs discouraged me from the flap technique given my active farm life.

Cleavage be damned but find a solution that keeps you balanced in the tack!

Now 7 years out and Life is good! Some times I even forget I ever had cancer. I never forget I love my horses!!

jnel
Nov. 20, 2009, 11:35 PM
I'm sorry you have to go through this, but the wonderful people here give great advice and are really inspirational. I had a double mastectomy with same day reconstruction in May 08. Your recovery period and how fast you can get back on a horse will depend on how long your drains stay in and how much they bother you. I thought the drains were the worst part (mine were in for three weeks), that and not being able to sleep on my side for awhile made me very tired and cranky. My doctor did not want me riding until about two weeks after my drains were removed. I know some people here have said it didn't bother them to ride with the drains, but there is a risk involved. I had permanent saline implants put in after my chemo was finished and was only out of the saddle for a week.

The flap thing is where they take a chunk of muscle from your belly and put it in your breast. The recovery period is months long. They say you get better results that way but you really are limited during the recovery period to doing only "very light housework".

Good luck, we are all here to help and encourage.

FalseImpression
Nov. 20, 2009, 11:58 PM
Well, I had a mastectomy and radiation and I chose NOT to have reconstruction. I just could not fathom putting myself through more surgeries to implant something that was not supposed to be there. I just could not deal with that and I felt it would always be on my mind, that the implant would hide something. So I wear a prosthesis. I am used to it and don't think about it at all.

Maybe in the summer, it is hotter than a real breast. And it has to be replaced because it can break down and leak too. I am in Canada and the government picks up the tab (1/2 for replacement) and my insurance picks up the other half (once every 3 years). Of course, this time it failed 2 weeks past warranty and only two years... so I had to pay.

My cancer was 10 years ago and reconstruction has probably improved quite a bit since then, but I still don't think I would do it. I was 49 at the time and I don't ride, but horses helped me a lot during that time.

lolalola
Nov. 26, 2009, 09:44 PM
I had bc and reconstruction back in 2001. Interestingly, when they took off the breast they found another, smaller tumor, only 3mm, which didn't show up on the MRI. If there had been no mastectomy, that little bugger would have grown and caused a recurrence. Anyway, had the saline implants and the first reconstruction looked great. About two years later, I was in the shower and looked down and said, "Where's my boob?" The implant had deflated. Had an abscess with the second implant - man, now I know how horses feel when it's in the hoof. The third time has been OK so far but there is a lot of scar tissue and it doesn't look so great. I always wear a protective vest when riding, for general protection and for the implants should I land on them. Don't really notice them anymore - they're just part of me now.

shea'smom
Nov. 29, 2009, 10:13 PM
lolalola, you are another example of how tough and funny we survivors are! You made me laugh out loud!
I opted for no reconstuction, only a pain in swimwear. I use a light cotton filler thing in my regular bra, comfortable for riding.

HorsesinHaiti
Dec. 26, 2009, 12:33 PM
There's an article today in the Cincinnati Enquirer on a rider with a double masectomy. The article talks about the problems that transplanting abdominal muscles caused her.

http://news.cincinnati.com/article/20091224/SPT/912250369/1062/She+rode+tall+on+arduous+path

RedMare01
Dec. 26, 2009, 01:09 PM
I work in healthcare and am on the Cancer Committee at my hospital. All of our surgeons think that it's best to do the mastectomy and reconstruction as separate procedures. They do not recommend doing it all in one procedure. Get the cancer treatment over with before worrying about reconstruction. Also, I don't think they're too big on the flap method. FWIW.

Caitlin

lwk
Dec. 26, 2009, 03:04 PM
There is a flap procedure that doesn't involve the abdominal muscles and is supposed to be much easier.
It is called the Diep flap.

http://www.diepflap.com/

ToTheNines
Dec. 27, 2009, 08:10 AM
Thanks for the replies so far. I am not having the flap type reconstruction. I am thin and small breasted, so they are doing the one step with a small silicon implant. They will do some minor surgery on my "good" breast for symmetry.

I am very very lucky that I will not need any additional treatment, such as radiation or chemo. Maybe tamoxifen, maybe not. I do not take drugs without a fight.

I am expecting about 3 - 4 weeks of no riding. That is annoying, but it will be January and the horses can rest. I am more concerned right now with how long it will be until I can do things like lifting feed buckets and putting on blankets. Luckily I have only three horses, and lots of helpers.

gingerbread
Dec. 29, 2009, 08:22 PM
It may take a little bit longer ---maybe 6 weeks ---before you are up to riding again, as the mastectomy itself really is a major thing to heal from, and you want it to heal well, without infection. Your general energy level will be low because your body needs all your energy to regroup and repair---our mind wants to go faster, but we really have to be gentle and caring with what the body requires at this time. Use your helpers, enjoy staying warm and resting! Be kind to yourself.

The final surgery where they put the implant in is VERY easy to deal with, and you'll be ok to ride within a week or so, probably.
I went through this about 18 months ago...really wish you all the best! It's no fun!

jnel
Jan. 11, 2010, 10:18 PM
ToTheNines, it sounds like you are going to have a fairly simple go of it. I wouldn't be surprised if you were up and lifting buckets and such right away. The most annoying thing you'll probably have to deal with is your drain and being tired. I got a bunch of sport type tank tops with a built in bra and that kept my drain in place and gave me some support without being too tight. I found even right after surgery I needed something to hold everything in place. :yes:

ToTheNines
Jan. 12, 2010, 07:46 AM
I will post this to help complete the thread, in case someone has the same questions in the future. I am the OP, and a week ago, I had a simple mastectomy of one breast (lymph nodes were removed in 1996). The plastic surgeon placed a small silicone implant during the same surgery. It is the new "gummy" type that does not leak. It even has a moderate profile. The "good" breast underwent some minor cosmetic surgery for symmetry.

I had a very easy time of it. I only spent one night in the hospital. I took pain pills for three or four days, but am off them now. I am moving around fine, and already feeding the horses. The only things I don't want to do quite yet are cleaning stalls and blanketing, but I have help for that. I had two drains, and one was removed when I saw the plastic surgeon three days after surgery. The other will go out in two days.

All in all, it was much less traumatic than I expected. My new little fake breast will look pretty good -- it has to settle down a little bit. The plastic surgeon did as we agreed and placed the smallest implant he could that would look good. I will not need any exchanges or expansions. No more surgeries at all, knock on wood. I am very grateful to have it all over with. I am lucky that no chemo or radiation is recommended. The big question now is when can I ride? I expect maybe I will get on and walk around next week if plastic surgeon ok's (maybe even if he doesn't). I have some great close-front sports bras. Thank you everyone for the tips and support!


During all the stressful time of decision-making, other options were presented, such as double mastectomy, no reconstruction, and other types of reconstruction. I do not have a very agressive cancer, so I saw no need for double mastectomy. Once I decided that, I was willing to try reconstruction because it was only one side to deal with. Finally, the one-step implant surgery was a good choice for me. I can only hope the next gals have it as easy as I did.

I do not expect any of this to affect my riding long term. The only muscle that is sore is the muscle across my chest (pectoral), which is partially placed over the top part of the implant. I have been taught that if a horse is heavy or pulling, your strength comes from an appropriate balanced position, a smart elbow, and from the muscle on the back of your arm just above your elbow. I do now feel like any of that strength is affected. My horses are quiet anyway, although one can get heavy on the forehand.

Finally, I highly recommend the discussion forums at breastcancer.org for great information and people's stories.

ToTheNines
Jan. 19, 2010, 09:55 AM
I just wanted to update this again, for whomever might come along behind me with the same questions. Two weeks out from surgery, I have gotten the go ahead from my plastic surgeon to resume all my normal activities. It is amazing, and right now I am a big fan of surgeons. I got some good sports bras, and I will ride later this week. Everything looks pretty good too!

Going into this, I was so concerned about recovery and being debilitated, but it was not that bad at all. I was feeding within a week, blanketing within two weeks. The next big step will be throwing a saddle over, and after that, the fait accompli, closing the ramp on my trailer.

A horsie friend attributed the quick recovery to being around horses, and being used to getting knocked around. Probably true! I also have to give some credit to horse showing, and being used to going in and riding like a dummy and having to go back in and trying to save face! I think riding horses teaches us a lot about being knocked down, physcially and mentally, and getting back up!

DressageGeek "Ribbon Ho"
Jan. 19, 2010, 11:53 AM
So glad you are on the road to recovery!

selah
Jan. 19, 2010, 12:05 PM
I had not seen this thread before, but just wanted to add my $0.02!

I had a 2nd occurrance infiltrating ductal breast cancer 9 years after lumpectomy/chemo/radiation.
I did internet research, and decided bilateral mastectomy with DIEP flap was for me, especially as it can be done without taking muscle (just skin & fat) from the abdomen. The big hospital in Baltimore did not do a good job for me:no: So I was almost a year without breasts. Though I didn't think they were all that important to me...I found that my chest felt cold & caved-in, padded prostheses always rode up under my chin, and silicone prosthetics were heavy, uncomfortable, and expensive. Some insurance companies do not have to kick in for reconstruction if they have already paid for prosthetics. Oddly, I found myself dressing to cover up, not to accentuate me...started wearing my husbands old shirts, etc.
Anyway, I went to Cleveland Clinic, and they did a fabulous job with my bilateral DIEP flaps and nipple construction. My chest feels warm and comfortable...they look and feel like me! I am in my 50's and back in the saddle, and grateful to be here!
If I can say anything to help, please feel free to p.m.
Thanks OP for posting!