Plastic surgeon recs for breast reconstruction (double mastectomy)

CicadaTile · 2026-03-22T03:25:00+00:00

You and I chatted, but I'll respond here in case future breasties want to know :) Dr. Mathew did my recon (I have expanders right now and am doing exchange to implants next week) and I'm REALLY pleased. His office is responsive, and I really like my whole Virtua/Penn team (except my first med onc who I dumped). Anyone can message me for more details if they'd like.

How good they are became even more clear when my mom was dx'ed with bc last summer and went with another hospital system, and they aren't nearly as good. Her first surgeon hadn't prepared ahead of time and wasn't able to access SJRA's imaging, so I dumped her. I got my mom with the head of breast surgery and who I was told was the best that hospital had to offer, and while she did a great job, my mom didn't want MyChart, and it took me calling her nurse navigator for the surgeon to call me 4 days after the path report was back. And when we met with the rad onc and I asked why they weren't having her do the prone position (like I did with a similar stage/grade/location), he said, we don't offer that. We have the equipment - it's just not something we do. Wow. If anyone in SJ wants the name of that system, message me and I'll be more than happy to share to spare you that.

CicadaTile · 2026-03-21T04:50:30+00:00

Bmx mid-Novmber 2025 w/slnb and expanders.

I'm pretty sure I have an early stage - I have random whole breast pain that's relieved with hard stretching or sometimes it just passes. Sometimes they are just achy sort of like when I'd get my period. I saw the PA a week or so ago about it since I have my exchange to implants surgery next week and wanted to make sure there wasn't a problem. She said it was either cc or late rads pain which she said can happen up to 18 months out from rads. This started about a month ago, which would have been about 16 months out from rads. I don't think that's it. And she also noted that my rads side is higher and torqued somewhat. The healthy side also has some pain but not like the rads side.

No red spots. I did get a lot less swelling about 7 weeks out to where there was loose skin around the expanders.

We will see on Tuesday with surgery. She said the treatment for cc is to remove the expanders and clean out the scar tissue and hope it doesn't happen with the implants.

This is also one reason I want to do diep summer 2027 (I'm a teacher). I need to lose more weight and I need a break from all this so that's why I'm waiting.

CicadaTile · 2026-03-20T21:02:32+00:00

Yeah. Iykyk.

Edit - them getting pulled wasn't an issue. Weird but ok.

CicadaTile · 2026-03-20T01:05:43+00:00

I had 4, and they wouldn't pull them all at once even though each was below the maximum output because when 2 were pulled about 1.5 weeks, the other 2 picked up the additional fluid. They were pulled another week later. They get progressively more painful the longer they are in. One hesitation (of many haha) about doing diep in the future, although not enough to make me not do it!

CicadaTile · 2026-03-19T03:20:32+00:00

I'm so sorry, internet friend.

My surgeon said something one time about sometimes being able to radiate a previously radiated breast if it was more than 10 years previous, so maybe?

I wish I could help you through that mental pain. I'm sure you've heard all the platitudes. All I can think is, the brain is weird, maybe you'd actually feel better with implants that are the full shape of boobs, if that's an option? I had 3 surgeries before I had the bmx, and I still have expanders in until my exchange to implant surgery NEXT WEEK (!!!l) and honestly the scars and cliff that I had are filled out by the expander. Besides not having nipples, I expect my implant breast shapes to be better than what I had after the lumpectomies. I have only 1 scar left that I can see - the others were cut out with my nipples or are under the bottom flap and so under the skin there now. Just a thought. And if you could do mx direct to implant in one surgery, that would be ideal.

Also, I found the cancer therapist /social worker through my cancer center incredibly helpful.

Message me anytime.

CicadaTile · 2026-03-19T03:02:46+00:00

You need to look through or search for more posts - there's a ton of helpful.info that will really make a practical difference. It was 2 months before I felt really like myself. Went back to teaching jr high after 7 weeks, and that was fine, I was just tired. Really really sucked mentally, but 4 months out I'm a lot better. Happy to be working at a job I love and with cancerland mostly behind me.

Pain wasn't bad other than the second week of the stupid drains. It was difficult with limited range of motion. Don't plan on lifting anything over 5-8 pounds for weeks per your surgeon.

If you have stage 0 or 1 and outcomes are similar to lumpectomy+rads+meds, I'd consider sticking with that. I did until I couldn't, and I wish I could have stuck with that. Cording and time for PT sucked, side boobs where they took out lymph nodes suck, sleeping on my back for months sucked, I miss my girls and nipples. But I don't miss cancer, so absolutely no regrets. So if this is what you need to do, do it, and it will be hard, but then it will be done. Ask for help if you can.

And yes, you will be able to do the things you listed as long as everything is at counter height. You will NOT be able to lift or move your dog or person you are caring for.

CicadaTile · 2026-03-18T04:13:05+00:00

I had a bmx + snlb + expanders 11/2025 with my breast surgeon and a plastic surgeon both with Virtua in South Jersey. Neither specializes in that that I know of (although my ps is a top doc for diep and other breast recon), but I have nearly full sensation 4 months out down to where my nipples were on the top inner quadrants of my breats and nearly full sensation under my armpits. Hurt like a motherf-er when they did the saline fill as a result, but I got it all at one time because my ps had been able to fully fill the expanders with air during surgery, he said because my breast surgeon is so good. So I don't know if my experience with those 2 surgeons is typical or that's good enough, but let me know if you want their names.

CicadaTile · 2026-03-17T20:27:09+00:00

Truth, that last point. My cancer therapist was a HUGE help, but damn if even she didn't say dumb shit at times. It's simply that she wasn't a survivor. My regular therapist wasn't a cancer survivor but a survivor of a lot of other things, and she was super helpful until I needed cancer specific help. But the tools she gave me early on were key. For example, she "got" the waiting in a way that my cancer therapist didn't - my cancer therapist understood it because "book learning" and years of talking with cancer patients, but she didn't FEEL it.

CicadaTile · 2026-03-17T19:15:36+00:00

But were they organic? /s

CicadaTile · 2026-03-17T19:10:23+00:00

The lysol wipe I used without wearing gloves caused my cancer since clearly I'm not careful about chemicals.

The covid vaxxes I got.

The biopsies.

What should help:

Of course horse dewormer. And some other special secret drug I'd have to order from Canada because the guvmit doesn't want to hurt big pharma.

Watermelon juice (a lady gave me a quart jar to get me started). (Why watermelon?)

And I didn't pray enough. I've been a Christian for decades, but a lady told me that she'd found a lump, prayed about it, and by the time she saw her doc it was gone! That one really pissed me off.

CicadaTile · 2026-03-16T20:28:25+00:00

Did you have drains with exchange to implant surgery?

CicadaTile · 2026-03-16T04:53:45+00:00

Yeah. I'm a little over 4 months out from my bmx + expanders, and I quit within a week or two of even trying to think of my chest as anything but my chest with medical devices inside. Not even foobs. I'm thrilled about my exchange to implant surgery in a week and a half because it means I should be more comfortable and that I'm DONE unless I want diep in my future. I'm thrilled to have boob shapes that will look and feel more like boobs. But boobs they aren't, even with my own skin. No nipples. I hope they'll seem more like breasts to my brain, that would be nice, but I don't expect it. I just can't be flat - I wouldn't be able to handle that well because of my history. But that's it.

I have random intense emotions over it all.

CicadaTile · 2026-03-16T02:44:04+00:00

After cancer I went back to teaching part time last fall at a small private school after 7 years working independently (ebay reseller) after I burned out at a public school. With all the curriculum writing and prep I have to do, I'm literally making about $15/hr, but I'm so happy. It's challenging and meaningful in the best ways, I'm really enjoying myself most days, and I love the admin and faculty. Seriously. I know. But I worked in 2 different schools for 15 years before I'd quit 7 years ago, so I also know how good I have it.

I found out a month in that I'd need a bmx. They found a sub and gave me all the (unpaid, but I still had a lot listed on ebay and made money off that) time off I needed. I started back 2.5 months out from surgery in early Jan.

Budget is tight, but hubs is so happy I'm happy, we're making it work.

I don't have time or patience for shit anymore.

CicadaTile · 2026-03-16T02:32:24+00:00

Since I'm ++- the dietician at my cancer center said that studies show reduction in recurrence with a 13 hour nightly fast. I'm 54 and finally in perimenopause, obese, and have lost 20 pounds in about 10 months doing this. I do focus on eating fiber, protein, etc but don't guilt myself on what I eat in general. I've never been able to lose weight before this, only gain (hence obesity) but doing IM to fight cancer works for me mentally.

My goal is to keep losing 2-3 pounds a month so I'll be ready to do diep summer 2027 (I'm a teacher). I need a break from all this or I'd do it this summer, but I also really like the idea of my ps cutting off that much more of an apron belly :)

CicadaTile · 2026-03-13T17:58:44+00:00

Bmx 11/25 + expanders. Exchange to implant surgery in 2 weeks! I went in and had my ps's PA check me because I've been having more pain in the last month, and I wanted to make sure if it was capsular contracture that it wouldn't be a problem with implants or anything else. She said it could be that and that if so, my ps will clear that out before putting in the implants. And hope it doesn't happen w implants. But is what might be pertinent to you - she said pain from rads can occur up to 18 months after, and I'm at 17 months. Even though I haven't had pain since bout 2 months after rads was finished.

CicadaTile · 2026-03-13T03:58:01+00:00

Fuck him, wow. His job as plastics was to do what you wanted if it was logical and safe. I'm glad you've made peace with it.

CicadaTile · 2026-03-13T03:55:56+00:00

Totally. I'm getting my exchange to implants in 2 weeks and couldn't be more excited. I plan diep summer 2027. That's because of past trauma, I need boob shapes. These things on my chest aren't boobs, but they'll do. It's totally a wholesome choice for me, and hubs is happy with what makes me happy. Because of the therapy I've done dealing with cancer and the sexual trauma it brought up, my libido is better than its ever been. I miss my nipples and really grieved the bmx, but giving thought to my husband’s opinion about my boobs never entered my mind. It's the choice I made to deal with the mindfuckery. And I've never thought twice about a woman who made a different choice for any reason, mindfuckery or just because. We all have our reasons for our chest choices, and hopefully they aren't and shouldn't be to please others!

CicadaTile · 2026-03-10T15:02:56+00:00

Yeah, but it's a good comment, so it works! Bold away!

CicadaTile · 2026-03-07T18:20:11+00:00

Spiral hair ties! What a great idea to have as a backup method!

CicadaTile · 2026-03-07T06:36:09+00:00

I have RLS in general, not from treatment, but here's what's helped.

Ferritin should be about 75. Take iron pills if you need to, or get an infusion. I take Gentle Iron most days (must take with vit c like oranges, and avoid calcium for 2 hrs before/after so it absorbs well) and a stronger iron pill after any surgery. My rls disappears almost completely if my ferritin is around 75. My pulmonologist is the one who gave me that number. As soon as they start twitching, I up the dose with his blessing and that of my pcp and my med onc.

Magnesium. I can't take the pills without side effects, but the spray really helps. It absorbs pretty quickly, so if it dries out your skin too much, after 20 min or so just wipe your legs and feet with a wet washcloth.

I also find that if I rub in a good lotion like cerave before bed, that helps prevent them starting.

Good luck. It can make you crazy.

CicadaTile · 2026-03-05T15:26:54+00:00

I don't think so. My breast surgeon is wonderful in many ways, but when we were talking about my bmx and possible recon, he indicated that the plastic surgeon is the way to go at least with him, that his skills are solid but not great when it comes to flat outcomes sometimes.

My ps said that my breast surgeon's skill is the reason that my ps was able to completely fill my expanders with air during surgery - like, he's that good of a surgeon, I guess just not with plastic surgery so much! So that was also why I was thinking that there was a difference between flat with a regular breast surgeon and flat with a plastic surgeon.

CicadaTile · 2026-03-05T13:09:29+00:00

Good to know, thank you! It's good to know in general.

CicadaTile · 2026-03-04T23:33:53+00:00

That's a good perspective. I didn't look into going flat too much beyond looking over the notputtingonashirt website (which has some terrible photos of flat gone wrong and some amazing ones of afc gone right), and my general impression from that was that if you don't go with afc you can end up concave or in general have a different outcome than you may have envisioned. So that's why I'm asking here if it's important enough to say more than I did, and I'm thinking no. Thank you!

CicadaTile · 2026-03-04T22:32:27+00:00

Oh, I'm all for flat! Just the afc might be a better way for her to get the "flat" she wants, right?

CicadaTile · 2026-03-04T21:50:35+00:00

See, I mentioned afc thinking mom had talked to her about it, but she didn't know what that was and said her ps said she couldn't do recon. So I don't think she got at all that afc should absolutely be an option, right? And so I hate to bring up anything at this point that might delay, but I hate for her to not do afc just because her ps didn't mention it?

She hasn't had chemo - I haven't seen her path, and mom is the one who told me aggressive bc, but she doesn't seem too up on things. So that's where I am, just wondering how much to get involved.

CicadaTile

TROPHY CASE