Hi girls.
I had a right side mastectomy last July, chemo, no rads. The mastectomy has left a really good scar, clean, the doctor salvaged as much skin as possible and some sub-cutaneous fat, so even today it looks like a "mini-breast", maybe a very small A size. no nipple of course.
On the other side, I am a DD. I am quite slim, so it is really breast tissue.
I am planning to do a second mastectomy - preventive - on the left side (should be lighter, as there is no node dissection), and at the same time, to have matching implants put in, under the muscle. The PS says that I could attain a size B without going through the expansion time, and that at a later step I could have nipples done and tattoed. I think I'd be perfectly happy with a size B...
Anybody managed a one-step procedure? in that case, are you happy with it?
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mradf Joined: Dec 2007 Posts: 120 |
Apr 14, 2008 06:20 pm
mradf wrote:
lilith, The only "one step" I can recall reading about was "femme" who posts on this website. Her experience was very bad and she had the implants removed recently. I don't know how her situation will compare to yours, however, so you may want to pm her. Good luck, Maria ALL WILL BE WELL. - Julian of Norwich
Dx 11/2007, DCIS, 4cm, Stage 0, Grade 3, 0/7 nodes, ER+/PR+ |
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caitb Joined: Jan 2008 Posts: 23 |
Apr 14, 2008 06:52 pm
caitb wrote:
I had a Becker implant which is both a tissue expander and an implant. I had very good luck with it and it was less painful than using an expander and then an implant. Had an implant on the right side the boost the shape. Lost the Becker due to a recurrence but up until then, it was perfect. Once you can accept the universe as being something expanding into an infinite nothing which is something, wearing stripes with plaid is easy. Albert Einstein
Dx 10/19/2006, ILC, 5cm, Stage IIIb, Grade 3, ER+/PR+, HER2+ |
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ehk Joined: Jan 2008 Posts: 65 |
Apr 14, 2008 06:57 pm
ehk wrote:
Not sure if this helps but had a girlfriend that did one step and ended up back in surgery 4 mos later. Apparently laying in bed and recuperating caused them to move so she ended up with them really far apart and under her arms. New ps had to go in and sew those pockets back up on the side to keep the implants in the right place. This was no shoddy job either- it was at MD Anderson in Houston, so it's worth asking your ps about. Dx 10/19/2007, ILC, 2cm, Stage II, Grade 2, 0/3 nodes, ER+/PR+, HER2- |
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femme Joined: Dec 2007 Posts: 168 |
Apr 14, 2008 08:06 pm
femme wrote:
Be very careful!! From my bad experience with an alloderm one step reconstruction, all I can advise is that you make sure your plastic surgeon is skilled in this procedure and has done many of them successfully. The last thing you want is someone who is flying by the seat of his/her pants with your body at stake. You can pm me if you want to know the gory details. Otherwise trust me, I had a pretty awful outcome and after a second surgery I now have no bumps on my road, so to speak.
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lilith Joined: Sep 2007 Posts: 191 |
Apr 15, 2008 12:05 pm
lilith wrote:
Hi Femme, and all, and thank you for your words of caution. :) I will ask questions to the PS to get as much info as I can. I fully trust the doctor. She is one of the best known PS in the swiss city where I live, comes recommended by all my medical team (who has been wonderful so far), and what she says makes sense. It wouldn't be a classic one-step implant surgery, in the sense that I actually have alread the space inside (they left the skin), and the doctor says that she has already seen similar cases, and that it is more and more frequent now that surgery spares skin. Also, she was in contact with my previous surgeon, and instructed her (also a woman... ;) ) on how to keep the skin, where to place the incision... so I really hope that it would be totally un-eventful. I am so glad that a second procedure took care of the problems.... what went wrong? I don't want the "gory details", but if you could tell me just a general idea of the issue, I could ask my doc... Ehk, thanks for sharing. I'll ask about the moving around concept... Dx 7/4/2007, IDC, 2cm, Stage II, 1/8 nodes, ER+/PR-, HER2+ |
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femme Joined: Dec 2007 Posts: 168 |
Apr 15, 2008 12:23 pm
femme wrote:
The Alloderm was used on the top and bottom of my implants, impeding circulation to my skin. This is not the usual protocol. It is usually just used on the bottom as an anchor. The overlying skin became necrotic within 48 hours as the mast left the skin. There wasn't enough blood flow.. The ps wanted me to keep the implants in for 10 to 12 weeks to see if they'd "take' and thus there were more complications, gangrene andanother ps removing it all necessitating a skin graft to close. It was thru this board that I got an alloderm referral for the doctor who literally wrote the book. I owe much to the generosity of this board. (I now wear falsies and am content to be alive through all this.
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mrsb Joined: Sep 2007 Posts: 90 |
Apr 15, 2008 12:39 pm
mrsb wrote:
I have one of the Beckers one step(i don't remember its number. It is silicone on the outside and saline on the inside. Once placed the PS filled it in the OR and then did one other fill and then disconnected the port after i had al ittle leak from the port. Mine is 18mths now. I love it so soft , I am able to massage my breast.. gone is the heavy rock on my chest. I hated the saline ones i had. My reason for going with this product in the begiining, actually I did my research and requested it. was because i have a history of infections with expanders and this was my last shot at it. My expander is placed in a pocket created by the Lat flap . I find my breasts look very natural and are a good match. Mrs b |
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3XNOTACHARM… Joined: Mar 2008 Posts: 21 |
Apr 15, 2008 03:59 pm
3XNOTACHARM wrote:
Hi there. I just thought I would add to the conversation but I only had my surgery 14 days ago. I had the Alloderm with a silicone implant on one breast only. I had both of my drains taken out last week and am doing good so far. It does feel very heavy on my chest but my surgeon said that is because he made it very tight and it will get better in the following months. It was a good feeling waking up and already having a breast in place of the one that was removed. I've been off the pain meds since last week and the only problem that I am having is sleeping at night. I can't seem to get in a comfortable position. The only position that seems to work is on my back and I usually sleep my side. I'm hoping that this will get better as time goes on and the healing process gets better. If anyone has any suggestions for me on how to get a good nights sleep without sleeping pills, I would appreciate hearing them. |
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petitepart Joined: Feb 2008 Posts: 2 |
Apr 15, 2008 06:38 pm
petitepart wrote:
Lilith, I have just seen this thread. Do I understand rightly that you are in Switzerland? I live there (although I am English) and Dec 2005 had a bilateral mastectomy (for DCIS on one side and prevention/aesthetic on the other) with immediate "onestep" implants. (No rads, chemo or other treatments.) The outer skin is the original breast skin and the implants are under the muscle. The breast surgeon did the mastectomy and the ps then took over for the recon, all in one operation. I had no problems with the op and am very pleased with the results. Nipples were lost so I got recon ones 9 months after the mastectomy. Here too I am fully satisfied. The plastic surgeon (a well known lady) was fantastic. I wonder if she is the one you are referring to - you don't mention which Swiss city! Hope my positive comments help: let me know if you would like more info! Regards, petitepart |
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Kathy_K Joined: Feb 2007 Posts: 631 |
Apr 15, 2008 11:03 pm
Kathy_K wrote:
There are two ways to to the one-step. One is to just insert the implant and stretch the muscle over it - hence the B size - and the other is to use a derma-matrix product to fill in the gap, whatever size it might be. It sounds like your PS is proposing the former. I had the one-step done on my left side in Sept. using the latter method and have had no problems with healing or anything else. Waking up from surgery knowing that there will likely be no more surgery is a great relief. Good luck! When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich
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lilith Joined: Sep 2007 Posts: 191 |
Apr 16, 2008 08:35 am
lilith wrote:
Hello Petitepart, I am in Lausanne. Not in touch with the association you speak of... also because I am actually a fluent french speaker, so probably my docs didn't think of giving me the contact.
Dx 7/4/2007, IDC, 2cm, Stage II, 1/8 nodes, ER+/PR-, HER2+ |
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petitepart Joined: Feb 2008 Posts: 2 |
Apr 16, 2008 08:57 am
petitepart wrote:
Hi Lilith, I am in Jongny s/Vevey. I am also fluent in French but found the ESCA brochure at the HUG in Geneva where Prof Brigitte Pittet was my ps and there was nothing in French! I just picked it up out of curiosity. I was fortunate to get in contact through ESCA with an American who had had exactly the same op as I had and she gave me lots of practical hints. I know La Source, one of my sisters-in-law trained there many moons ago. I had an MRI there before my Gva op and unfortunately had a very unsympa radiologist who was very scathing about my decision to have a bilat mast - in front of a whole lot of people in the waiting room!!!! On the good side, I had my needle biopsy there, too, and the expert and her assistants were super. Have you a date for the op? As I said, if I can help any way . . . . All the best petitepart |
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Carmelle Joined: Mar 2003 Posts: 1533 |
Apr 16, 2008 09:24 am
Carmelle wrote:
I had one step/no expansion. Under the muscle. yes I am a B. The initial time it was extemely painful and I ended up in hospital for a few days (went into shock). My PS had never done before and I am allergic to codeine so he left the nurse with some Ibuprofen for me. Not good.You need painkillers and muscle relaxants as that was the big thing they kept contracting like childbirth and I would scream. He also used the wrong profile implants so that they were very full on top and not so on the bottom. One was under my arm and one under collarbone. I since moved and had a new PS who is very experienced and caring about outcomes. She removed and replaced with Inamed 3 Round Profile /wide version(important as they are made for BC patients and give a nice natural shape, also they are round so that if it shifts then you cannot tell) This was a day switch and very little pain as it was managed. She felt in my case expansion would not really change outcome. They are excellent and "feel" natural on my body. I can wear what I want again and not dig for my prosthetics. My nipple stuff didn't work out as I had rads on right side. But I had them tattooed and also had a lovely woman.No bleeding, very little healing and they look normal. good luck to you. It is a long road and hard after all we have been through but for me I'm happy to have done as I can forget as much as possible, which is my goal. Michelle Dx 3/7/2003, IDC, 6cm+, Stage IIIa, Grade 2, 5/15 nodes, ER+/PR-, HER2- |
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Kerry1000 Joined: Feb 2006 Posts: 117 |
May 16, 2008 02:14 pm
Kerry1000 wrote:
Wow Michelle I'm so sorry for all of your troubles in receiving your implants. One should NEVER be in pain after surgery. It sounds like you got over it o.k. but you still received terrible treatment; I'm glad it worked out in the end. I fortunately had a much better experience, my one-step silicon implants worked out great. My ps used a small amount of Alloderm, although he won't do Alloderm anymore in a one-step though as many of his patients did become infected. I'm not sure what specific type of implant was used but my breasts look great and have a good amount of sensation so I'm very pleased with the result. They actually look better than my old, droopy nursed-out breasts! Also, I don't have to wear a bra any more unless I'm exercising (I'm a C cup). Lilith you said that you're having only implants only though, no Alloderm, and it sounds like you have a very experienced surgeon so you should be fine! You also shouldn't have any pain (or have very little pain) after the surgery as long as they give you decent drugs; I had self-regulated morphine (think it was that) for about twelve hours after surgery and then oral meds. after that and I was fine. Actually I was surprised how little pain I did feel and also that I only had to take the pain meds for a few days - I was very concerned about pain issues to begin with, but it turned our not to be a problem. Best of luck Lilith but you probably won't need it as it sounds like you have done lots of research and have very competent professionals looking after you. I'll be thinking of you... Kerry Dx 4/19/2006, IDC, <1cm, Stage IIa, Grade 3, 1/5 nodes, ER-/PR-, HER2+ |
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