NOLA in September?
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hi cider8, 39 yrs old is a young age to be diagnosed with BC, but, with an option for skin sparing Bi-Mas, really sounds like the way to go, everything taken care of at one time. I was first diagnosed with BC in 1991, and at that time, they did a total auxillary disection and lumptectomy with 6 months of chem and 25 treatment of 'whole radiation'. In 2007 I was once again diagnosed with BC, this time docs strongly recommended mastectomy. I was so consumed with a second diagnosis, I mainly focused on that. Glad you have no regrets girl, and hoping your supplemental flap surgery does well for you honey. Will they be using your buttocks for that? Good luck and happy healing.
harmonysun,did you have to fly back to N.O for the 1b surgery the next day or did you address the problem in your hometown or not? Was the problem addressed then? Did you have delayed Recon from one hip to both breasts? Wishing you fast healing.
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Thanks for link to meditations. Dr. Massey gave me the ok for melatonin. Sounds like this was normal for a lot of you.
Brenda, thanks for sharing your experience. Although scary it still helps to be prepared the airport thing scares me a little. No one needs this at 1 week out. When they yelled at you was it in private?? Praying for healing for you and everyone who needs it.
I am leaving for son's rehearsal and dinner in 2 hours. Except for my husband, no one knows about my lack of sleep. I will have a cup of coffee to help me through the evening. It is nice to talk to people who understand.0 -
cherrie....dont worry....the airport will be fine...i just wouldnt let them touch me...and if i knew it was as simple as asking to go in a private room, it would have been fine but they werent good at communicating that at first....so you are able to ask for that if necessary...
.....it is so normal to feel the anxiety before.....weve all been there.....youll do great....go enjoy your son's dinner and wedding........just focus on this weekend with your family and enjoy...push away other thoughts....live in the moment!....:)))
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LAstar....thanks for reply...thanks for your help...do you know when you are going to get your drains out?.i hope you do soon.......dr massey says by 8 weeks they come out but i'm hoping a few days earlier so i can go to a concert and dress fun and summery and enjoy the first real night out.........yeah what a ride is right...lol...glad i get a lil chance to regroup here before i find out what the next ride is....talked to dr massey today....she was thinking from the picture that the breast looked like it had gotten smaller and then mentioned something about that sometimes they liquify and are absorbed by the body....kind of freaked me out...i know that has happened to a couple people here, but thought it is a bit unusual...anyways...told her this flap is still pretty firm but softening a bit around the edges and across the center....which is what i thought we were hoping for?....i could keep stressing about it....and constantly feeling it, trying to evaluate....but i guess at this point whatever is going to happen is going to happen.....i am very happy i will be able to see her in chicago in sept before my oct date so we can figure out what is what...
...so you have one breast that is harder?..i l have a little bruising on my harder breast also....is the other breast pretty soft?....my other breast is already soft and just like a breast....no numbness or weird sensations....they do feel heavier when i wake up but otherwise totally normal.....havent worn a bra at all except when i am walking or in the car....
.....so um yeah, sex....anyone care to venture any thoughts opinions or experiences bout this?.....like when do you feel comfortable that nothing is going to get broken?....lol....but seriously....would like any input....:))))
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naturegirl...thanks for your good wishes....no, i went back into surgery the next day.....so we are seeing how the flap does so when i go in oct we will either have to address that issue...or hopefully just fix things up....
....i had both hips for both breasts....without specifying a size, i wanted as big as she could get them....and without a lot to work with, she did great with that....i
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Harmonysun -You are planning stage 2 w/ Dr. Massey in Chicago? Have you done anything with insurance yet? I heard the facility they use has a high pre surgical fee that isn't always covered by insurance. Anyone know anything about that? Heard it could be cheaper to fly to NOLA, although I'd rather not.
For those who've had stage two-did you have one breast smaller than other that was successfully enlarged with fat grafting?0 -
no i'm just meeting with her in person so she can let me know if i will be having to get a diep....(curses)....or stage 2......nola end of october....:))
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....now looking again....even tho i'm trying not to obsess over it....if the flap is disolving...would it still have firmness?....does look a lil smaller...scar looks a lil droopy like not pulled as tight...but flap still has defined edges.........sigh.....
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Lastar... I had my drains for 8.5 weeks.... Ugh
Harmony... I have had firmness on the left since the beginning... Doctor D tried to work on it in November during stage II, but it is still firm... And the left side is definitely smaller than the right... So I am seeing him in October to discuss... And surgery for stage IIb in January. I have already used hips and DIEP, so I am curious what the solution will be.0 -
Question - in reading some responses here, I get the sense DIEP is worse than TRAM BC surgery, due to more complications. I thought DIEP was the lessor of problems and that TRAM BC carried more risks. Input please? Sounds like, by y'all, having delayed DIEP does not present as nice as breasts as nipple/skin sparing mastectomy at the same time as having DIEP/TRAM.
bdavis, I hope your problems get resolved to your liking in January. Are the BRecon. breasts supposed to be firm or soft eventually after the surgery?
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TRAM involves messing with muscles while DIEP does not so in my opinion TRAM is more invasive and "worse". DIEP is moving fat tissue.
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Naturegirl2 - I haven't been on here lately, and I suppose it's in part because I haven't had any complications, though I still read the posts almost every day simply because I feel so connected to this process and the women who have chosen and experienced the same thing.
I had the DIEP and had absolutely no complications. My drains were out within two weeks, I had virtually no pain (all but for that difficult third week - which I believe is just part of the healing process). My breasts are soft - my husband felt them (really felt them!) for the first time a couple of weeks ago and he gasped at how "real" they felt. He said they felt exactly like they used to. That made my heart sing.
My mom had the TRAM flap eight years and had a much more difficult recovery then I did due to the abdominal muscle that they take in the TRAM. Of course she is fine now, but I think it was several months before she could use her an muscles comfortably.
I had my BMX and immediate DIEP on May 30, so I think that's about 10 weeks ago. My breasts are a little smaller then they were, but they are perky and Dr. D. said he can get them to my natural size through fat grafting at stage two. I also had nipple-sparing, and my nipples need a little work. It's almost as if they need a little plumping up from underneath. I am looking forward to stage two - knowing how incredible these doctors are, I can't wait to see what they recommend and accomplish at this last stage.
Harmonysun, I have never heard that a flap can dissolve and be absorbed by the body - oh my goodness! I am sure this must be very rare. So great that you get to have a consult with Dr. M before your next procedures.
Love and hugs to all you amazing women!!!0 -
HarmonySun, my remaining hip drain is supposed to come out at 8 weeks too. Hard to imagine when it's still putting out 40 to 60 CC/day. I don't care -- I want it out! I'm shopping for compression briefs. Yes, my harder one is the cancer side and has the slight bruised look that is slowly fading now at almost 8 weeks. The other side is softer but still pretty firm inside. My local BS thought it was just normal variation -- they are not going to soften at the same rate. My NOLA nurse thought it all sounds normal and said, "Don't worry." I'm heeding her advice! I'm glad no one said the word "liquify" to me though -- dang! I can't believe you can go without a bra! I measured recently and was a 32H!!!! I told Dr. D that I wanted to go from F to C, and he said we worry about that at Stage 2 and now he is just concerned about moving the tissue and making sure it survives. These gals are heavy and even sleeping without a bra makes me sore. I am looking forward to no more side boob!
Cherrie, I hope you are having a great time this weekend and able to focus on the wonderful people in your life! Don't let BC take this away from you too! It's great to give your mind a break from it all, even if it's just for 10 minutes at a time.
Betsy, I hope Dr. D can do his magic on you with no more donations from your body!
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Sometimes firmness is fat necrosis. Sometimes fat necrosis dissoves (it's called liquefactive necrosis) and sometimes it doesn't. Sometimes firmness is just firm tissue, not necrosis at all.
Sometimes doctors don't know what it is until they examine you, and sometimes they don't know until they do imaging, or open you up again.
You really just have to trust that whatever's going on your PS will address. If he/she says they can address it, just trust.
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I had stacked DEIP GAP (4 flaps, 2 on each side) and had no complications either. None, smooth sailing.
I refused anything muscle. I am active and didn't want to be compromised in belly (Tram) or even the lat in the back.
It's a personal journey. But I must admit, I sort of cringe thinking about TRAM when DIEP is an option. It does take a lot less skill though, no microsurgery is involved, but you do sacrifice a muscle.
i have also had a friend look into the BRAVA method of fat grafting in Miami. That would likely be on another thread in here somewhere, FYI.
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I am popping in.
I am another DIEP person who didn't have any complications and have soft breasts. Stage 1 was in May 2011 and stage 2 was in November 2011.
I have one of the restored t-shirts and it is true.......I was.
After me two of my friends had recostruction also. One is totally done and the other still needs stage 2. They didn't have complications either.
Healing thoughts to all.0 -
Naturegirl... TRAM flap - like these other ladies have said - involves the use of abdominal muscle - your rectus abdominis to be exact. This muscle is part of your "core" and it serves multi purposes. Most frequently we think of abs as the muscles that we use for sitting up - true, and necessary, but they also serve to maintain your trunk in an upright position while you move and or lift with your arms and legs, they are necessary for posture, they are accessary muscles for breathing, and they help to maintain your internal organs (keeping them internal!). Unlike TRAM, DIEP does NOT sacrifice these muscles. They are "tweezed" through to reach the necessary blood supply required to transfer with the flap to provide oxygen and other nutrients to the flap. Once the flap is established, your body does an amazing job of making more new vessel pathways to maintain the flap. And yes, unlike TRAM, a sound knowledge and proficiency of microsurgery is necessary. Although there are many women that are happy with their TRAM flaps, it is important to remember that with a TRAM there is higher risk of absominal hernia, weakness and pain since the muscles are cut. I was offered TRAM and adamantly refused. I have two young children, I ski, I cycle, I run... I also have a degree in Physical Therapy and there was absolutely no way in H*ll I was going to let anyone take muscle from anywhere to make me a breast. In the end, TRAM and DIEP were not really an option for me since I did not have enough belly fat, but I made it clear to the insurance company when they were pushing TRAM that I had enough working knowledge to know that that was not the best option for me... And as far as I am concerned, for most. You will find women that have had "free" TRAM that have very good outcomes and so far no incidence of hernia. I believe that, as with any surgery, finding the best surgeon to do the particular surgery you want is vital. The local doc here excels at implants. And I mean excels. If they had not failed for me and I had wanted to try that route again, I would have used him. He does DIEP and SGAP too, but he does not do them frequently and does not excel at them - so there was no way I was going to use him for that. I felt like I had one shot left to get it right, so went where I felt I had the best chance at a successful outcome and that was to Dr. S. And I am grateful for him every single day. If you don't hear a lot of success stories on here right now it is because so many ladies over the years have come and gone, moving forward and are extremely hapy with their reconstruction. It is natural for people to seek out help and words of advice when we are having issues... And natural to move away from the boards when we start feeling better. I stick around because I want to help in the same way that a couple of really awesome ladies helped me... But I am definitely not as active on here as I used to be. And since I am still fighting for lymphedema surgery, my travels are not quite over. The thing is, you will find women that have had good and bad experiences with ALL the types of reconstruction available, but finding objective (rather than subjective) information regarding risks and complications is vital in the search for reconstruction. Anyway, I think I remember you saying you had opted not to have surgery to reconstruct? If so, that is okay too! As with everything in this journey, you have to do what is best for YOU. Anyway, just thought I would add my 2cents! Take care!
Harmony sun, I had one breast that was fairly firm, but after about 6 months it softened up all on its own... But I did have 7 months between stages 1 & 2. Hang in there!0 -
thank you brenda for the info on the firmness/necrosis.....and thank you to all that are commenting about having dieps that are complication free...that is so impt for me to hear, as i am afraid that is where i am heading.....this breast is def getting smaller....i was totally against diep as i am very into fitness and lift weights and need a strong core...dont want to lose any of that.....so anything good anyone has to say about it, i really need it...feeiing really down and sad about this.....thank you...
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Harmony Sun... I believe there have been a couple ladies over the years that had an additional "baby" flap to supplement a flap that had gotten smaller. I don't remember anyone having a negative outcome from it. If they do DIEP, once you are healed, you should not have any limitations with your abdominals. They do not cut them, just tweeze through them. Of course you will have normal down time post surgically, but that should be it! Ask Spring, Betsy, Soccer Mom, Minnesota and Mom's daughter - all have had diep or stacked diep, had their surgeries a while ago and to my knowledge they all are doing great! Big hugs your way. ((((()))))
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Hi Harmonysun, I'm kind of where you may be down the road. I had S-Gap flaps done in March. I had a bony defect on my right side so the breast presented much smaller. I had a Diep flap added about eight weeks ago. I only had a small amount of stomach but it made all the difference. I certainly understand how you are feeling. I wanted to be textbook......Stage 1 then 2 then nipples and done. It just hasn't gone exactly as planned. I'm healing well and resuming normal life. My Stage 2 is scheduled in October. Hang in there. Happy to answer anything I can. Hugs, Jamie
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Anyone who used Dr. Massey......I need her name and contact info. I have a friend with a serious lymphedma problem.
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Bettye--- Hi! It is nice to see you on here! I hope you are feeling well. Here is a link to Dr. M's website, specifically her office locations with phone numbers.
http://drmarga.com/office-locations.html
Good luck to your friend.0 -
Ladies, I have developed a seroma(abdominal) at 5.5 weeks. I noticed a small amount of serous fluid leaking at the bottom of a 1 inch scab left on incision. Dr. M. wants me to start wound care this week and tackle this thing while it is still very small. I want to get some compression panties or a short girdle. I know the Marena has been mentioned many times on here but I didn't know which one's were the comfy favorites! I don't need something big like the big black monster they give you for your stage II. I just need a pantie type style or as close to that as I can find. I tried to pull up the link that Spring posted at the bottom of the scheduled surgeries at the top of this page but it says "not available". I plan to order today if I can and have it over nighted. So, if you have suggestions or experience with any style, please let me know!!!
I hope everyone is healing well!! Thanks!!!! katiejane
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Thanks Nordy,
I am doing better than most do with multiple mets. Just waiting on the cure. It will come, I just hope I am here to make history.
Thanks for the info. I am passing it along to my friend.0 -
Had a good weekend. My mom remarried and we celebrated her special day with some great weather here in Wisconsin. Sunny and 75 degrees.
My mind seems to be focusing on surgery as the days grow closer- even over this weekend. Trying to keep myself busy and can tell my husband is focused on keeping things that way for me as well.
Liz from the Center called last Thursday with some more details about the surgery. My husband would like to book our flights shortly and she mentioned a Katie would be calling to discuss travel arrangements. I wasn't sure what she assisted with. Is that more with lodging? Since patients are flying from around the country I thought the flight arrangements would be managed on our end- we book our own flights. Curious what others experiences were. I read about others requesting special seating arrangements on the flights but I didn't know if they requested that or the Center was involved.
Thanks- Kerry
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You handle your own flights and lodging outside of the hospital stay, then give Katie all of the information and she arranges the car service and creates an itinerary. I chose to fly back with Southwest because they are so flexible with changes (pay the difference in fares but no penalty). I could also use early boarding with a wheelchair and was able to sit right up front.
It's so hard to keep your mind off things, but try to enjoy your able-bodied time before recovery time! With the meds, the pain is not so bad -- it's the boredom from sitting around all the time! I read books, watched some movies I'd been meaning to see, and caught up on phone calls while recovering but I really wanted to wrestle around with my 4-year old, do the dishes, & get some good sweaty exercise. You might want to have a lot of sex now too.
You're having bilateral hip-flaps with Dr. D like I had. He took great care of me and I woke up with beautiful (although large) breasts. All of the docs who have seen me since have been so impressed with the shape and symmetry of my breasts, and it's only Stage 1. You are in great hands!! 0 -
Hi everyone. Reconstruction has been a long process for me since my mastectomy and initial (failed) attempts with tissue expanders in February 2011. Five surgeries later, I have great breasts thanks to the skilled doctors in NOLA and a SGAP. I'm headed down the final stretch of reconstruction and looking for some advice from anyone who has had fat necrosis after stage II that required additional fat grafting and/or flap rotation.
After my stage II surgery, I developed a fat necrosis the size of a walnut directly above the area where rib was removed to allow the mammary artery to feed blood to the flap. Seven months later, the necrosis has dissolved and now I have an indentation where the rib was removed and where the fat grafting failed. Unfortunately, it is near the sternum so my cleavage looks strange on one side. Any movement of my pectoral muscles reveals the deformity.
I have spoken with Dr. S as well as local doctors who have experience with free flap reconstruction. I am getting conflicting information and recommendations. One recommendation is to insert alloderm or mesh to cover the rib opening. This isn't an option for me since I rejected alloderm and tissue expanders three times before undergoing SGAP in NOLA. Another doctors reccommends leaving things alone. He was quite impressed with my results even with the pectoral issue (definitely a testament to the skills of Dr. S). I was also told that the only way to fully correct the problem is to incorporate alloderm or mesh. Fat grafting alone, according to 2 doctors in the Los Angeles area, will not fix the problem.
Dr. S recommends rotating the flap and another round of fat grafting. After sharing this with the other doctors, I'm a little wigged out because both thought this would throw off breast symmetry if the flap was moved medially. I love the outer curves of my breasts and very happy with the symmetry. I'm not thrilled about having another incision and drains if I go forward with the flap rotation but my greatest fear is losing the symmetry.
Please reply if you have had a issues with concavity and how it was addressed (including leaving it alone) or if you had a flap rotation and/or any complications from a rotation. I would greatly appreciate any insights that might calm my fears and help with deciding how to proceed.
Thanks!!!!
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Buena, I can't remember anyone here having exactly this issue. I had a bit of necrosis in the same area. Dr. D blasted it with some water to reduce it. It's still there. Never went concave.
Why would fat grafting not work? It's too big a dent?
And are you sure you rejected alloderm, and not the implants?
KerryA - I added your DEC 20th Stage 2 date. Already into December!!!
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Hi Springtime,
I am not positive fat grafting will not work but the deformity is fairly large and the plastic surgeons I consulted with were strong in their conviction that I needed something more than fat grafting. I can live with a little imperfection but need to add some curves to balance my cleavage so fat grafting might be enough. With regards to the alloderm and implants, again, hard to know for sure whether my initial rejection was alloderm or implant. After the struggles from my first surgery, my doctor replaced the implants without alloderm and my body rejected. Bottom line...I am not in favor of leaving anything foreign in my body. I'm embracing the idea of another round of fat grafting but needing to weigh the merits and understand the risks associated with a flap rotation.
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Buena-- has anyone suggested the TDAP as a supplemental flap? http://drmarga.com/TDAP.html0
