NOLA in September?
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Ok yippee I am tentatively set for stage 2 in NOLA for Dec 14 : ). Thanks for all the posts and glad to hear everyone is doing pretty well all things considered!
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Ok yippee I am tentatively set for stage 2 in NOLA for Dec 14 : ). Thanks for all the posts and glad to hear everyone is doing pretty well all things considered!
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Jacee~
Thanks for providing a perfectly clear explanation on adding extra flaps from Dr. Massey.
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Thanks Jacee. That was a very clear discription.
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LesleyAnne - I added your stage 2 Dec date.
Betsy, I added Cheryl's date too per your PM.
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Spring you are awesome just in case no one has mentioned it or thanked you lately!!!
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Surgery went well today. Dr S used the rotational flap from under the armpit area. I think it will be nice to have a smoother side and my recovery will be easier than a baby hip flap. I haven't seen anything yet. I did wake up in just a waist binder, not a girdle. I did not have any lipo on my thighs (he said they looked good and I don't mind leaving well enough alone). I'm sure he would have lipod the thighs if i asked. I was marked up for a lot of lipo on my hips, flanks, back and belly. My Stage 2 results were so nice so I am looking forward to these results.
I did have my left breast lifted just a bit more to try to get better symmetry. I has some fat graphted on the left around the rib resection. I think these babies are going to be perky! My right nipple was reduced, but my husband thinks Dr S said the placement was off. I've got the two nipple guards again. I can't wait to hear what he has to say tomorrow.
Jacee, thanks for posting that detailed explanation.0 -
PinkHeart -- thanks for the links for hyperbaric (HBOT). I still haven't decided whether to go through with it since it looks like the abdominal wound may be healing just with the debridement and ointments -- slowly, but the wound care doc didn't promise any faster with HBOT. It helps to have more info, of course, and I'll be asking more questions if/when the doctor returns my call from yesterday.
Lesleyanne -- I'm concerned about the confined space in the chamber too, and fatigue as a side effect (to stack on top of the fatigue I already have). I understand about your implant attempt -- I had a failed TE followed by radiation on that side and was told I shouldn't try it again because the skin wouldn't tolerate it. Good to see you on the stage 2 schedule for December, although I think you'll be gone before my stage 2 the next week.
gmp300 -- I'm glad the wound vac is working for you. If I turn down hyperbaric, I wonder if wound vac will be suggested. Then I would call Dr. S to see what he thinks. In fact, I have already asked the nurse what he thinks about HBOT, but they are busy catching up after Isaac, so I'm not bothering them at the moment. Dr. S probably would rather just close the wound surgically, but I'd have trouble getting back to NOLA now that DH, my caregiver, is back at work.
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Cider8, so glad things went well for you! How do you know when the fat grafting has been successful?
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Florafarm, I don't really know the answer. I'm inclined to think if volume doesn't go away, then it's successful. I don't know what the time period is for it to take. Another topic to add to my list of questions!
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Ann
The other thing with HBOT is that is is cumulative so you do not see and feel results right away takes about a month....
I have great insurance but miffed right now because I had a co-pay for all 38 treatments that they never collected and now I have a 1400 bill they want me to pay....
So just some things to think about ....
Lesley0 -
I have joined the ranks of the "appealing" now that my insurance company (Providence) informed me that they will not cover fat transfers and injections. I spoke with someone at the Center who encouraged me to not worry because they will appeal on my behalf and will work with me if the appeal fails. With less than a month until Stage 2 and airlines tickets already purchased, I will try not to worry and just focus on getting through the reconstruction.
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Lesleyanne -- When you say you don't see HBOT results for about a month, do you mean you don't see signs of healing in the wound for that long? Ouch on your copays. I should be OK if I get treatment done this calendar year. It's just the out-of-network charges from DIEP that we're trying to sort out.
LAstar -- I anticipate I'll have those issues with insurance after my stage 2. It's good to know the Center will appeal on your behalf!
Is it unusual to have any healing issues after stage 2? Does the lipo and fat grafting and scar revision go smoothly? I don't want to revisit wound healing problems and infections going into the new insurance year (or ever, for that matter - ha).
My stage 1 results are a little small and asymmetrical. I'd be satisfied to end up as a full B, but it looks like I'm getting smaller than that already, less than 2 months out of DIEP. So...I'd like a little fat grafting as needed for sizing and to even things out, but is that risky as some of the fat absorbs and we can't predict how it will end up? And if there is fat necrosis, will it resolve over time or need a 2B to try again?
Also, is less lipo better? Did any of you who had it get saggy skin from more lipo or does the skin eventually adjust? I'm thinking about these stage 2 things too, even though I'm not healed from stage 1. I drive DH a little crazy pondering this out loud.
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Thanks, AnnAlive. I have those same questions...: What happens to the areas where lipo occured? Does your skin appear saggy? Do you have any loss of sensation? Do you notice, say, more fat deposits near your ankles if you lipo your knees? Where does the fat go if it is reabsorbed?
More questions: How did you like your breast lifts? Do you think the extra recovery was worth it? Are the scars around the areolas fading well?
I am tentatively scheduled for stage 2 Nov 2, but still have not received pre-auth from my insurance. Thanks everyone! Peace, Tamara
p.s. Cherrie, I pm'd you with my contact info in case you want to discuss the body lift procedure.
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Paula.. Glad to hear you had a successful surgery. As you know I may have the same. So... how did he even out the other armpit?? Did he cut out the fat and chuck it?? And where is the scar? I am thinking that may be the best solution for me.
As for lipo, I had a fair amount and my skin was taut from the get go. I assume that while he had my butt incision open, he just pulled it tight and removed skin... my guess as I was asleep and never asked.
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How do our Center docs do liposuction? Is it with a needle or are there little incisions and other instruments used? Are there sutures after it? Is the fat grafting from lipo injected with a big needle or, again, is an incision made? Then do you have little wounds wherever fat is drawn out and injected? Lots of bruising? Jane123 and I (and others, I'm sure) want a Lipo & Fat Grafting course!
But just about the way the Center does it.How about the scar revisions? Is each scar opened completely in a very shallow way to make it neater, but less traumatic for healing than the first time around?
OK, make that course Stage 2 for Dummies.
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Cider8 -- Welcome back from the other side of surgery. What is a rotational flap? A lat flap from the back? I have a really messed up armpit from axillary lymph node dissection plus radiation. Part of it was taken care of with the DIEP flap, but it's still kind of a sunken, wrinkly mess, waiting for stage 2. I don't know if fat grafting would be enough for it.
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Ann... I believe they use a cannula to do fat grafting, and if there is necrosis, they use the same cannula and jet water at the necrosis to break it up. My lipo sites had small incisions that had stitches (had a total of 4 incisions).. some of the lipo I think was done through an open incision during revision. I am unsure how they get the fat into the breast. I didn't see any evidence.
About scar revision, they just neaten up the scar line... My incisions are post 10 months now and have to say they are almost invisable. I believe that when Dr D revised my butt incision, he reopened the incision, did the butt lift, lipo'd the love handles and outer thigh and then removed any extra skin and stitched me back up... My guess that that is what he did. I never asked.
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Ann
The HBOT is a cumulative effect and depending on rhe condition and circumstance you may not seenamy visible improvements of much consequence until 30 days but I am not a Dr or expert I am just going by what I was told0 -
Hi, Regarding HBOT: At my consult my doc told be the "ideal" protcol would be to have 20 sessions before surgery and then 10 sessions immediately following surgery. He did also say of course it depended on the patient and what the reason for HBOT therapy is being used for. There have been lots of studies, but none exactly that fit my circumstances, so this is his best advice. I have not had any wound healing problems but have delayed radiation tissue damage. He showed me a chart with a bell curve showing 20 visits minimum to be effective and then anything over 30 did not seem to make any difference. He also added that if I did not appear to have any healing issues after my Stage 2, then the 10 sessions afterwards could probably be skipped, he would leave this decision up to Dr Kline at the time of my surgery.
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AnnAlive, the rotational flap is a variation on a latissmus flap. I'm pretty sure when our docs refer to a latissmus it does not include muscle. This rotational flap is located on the side of the breast under the armpit. My incision for the rotational flap just extends from my inframammory fold incision. It's called a rotational flap because the flap is not fully removed; the vessel stays attached and the fat is just rotated around into place. It seems to be a good baby flap. I only got to peek at my incisions once, when I took my shower. The nipple guards are obstructing my view.
Betsy, I would not be surprised if you end up with a rotational flap. Oh, I did not have a baby flap removed from the other side. I think he just lipo'd the heck out of me. Time will tell how i even out. I have a little 1 stitch incision on my good breast where I had more fat injected for contouring. The fat injected area is bruised like crazy.
I do think healing issues after Stage 2 is unusual. I think sometimes the first Stage 2 does not totally fix issues that develop from Stage 1 or previous failures. So many sail on after only one Stage 2.0 -
Need2New had small incisions in her breasts where the lipo fat was transferred and the scars were disappearing nicely. Are you out there Need2?
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hi all!....drains out 2 weeks now..after almost 8 weeks...been keeping compression always.........how to tell when/if needs aspiration?........my shark bite is gone and buns seem to be filled out....is there a lil hole after that, or heals up right away?......is there a danger in waiting if it needs to be aspirated it besides discomfort?.....thanks a lot for any input...
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Harmonysun, when my shark bite is gone, I definitely need aspiration! Does it jiggle like a waterbed? I'm at 11 weeks now. I had 230 cc and 340 cc aspirated yesterday. So tired of it!
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oh thanks leigh ann!.....yeah, shark bite def gone, in fact buns def dont look like the droopy lil way they were and look filled out...lol.....and waterbed like too...
....how many times have you had it since drains out?....that was a lot you had out yesterday, how long since the last time?.......how long does it take to aspirate?....does hole close up right away?
...do you know if it can cause problems if not done right away?...like if i cant get in tomorrow, should next week b okay?.....
....thanks again....:)
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Thank you Lesley!
Paula, glad to hear all is well, Never heard of the side/rib flap, very cool. Did they reduce the other side so you are symetrical? Curious.
SydGrace! thinking of you!
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Well, my other side was lifted some more for better symmetry. Dr S said I shouldn't lose any volume. It's so hard to tell right now! My left side looked so perfect. Dr S seemed a little disappointed that he needed to do more on that breast. I hope it still looks as good.
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Spring -- I am looking at November 6 for Stabe 2 b. Can we put it on the calendar? May change, but I think it is pretty solid.
Thanks!
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Harmonysun, my right drain failed at 3.5 weeks and that was my 4th aspiration on that side. My left drain came out at 8.5 weeks and this was my first aspiration. I have gone 9 to 16 days between aspirations. The fluid can prevent healing and infection can occur. Early on, there was concern that the seroma might cause an incision to open also. I think you might need to go in! It's really not a big deal -- just don't look at the needle. Your hip numbness will come in handy. 0
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Hi HarmonySun and LAStar - I had a persistent seroma on one side of my hip incision that was aspirated ten times. I know that sounds awful, but each time there was a smaller quantity, or less output per day, so I was encouraged even though it kept refilling. I had it aspirated about once a week or a little more frequently. I knew I wanted to wait for a while for Stage Two (still haven't done it yet for various reasons, almost a year later), so I worked really hard with the compression to get rid of the seroma. I wore the DOM or Marena around the clock and also made a pad of many layers of terrycloth stitched together to put extra pressure on the seroma area. I just cut up an old towel for the pad - it was pretty easy to make and I think it really helped. The last aspiration was around 10-15 ccs and then it never came back. I had no pain from the aspirations and no infection. It was all done with ultrasound imaging.
I first noticed the seroma when my shark bite disappeared, so Harmony Sun, I agree with LAStar that you might want to get it taken care of soon.
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