One step implant procedure with Alloderm - Anyone?
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Hi ladies,
I go see my PS at 1pm. I am certain to get the left foob drained. Nervous for sure. I think I will take an ativan and put chemo creme lidocaine on my scar to numb it. I was told he'd use a needle in the scar to draw fluid. ugh. Wish me luck.
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yes Mareluna, good luck, hope it's quick and easy
-jocelyne
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Hi,
I was glad to not have to be drained. I go back in two weeks.
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Hi,
Tomorrow I see my gyn doctor about my next surgery on april 2nd. I am having the salingo oophrendectomy. (sp)
Anyone have that done yet?
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nope but I hear it isn't too difficult surgery-wise. Might do it down the road.
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Laproscopic. I have had that type in the past. Not near as bad as BMX. I head to se doc in about 30 min. How are you? I am 7 weeks post op. Not as painful as it was.
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I feel better - my energy is coming back but not quite normal yet, still a little tired. The boob feels good but will be exchanged in May for a gummy. Not looking forward to more surgery. But the other one will be done and I'll feel better about my body. Not an easy process...
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Hi Lady's,
I have been reading this board since before my surgery but am just now poking my head in to "talk" a little. I had what was supposed to be skin and nipple sparing BMX last October. I, too, felt very rushed to make decisions and I feel that I caused myself some problems in not taking more time to interview doctors. I feel I was pushed into surgery with a couple of doctors who may not have known as much as they said they did. I was told that choosing this type of procedure for my DCIS would mean 1 trip to the OR and no additional treatment would be needed. Neat and tidy solution to my BC. Well, it did not quite turn out that way. My BC was in my right breast with 2 locations, one with comedo components. So the advice sounded good. The problem was the lack of experience in doing this exact procedure. The BS took MUCH more tissue from the "good" left side and left suspicious margins around the cancer, itself. And SOMEBODY, (neither doc, of course), will admit to whom, left the retractor compressing the left nipple too long and destroyed the blood supply. So I came out of the OR with a black, dead nipple on the side with no disease. So...I am left with very uneven results and an additionally butchered left breast when the PC removed the necrotic nipple 2 weeks later, and radiation on the right with implants already placed. Having said all of that, I am truly blessed to be, as far as I know, cancer free.
My question to you ladys is this...I am still, after 6 months, having some significant, intermittent pain in my right breast. I am thinking that,due to the locations, it is probably still internal healing of the alloderm and muscle connections that were slowed due to radiation. Do you think this is possible? If I need to consult a doctor, I am going to find another PS as I refuse to go back to the "butcher". So any thoughts are very welcome.
Vickie0 -
Oh I am so sorry you had to go through that....WOW is all I can say! I am going to be honest, I still had intermittent discomfort after six months...I wouldn't call it pain. And, if you had radiation on top of the mastectomy (by the way, why did you have radiation for DCIS, no nodes....just curious) then that very well could be the reason for the delayed healing/symptoms.
I think you are spot-on saying that the lack of experience in doing this procedure was the main problem. If you have PS that has done the procedure over and over again, it is a very good option for anyone who wants to stay the same size and not deal with additional surgeries. And the BS and the PS have to be on the same page and communicate well before the procedure. My PS and BS did this procedure quite often together. In my particular case, when the BS came out of the OR to talk to my husband, he felt that he didn't leave enough skin and that the PS was going to have to give me expanders. Fortunately, that was not the case. My PS did a beautiful job and I was able to go direct to implant. I remember in the beginning being frightened because of what the BS said to my husband and feared that the PS pushed it by giving me the implants immediately, but I am now 1 year out from surgery and I am doing well.
So, yes I feel that regardless, you should go talk to another PS.......just to get his opinion regarding your situation and see if there is anything he recommends. Again, so sorry that you had to go through that. A lot of PS will "pooh-pooh" the direct to implant and its usually the ones that aren't trained in the procedure. I had three opinions and was discouraged by the one PS to have it done, but I truly believe if you find the right PS, it can be very successful. But, there aren't too many docs out there that do this on a regular basis. Anyway, keep us posted on what you find out. Best of luck to you!
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Wildrumara,
Thank you. I had rads due to questionable margins on the comedo DCIS that was near the chest wall. I really question that procedure because there is so much tissue still in my right breast. The left feels "empty" except for the implant and is almost 2cup sizes smaller, which is what I expected them both to be like. My right side almost looks like I just had a small augmentation. That makes me think my BS simply did not "clean out" the skin as she should have. It also makes me think she was too aggressive on the left, killing the nipple so was more sparing on the right. She told me before surgery that she would start with the non-cancer side. Just a lot of unanswered questions.0 -
Vickie,
I had the one step jan 9 and still have enough discomfort to not be able to move comfortably/sleep more than an hour even with Ambien. I have a pinching feeling all around where the alloderm is attached to ribs and underarms and constant heavy pressure against wall from implants. Long story short, I have now had four second opinions. All say implants were wrong and area is too tight. One says take out alloderm and redo and one says score alloderm to relieve pressure. All also say they do not do one step, and that it was tried for a few years but now most think it has too much room for error and don't do it. I have to finish chemo before I can do any of this. Joy. Anyway, I'm done with the not sure what to do feeling and so I'm going to see the Director of Reconstruction at Johns Hopkins in Maryland. I called my insurance company (united healthcare) and they are reimbursing for flight and hotel. I would highly recommend multiple opinions and getting the best. We should not be having pain after this much time.
Best of luck.
Mareluna - best of luck with oomph. A friend had it and said it was quite easy.0 -
Lmimp64,
Oh my! I am not having that much pain. I am sleeping well and have good mobility all around. What I do have is sharp, burning pain underneath my breast and on both sides where pictures of the procedure show that sutures are placed. The pain is intermittent and is getting to be less often. That is why I suspect slowed healing due to rads. I do think I will look for different doctors. I have already "fired" my PS and am really considering the same for the BS and just getting a new start. I will be praying for you and the decisions you must make.0 -
Well, sounds as if a second opinion should definitely be in the cards for you Vicki!
I feel very blessed to be under the care of a plastic surgeon who is very knowledgable and trained in the one-step. I guess if there is one thing that patient's should be aware of is the experience of the plastic surgeon when doing this procedure. Ask lots of questions and how many one-steps he has done and talk to his/her patients......
Oncoplastic breast surgery (which the one-step falls under) is actually a fairly new area of study for plastic surgeons, so I believe that doctors who graduated from residency in the last 10 years or so, are being exposed to this.
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Vickie,
I am sorry you had to go through that. I hope that you get everything resolved with a good PS.
Wild,
I see you are from Pittsburgh. Where from? My dad was from the North side. I used to live out in McCandless. My cousin lives of McKnight road. I miss it so much.
Everyone,
I am having surgery on April2nd. Supposed to be a 45 minute procedure. I have had Laproscopic surgeries before. It was not too bad. After the BMX I think it won't be so bad. I just am tired of being in pain. My Pec muscles are really tight right now. I went from a D cup down to an A. Glad I went smaller. I get painfree moments. I feel like I have bocce balls in my chest when I try to do anything.
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Hi Maraluna - I am cracking up! I used to tell everyone that the implants felt like bocce balls too.....that's exactly how I described it..hehe!
I live North too, in Cranberry TWP. I'm sure you don't miss the weather, especially the 6 inches of snow we had today.....It's March for goodness sakes!! It was actually raining snow today....that's the best way to describe it!
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Oh but I do miss those six inches Wild. We got 2 inches of snow. ANd I love Cranberry Township Eat and Park. My aunt and uncle would take us there when we visited. I don't like Virginia too much.
I see the PS tomorrow. I also will go to hospital to prep for next week's surgery. SO I will be almost done. I think I will be doing revision on the dimple on my left boob. The PS said they just recut. Said that the thickness of the skin varied and causes that.
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Vickie....geez....you have really been through it! I am sorry to hear that your surgeons did not live up to your expectations. And I agree with the others who suggest it is time to have someone else look at you and see if they can fix things more to your liking. I'm glad to hear that your insurance company is helping with your travel expenses.
I had a direct to implant UMX using alloderm. All in all it went well. I did have to have mine altered some when I went back into surgery to have the natural side lifted and the nipple made on the foob. My implant was moving around too much when I would flex my arm and chest muscles. It would nearly move into my armpit and man, was that distracting!! My PS totally agreed and so he removed the implant and put some internal stitches along the outside edge of the "pocket" to prevent the implant from moving that direction. I still have some movement and it looks weird when I flex those muscles, but when I look in the mirror my breasts really look pretty amazing considering... They are certainly more perky and even than they ever were pre cancer. Are you planning on having nips done? I have to say that if I would have had a BMX, I think I would have skipped the nipple part and just had nipple tattoos. I would have liked not having to worry about the "headlights" effect, but since I had a natural nipple I wanted the look to be similar. And my fibble has pretty much gone totally flat anyway. The lifted natural breast's nipple is always perky now. That is the one thing I'm not crazy about with that breast. I have to use those little gel stick on "petals" on that side when I go braless, otherwise the at attention nipple is very noticeable.
Pain? Yes, I have had a fair amount off and on. I took Soma (muscle relaxer) for months and it was probably 6 or 7 months before I could sleep on that side the way I like to. I continue to have occasional pain in the upper outer quadrant that almost feels like nerve pain. Strangely enough it is right where my biopsy was. It is a strange kind of pain...both superficial and deep at the same time. I can run my hand over that area and it causes the superficial pain. And I can raise my arm and the pain feels deeper...pulling. It comes and goes. Knocking on wood as I type this....It has not been bothering me much lately at all. I continue to see my physical therapist on a regular basis. I have developed a lot of neck, shoulder blade pain on that side in the past few months and I feel that it is related to my UMX. My PT uses myofascial release techniques. I highly recommend all mastectomy patients to have access to this kind of body work.
Good luck with the search for new docs and answers.
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Mareluna...Good luck with your upcoming surgery!
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1openheart,
Thanks for your reply and the encouragement. No, I don't think I want to rebuild the nipple. At least not now. I use the nipple petal on my right side as I have not been able to find a bra that is comfortable. I never could ware underwires so that is still not a consideration. All the ones I have tried so far make me very sore, so I am happy to be bra-less. I have never been able to do this before as I was a D cup. I still am a D on the right side and seem to be a small C or large B on the left. So now that I am naturally "perky" and don't jiggle, no one is the wiser. My pain is very similar to yours and so I suspect I just need to wait it out. I have not taken any muscle relaxers, maybe I should try that. I am looking now for a PS to check me out and see if they can tell if all is ok and a BS to use as follow up in general. I really don't know who else might be good to follow me in the future...maybe my personal doc, I REALLY like her. I will email her and see if she is comfortable with that. I just feel that I don't trust (or like) my original team so I want to regroup. I am thankful for all the info and encouragement on this board!0 -
Vickie... Pre BC, I was a 32D. I was always abit larger on the cancer side, so I wanted to be more like a full C cup post surgery to match the remaining breast. My PS said it was important for me to take the Soma to allow the muscle that was over the implant to relax and stretch. I'm really surprised that your surgeon did not prescribe this to you too. It might give you some relief now. I makes you sleepy, so you may only want to take it at night.
I found a bra that I really like that is not an underwire and gives a real pretty shape. It is made my Soma (strange we are also talking about the drug, Soma). It is one of their invisible back bras. Also, I had a bunch of really pretty underwire bras that I hated to throw away and they suggested that I take out the underwire. I just made a small slit and took a pair of pliars and pulled the wire out. Some of the bras fit fine with out it. A couple tend to ride up. But it might be worth a try when you start to feel like wearing a bra again. My surgeon wanted me to wear an underwire for several months after I stopped wearing the sports bra (which I wore for about 3 mos) post surgery. Now, he says I can do whatever is comfortable. But he recommends not going braless all the time so that the lifted natural breast will not droop as quickly over time.
Did you consult with an oncologist? I see one every 6 mos and I have alternating mammograms and MRI's every 6 mos as well. But, I still have my natural breast to watch over. I also take tamoxifen to help protect the remaining breast from developing a new cancer. Since you had some close margin issues, it might be worth considering consulting a good oncologist to see if they recommend any further treatment. I bet they won't since you did the RADS, but might not hurt to consult.
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1openheart,
Yes I saw a wonderful MO who said that hormonal treatment was not indicated in my case. The lack of interest my PS has shown is a major part of my problem with him. His instructions post op were "do what ever you feel like doing". He poo-pooed physical therapy and said I would not need anything medication wise after the initial pain meds. He is also the one who laid me down and took hold of all 4 of my drains and jerked them all out at the same time as quickly as he could pull. I could not breath for several minutes and I could not even speak, much less scream with the pain. Thank you for the bra suggestions, I will check into them.0 -
Vickie,
OMG that is unacceptable! My PS is so kind. He tugged so very gently. I am so sorry that you went through that.
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Mareluna,
It was quite an experience I assure you. I guess you can imagine why I am nervous about docs at this time.0 -
My PS was very gentle as well. Maybe your guy thought it was like ripping off a bandaid quickly rather than slowly???
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1openheart,
Yes, that seemed to be his attitude.0 -
I wonder how he would feel about someone ripping something out of his you know what!!
Honestly, I was so happy to have those drains out that I might have even been willing to have them ripped out!
My PS was really funny that day. My husband was with me and was telling him about how much fluid the drains were producing. He said," She is not putting out like she was before" and my PS said, without missing a beat, "Neither is my wife"!
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I have wondered about that myself
It took me a while, but I was glad to have them out for sure.0 -
Hi,
Just got in from PS appt. He trird to drain my left foob but not one drop of fluid came out. SO he said, it's just sweLling of tissue. I go back in a month. So that did not hurt. Allergy shots are worse.
I went to pre-op this am. I only had blood work for that. So next wed. by this time surgery will be done. so ready...
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You have done so well with the implants. I'm impressed. You will do great with this surgery too. Best.
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Hi friends,
I had my surgery yesterday. I was home by noon. My gynecologist told David that all went well. I get results Monday. I did not think I wanted to go for follow up Friday. Only the incision on my right side hurts. It hurts to get up and down. So I am sleeping upright in my recliner.i am using a foot rest.
I hope everyone is doing ok. Nite.0
