One step implant procedure with Alloderm - Anyone?
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Thanks for the info, that seems like a long time! I wonder if the type of implant makes a big difference. I will also ask the nurse at the PS office when I see her to get my last drain out in a day or two. She's been a good source of info so far, I didn't think to ask her when I saw her last week. My husband is very concerned about me getting fitted for good bras now, almost like he was mad at my old Walmart bras. lol I told him there's no point getting fitted just yet - it's too soon.
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hi ladies!
This one step procedure was brought up by my MO today so doing some research. I have to meet up with breast surgeon and plastic surgeon in next few weeks to discuss options.
I am stage 2 (2cm in breast 1/14 positive node also 2cm) TNBC BRCA1. I was diagnosed when 19 weeks pregnant. I've had 3rounds AC so far. One more before I deliver,than 4 rounds taxol before surgery....barriers discussed were timing bc as my surgeon put it mastectomy after pregnancy is "messy" d/t milk ducts and such. Other being I will also need radiation .
1.Any ladies have radiation after one step reconstruction. How did the implant hold up to it ?
2. Anybody have mastectomy shortly after pregnancy?
Thanks
Katie
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I am not sure I have seen anyone on here with one step followed by radiation. My concern would definitely be the high failure rate of implants with radiation. Your tissues can get pretty compromised with one step as is as it is a bit more trauma to the tissues than slower expansion.
Women who get TEs generally get expanded before starting radiation...with some extra to allow for skin shrinkage and tightening from rads, and then wait a long time after rads to exchange (I have seen some women exchange after a year). Maybe someone else will chime in who has had one step before rads though and prove me wrong!
I would definitely be asking your surgeon, in any event, whether he has done one step before rad treatments before, and what was the outcome, and how he factors in the radiation treatment. I'd also want to talk to your rad onc to find out what they think as it could interfere with timing for radiation.
I do know there are some women on here who were diagnosed during pregnancy, so you might want to make a new thread with a header about "Mastectomy just after pregnancy?" or something as I am not sure how many of those women would also be checking in on this thread (which has not been very active lately!) as they may not have done one-step
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thank you ! Not much activity in pregnant section either.
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When I hear one-step, I think of what I experienced. Bilateral mastectomy with permanent gummy bears placed immediately. I had a failure with migrating implant on the left-side. Had repair two weeks after initial surgery. I'm somewhat confused by the term one-step being used for implants without TE when it occurs months after the mastectomy.
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Becky63,
I am not sure who you are referring to as using the term "one step" in that sense? I don't think anyone on here has used it in any sense other than having implants placed at the same time as the mastectomy. What you are describing would be a two stage reconstruction (though in cases like that I have always seen a TE being placed later before an implant)
Katie above has not had surgery yet and is discussing having mastectomy with direct to implant (aka one step) following her pregnancy.
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Becky63: I have sent you a private message!
Deborah
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hi ladies, I would love to have less surgery, but am HER+++. i really hate the idea of tissue expanders, and the gals that get them all have awful experiences with them! Am I a candidate for one step surgery, or will they need to take most of the skin, so that I require TE? Sighs. Surgery in December, have not met with PS yet. Any insight is appreciated. Thanks!
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bippy - unless you have skin involvement, which it doesn't look like if you are stage II (I assume clinically if you are doing neoadjuvent chemo) there is no reason you would not qualify for a one-step just because you are Her2+. I had a skin and nipple sparing, although I went with TE to implant, and it was known that I was Her2+ prior to surgery. The criteria are more associated with breast size, desired size after recon, ptosis (droop) and tumor size and location.
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If u do have skin involvement, how come u can't have the one-step?
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The assumption would be that the area with skin involvement would need to be removed during mastectomy. Most one-step candidates are smaller breasted so this would limit the remaining skin and thus the size of the implant. Also, if radiation is required due to the skin involvement some surgeons would not do the one-step since the skin can be further damaged by radiation and the muscle and implant can tighten and distort or lack symmetry, so would recommend another type of recon.
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Thanks specialK.
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special k, awesome info. I would like to try this before anything else....good to know it may be possible! Now I can discuss with PS.
Thanks!!!!
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You are welcome - we ladies in "the land of the weird" gotta help each other, lol!
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tee hee, it is true. No other place with real face eating zombies!
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I have not been on the forum in a very long time, but just stopped in today. I had one step surgery and then radiation with no problems with my implant at all. I hope this helps some.
Vickie
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Hi all! I am recovering from a delayed reconstruction with alloderm. My left breast is being reconstructed. I have one drain right now. Pain of course but am doing ok. Glad I found this thread. I have 2 more to go to finish up my recon.For lift and nipple. I am so grateful for all the info you all have!
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Christmasgirl, I need a revision due to scar tissue to my shoulders are no longer even and I am having pain. How long were you out of work or "laid up" after the revision?
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It has been five years since I had a PBMX. I am going to have revision surgery but I am scared. I hope the surgeon Dr. Chasan in Del Mar, CA can improve the symmetry and size of the one step surgery with alloderm. I'm wondering or asking if a revision surgery five years later is often successful and easier than the original surgery?
Thanks,
Amy
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Hi all, I had a one step direct to implant with Alloderm in February 2017. At my 4 week appointment my plastic surgeon mentioned that it looks like the pocket she created for the left breast may be too small. She mentioned I may need a revision to open the pocket up some. On that side the implant is not descending. It's almost as if the implant is hitting the corner of the pocket and sitting on top of it instead of fitting in it. I am now 7 weeks post surgery and it still looks like the implant is sitting on top of the pocket.
1. Has anyone had to have a pocket revision after one step with Alloderm? Was it as painful as the original mastectomy and reconstruction?
2. Is it possible that the corner of the pocket will stretch and the pocket won't need to be moved?
3. At 7 weeks post op my breasts are still very hard and they do not move. Actually Ican't even see the bottom of my breasts because they are so hard at the incision. Will they ever feel softer and closer to the feel of normal breasts?
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Krma, my surgery was in 2009 when the one-step was fairly new. I had different issues. The right breast was and is slightly higher. The left incision didn't heal. I went back to surgery after a few weeks and had the incision redone.
Sorry you're having these problems. Revision surgery is fairly common and not usually as drastic as the original surgery. If I were younger, I would have gone back for cosmetic improvements.
Best of luck and gentle hugs
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I too am asymmetric and was that way immediately after surgery. At my first follow-up I asked about "settling". I was told by my plastic surgeon that with the ADM (Alloderm), there was no drop and fluff expected. One is definitely "tied in" tighter than the other and sits higher. I am bothered by it, but I'm thankful I had no medical surgical complications. I have no urge to get back into the operating room and expose myself to additional risks even if cosmetic improvement were possible.
P.S. Thank you to all the women who shared their stories. I read the entire thread after my surgery.
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Hello.
I am looking to do DTI with Alloderm. BMX. Surgery is 5/10 with Dr. Tchou and Dr. Wu at Penn Medicine. Anyone have any comments or suggestions about DTI? I have a list of questions I'll be asking at my pre-op appt. Also, any tips or tricks I should know with drains, pillows, clothing, bras? Anything would be greatly appreciated!
Thank you!! Cheers, Tracy
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Hi Tracy,
I have met with Dr Wu as well. I am wondering if she does pre pectoral placement? I am now looking into this.
Good luck on 5/10
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Hello.
I am looking to do DTI with Alloderm. BMX. Surgery is 5/10 with Dr. Tchou and Dr. Wu at Penn Medicine. Anyone have any comments or suggestions about DTI? I have a list of questions I'll be asking at my pre-op appt. Also, any tips or tricks I should know with drains, pillows, clothing, bras? Anything would be greatly appreciated!
Thank you!! Cheers, Tracy
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Hi all. I also had this type of reconstruction done by Christine Rohde at Columbia University Medical Center in NYC. I was a DDD and she told me the biggest I could be was a full C. It took me awhile to get used to having smaller boobs. Other than tat I I was happy with it. I didn't need any revision surgery and my recuperation was uneventful. I was thrilled to avoid TEs, fills and a second surgery. My only advice would be to find a PS who has done this type of reconstruction frequently. Hope this helps!
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would you recommend Dr Rhodes
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i went straight to implant and one breast was perfect, the other breast had a piece of tssue cut out of the flap because it didn't get a blood supply. It's taken three surgeries, but the girls look pretty good now. The good breast has feeling, the other not. No other commplications.
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I had bilateral nipple sparing mastectomy 4/17 with Alloderm. Got my 4 drains taken out after 2 weeks. My surgeon cut under the breast and implants, gummy bears went right in. Very sore where drains came out, and swelling under both arm pits which is "annoying" I lost my right nipple as the found some cancer cells in the nipple, so that will be reconstructed at a later date. Still have sutures under both breasts after 2 weeks. Dr told me to keep drains in until there was less than 20cc/24 hours in each drain or I would develop seromas. Both my chest and armpits are swollen, but Dr says this takes time to go down. Implants look good. I had ADH originally in the right breast but they found DCIS hiding out when I had a lumpectomy in Feb. I said get them both off! Nodes, 4 were taken out all negative for spread. No cancer at all in left breast..My Surgeon was Dr Ashikari at Asikari breast center in Westchester, and my plastic surgeon was Dr Koch. Both fantastic!. l have to sleep on my back with a wedge as too painful yet to sleep on my side. Breasts reconstructed look good. I did not want expanders, so am the same size. Surgery was not a walk in the park, but glad it is done! Each day a little better!
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Hello all. I had my BMX May 4th and am now home recovering. The BS left it up to me as to wether or not I felt up to coming home after 1 night stay in the hospital or if I felt like I needed to stay an extra night. I chose to come home after only 1 night stay. I felt fine after surgery and while I did have a pleasant night at the hospital (pain was managed well), I felt I could watch television, read and take my pain meds at home just fine.
I chose to give reconstruction a go and I must say that so far I am very pleased with my results. I was able to do skin sparing and nipple sparing and my implants were placed over the muscle with Alloderm. I was originally a little bigger than an A cup but barely a B cup. I told the PS that I would object to being a little bigger, but my ultimate plan/goal was to minimize the number of surgeries as possible and to possibly avoid the use of tissue expanders. So far so good. PS says I'm a little bigger than my original boobs were.
Pain is very manageable. I have a ParaVertebral Block (PVB) so I am carrying around 2 bags of the pain medicine which is a pain in the rear, but I'll only have them for 4 days so it's very doable. I also have a few other pain and anti-inflammatory meds to take and so far so good. Now I just need to watch for any signs of infection.
Thanks so much to everyone for the well wishes regarding my surgery.
~Dee
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