One step implant procedure with Alloderm - Anyone?
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About how I am feeling at 6 months...... My pec still feels sore now and then, at the upper corner where it all comes together at the shoulder/armpit. If I do any heavy lifting it complains, but I can do absolutely anything I want to with no weakness. I have an "active" muscle that pulls my breast to the side when I use it. I whined about it for quite a while but am trying to accept it as a bit of slapstick comedy and move on. The breast has been soft and nicely squishy from the start. Not like the real one, but pretty darn close. The incision is fading to pink but the scar is stiff and thick feeling and continues to keep the new breast rather flat in front. My PS is trying to figure out what to do about it, if anything. There might be an exchange of implant in my future. There is not enough skin to make a nipple. I'm going to wait and see if it softens and changes. In clothes you would have to look closely to see the difference.
I have a little 'dog ear' at the end of the scar. My understanding of it is that it's a bulge at the end of the 'seam' where it wasn't tapered off quite enough. My PS says that it is easy to fix. It would make a nice nipple if it were in the right place, sigh.
Welcome ReneeJean. You're in the right place.
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Hi everyone!
Visited the PS surgeon yesterday. The poor guy looked like he needed a good nap! Moved his offices and construction isn't finished. He was incensed that his patients, who are going through their own difficult transformations, would have to put up with an unfinished office or glimpse a construction worker. He's a very nice, mild mannered guy, but I think he had resorted to confronting various construction people wandering in throughout the day and yelling at them to "Get out!"
The slight mess didn't bother me as I've been through my own construction nightmares. I feel his pain. On the positive side, I think I was the only patient in the office! We had a nice long talk about nipple reconstruction and my little pain issues, as well as "incision revision". As far as the small jolting pains in the chest and back, he explained that there are two muscles involved in reconstruction, one which reaches around to the back. So, the upper torso pains are probably muscle spasms/healing. As for the occassional, random pin pricks all over my body....he didn't have any real answer. His suggestions were possible dehydration or perhaps "over doing" it. He suggested taking a multi-vitamin and that if it didn't resolve, call back. I'm fine with that for now. It's only annoying, not dibillitating or anything. I notice that it seems worse when I'm tired....I think....it's rather unpredictable.
As far as revising the incision, I have "redundant tissue" at the ends of each incision that gives me a less than rounded breast form. They both have a somewhat angular quality. I would like to have that fixed if possible. For now, that's more important to me than the nipple reconstruction. I'm actually beginning to wonder if I even want to have reconstruction done.
I have to confess something kind of funny. I found myself in the craft store yesterday afternoon and it popped into my head that it might be fun to buy some face paint and see if I could paint my own nipple tattoo. I painted a rather wild flower on one side and a reasonably realistic fake nipple on the other side. Boy, that art degree is coming in handy! I was actually pretty satisfied with the outcome and was reassured that maybe I'll only opt for a "3-D Tatto". Who knows...I say, try before you buy. It was fun.
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Good morning okiegal,
Painted nipple, yay, I did the same, with a won't wear off sort of lipstick/paint. I too found it very satisfying. The mound instantly became a breast. It made me think I would really like a nipple. The other part of me thinks that since it has a real nipple to match, it will just look fake. Might be a moot point anyway. Or lack of a point, ha ha. I await the guidance of my PS, who wants to 'complete' the reconstruction. So I know he's thinking about it, like an artist/sculptor in flesh.
The redundant tissue is the 'dog ears' people talk about. The slightly angular effect is what I have too, a soft little corner.
I was thinking about your pin prick feelings. I figured that it was nerves reconnecting. Often it would zap in two spots simultaneously, and I imagined it to be both ends of a nerve path. I welcomed it as a possibility of regaining sensation.
Are any of you star-gazers? There was a meteor shower last night and will be tonight too. It was completely overcast here, nothing to see. It would have been spectacular in the dark sky places of my vacation trip.
I should slightly revise last night's comment. I can truly do anything I want to after 6 months. But I have never been good at push-ups and pull-ups. So if you guys are athletic, I have no insight into that. I am a potter, and use my arms and torso vigorously, but it's a different sort of movement. It's also why I chose this surgery rather than one of the muscle moving reconstructions.
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I'm back from my trip to see the NP. She had the PS's assistant come in and inspect my breasts, too. Once again I didn't get high marks for healing. Apparently the NP has one other woman and me who are flunking healing. The nitroglycerin ointment did some good but now I'm to use another cream called Silver Sulfadiazine, which is used on burn patients. I'm to apply it to some black areas on the incisions that are necrotic or deadened skin. So far there has been no discussion of trimming the edges of the incisions and re-suturing. I will probably have scarred suture lines rather than the desired faint pink lines. Maybe I won't make it into the PS's album of patients!
I go back on Tues. for another check-up.
Fortunate1, I heard about the meteor shower on the news, but the time for viewing it was between midnight and 5 am. That pretty much excluded me from the viewers! You're right. What a sight that would be in the Wyoming or Montana sky.
How wonderful that you're a potter. Pottery is one of my favorite art forms. I have a large collection of clay art. When I was writing romance novels, I decided to create a character who was a potter. As a part of my research, I took pottery lessons and got hooked. I bought a wheel and a kiln and set up my own little studio. It became a passion for several years. Then we moved and I dismantled the studio.
Okiegal, you seem to have been satisfied with your appointment with your PS. I have a cousin who's a 12 yr. bc survivor. Two years after her bilat mx, she opted for reconstruction. Had to do the TE's. Instead of constructed nipples, she went to a tattoo artist and has pretty flowers where her nipples would be.
It's my understanding that you don't have to have enough skin for nipples. They can be constructed--is it out of Alloderm? Then the aureoles are tattoes. I've read that it's very real looking.
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Hello everyone!
Okiegal - Funny you mention painting on a nipple. My girlfriend and I were joking one day that if I decided to get my nipples tattooed maybe I should consider two smiley faces...One smiling and the other winking. How funny would that be when getting examined at the dr office!
I also have that angular shape...I mentioned yesterday that I thought I was developing the "dog ears" that some talk about. I am more concerned with capsular contracture which would also misshape your breasts. I still feel so tight and my breast do not feel soft to me. Maybe this is my new soft? I guess I'll find out when I see my PS in Sept. Does anyone know if correcting the dog ears would require drains again? If so, I think I'll keep them and name them Fido!
Please excuse my humor today. I'm over tired from working on the newsletter I do and many other things that need my attention. I'm not sleeping well and I just can't get motivated. I was never like this before.
My friend was all ready to get her tattoos and then she got capsular contracture in one of her breasts...she was glad that her tattoos weren't done. They would be misplaced on her breast now. I have seen some pictures and some look OK and other look really fake. A tattoo is so permanent...I don't think I feel confident enough to get them now...there's time to decide.
Fortunate 1 - My family and I do enjoy star-gazing. When we know of an event that is coming within our view my DH will set up my son telescope. Unfortunately, there's usually an overcast. The weather here has been hot and humid during the day and stormy at night.
I have to get back to work. I hope you all have a great day!
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Carole - Sorry to hear the first cream isn't working, but I am glad to hear someone else other then the NP looked at you. I hope the new cream works.
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Meg9- I agree, there's plenty of time to wait before doing the nipple recon. I wonder when we can be sure that capsular contraction is no longer a worry. My PS said it has never happened to any of his one-step patients, and that the alloderm sling is the reason. A vote of confidence. Also,I think, and hope, that the dog ears are a minor correction, probably no drains. Bye bye Fido.
Carole- Good luck with the new cream. Hang in there. You save those nipples, and I'll ask what can be done with alloderm for me.
A fellow potter, we're an artistic bunch aren't we. It makes for an odd but satisfying career, a little short on the income. No meteorites for me last night either, maybe the Leonids later.
Have a good day everyone.
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Thanks for the welcome ladies! I am taking notes from y'alls experience to ask my PS about next week. Yes, the waiting is the worst....my entire summer has been 'waiting' it seems. I am just ready to be 'done'(as all of us are I am sure).
We saw a few meteors but not nearly the amount the media said we would.
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Meg9 you are cracking me up! You sound punch drunk! My sister suggested I get my almamater tattooed instead of aeorelas or smiley faces....I considered wearing two wash-off tattoos of flowers to the PS, but I just did't think they would find it so funny...
Fortunate1, that's reassuring about the capsular contraction being unlikely with the Alloderm. My PS was pleased with the way things are softening up and so am I. He said they would continue to get softer...I was surprised. Meg9, what type of implant do you have? I have the Natralle cohesive gels. Have your breasts become softer since you began massaging? If you are developing some sort of adhesions or capsular contracture, they can address that, surgically, of course. And I also understand that the trimming of "dog ears" is very minor. Snip, snip!
Glad to have you joining us ReneeJean, keep us posted! I would have loved to have seen the meteor shower. My niece layed out under the stars on a blanket with friends. Ah, to be young and able to burn the candle at both ends!
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Hi ReneeJean - The waiting was not fun, but I kept myself so busy trying to get my life in order before the surgery the time went quickly. I knew no one who had the "one step" so I didn't know what to expect. If it wasn't for the "one step" I would not have had reconstruction surgery. It was after my surgery that I found this site and learned so much more....like a possible second corrective surgery! No thanks, What I have, is what I'm keeping!
If you have any questions that we have not covered in our conversations here, please feel free to ask me.
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Okiegal - I just looked at the booklet the PS gave me about my implants. They are Mentor Memory Gel-Filled Implants. I'm not sure what that means...but they do not feel soft to me and massaging them has not helped. After I started to massage them...the "dog ears" showed up. I think that was going to happen anyway. I don't think there's a snip, snip in my future. I'm to chicken. Everyday it's something new. I noticed today when massaging by breast...if I push the breast up, even the skin on my stomach moves up. Now, that'is what I call stiff!
I have to get back to working on the newsletter...Ugh!
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I think I might have different implants than you all. I was way too uninformed when I went into this. I chose the surgery, never having heard about it before. It just sounded right. All else I left to the PS, not knowing that there were different types. I was much more concerned about the cancer being out of me ASAP. He did say that there had been a lot of improvements in implants. I'm pretty sure that it is moderate projection(?), which might be why it is kind of flattened by my muscle. Or that could be the tight incision. I don't think it is cohesive, which could explain the softness. It would be strange to have one soft and the other hard. Is that the case with any of you, or did you all go the bilateral route?
Renee - Waiting is horrible. I was frantic with it. Relax as much as you can. I was sure the cancer would spread while I was waiting, but was told that it doesn't move that fast.
I saw a mastectomy tattoo on the web. I think the woman is in England. No reconstruction, a delicate vine twining across the scar and slightly on to a lovely remaining breast. I found it very touching.
I'm off for tonight, working as a volunteer usher with DH. The best way to see a lot of theater!
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Fortunate1 - I felt like I did research quite a bit, but I must not have been absorbing much. I did a little more researching this AM. I didn't realize that there were differences between cohesive gel implants regarding firmness. Here is what I found out about Mentor Memory Gel and this link leads you to the Allergan/Inamed Natrelle website. There's a series of tabs at the top right hand corner.
I've read about "gummy bear" implants and knew that mine are cohesive gel. I'm not sure if there is a difference, but what I learned this morning is that cohesive gel implants are a silicone shell that is filled with cohesive gel. I guess I assumed they were just one big form of silicone gel. I had seen and touched them at the the PS's office and they seemed like filled shells, so I'm not sure where my confusion came from. Maybe I was worried about other aspects of all of this? I have read about different implants feeling firmer than others and don't understand whether there is a difference between brands. The pictures on their websites look the same and I'm inclined to think they are very similar. I know saline implants feel more firm.
I looked at my Natrelle "warrenty card" and realized that I was given the high profile. Glad to see that, but for the record, there is a rather flat area at the center. I guess that's better than having a peak in the wrong place.
Meg9 - your implants sound too firm to me. In my research, I found that there is a scale for capsular contracture. It's called the Baker Classification and here is a quick discription. Sounds like you may have something like that, but not something that needs an additional operation. Hope that helps. Sorry to be so link heavy, but I thought others might still in the research phase....
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Just back from my morning walk, a little over a mile. I could walk farther, but am still avoiding perspiring heavily.
Renee, I totally empathize. The month between dx and surgery was very long. My BS ordered an MRI of both breasts and a PET/CT scan of my body. Once I had those, then it was wait for the results. Both showed the only cancer was the small tumor in my right breast. When the day before surgery finally arrived, I was scared to death but relieved that I was finally going to get the cancer out of my body the following day. Time can seem to pass agonizingly slow but it passes.
As for implants, mine are not gel. I have two device identification cards that I'm to carry with me. Mine are Naturelle Silicone-Filled Breast Implants by Allergan, 457 cc.
Fortunate1, I remember a discussion between you and Yearofthehat about your breast jumping when you flexed your pec muscle. Mine do the same. In fact, I can make them jump! It makes sense when you think about the implants being stationed by the pecs.
Meg9, I can feel cold liquid going down, too. So far haven't noticed it with hot liquid. I would guess it's losing the insulation of the breast tissue.
I had bilateral, Fortunate 1. It would have been very challenging for the PS to match my small natural breast. Plus I wanted to rule out future mammograms and new tumors. I mistakenly thought I would be avoiding chemo and other treatment with bilat mx whereas I could be faced with chemo depending on my oncotype dx. And since my tumor was ER/PR positive, I'll be taking Arimidex for at least 5 yrs. if I can tolerate the SEs.
Meg9, what kind of newsletter do you write?
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Hi Everybody,
I too did not discuss my implants with my PS. She told me what she used and why and I excepted it. She said that she would try to use a full B, but she would not know until the day of surgery. I think the size has something to do with your muscle structure. She never mentioned profile. I never got a warranty card...I'll have to ask about that when I see her...thanks.
From the time I was dx, I didn't feel like it was me. I didn't feel sick...I was myself. I used to think... maybe this is a mistake...How can I have BS, I'm so healthy? People would say to me, "I can't believe how calm you are" or "what a great attitude you have". I planned for the surgery by getting my life in order, but that was it. I didn't look up anything on the internet..my DH did. I didn't what to scare myself by reading things that may not apply to me...so I stayed uninformed and trusted the people around me...my DH and doctors with good reputations. This was a first for me! I'm usually the one with too much information.
I do think my implants are too firm from what I have read. The implants looked so soft on that website. Our muscles were not stretched out by expanders. I used to work out with weights...maybe that has something to do with it?
It is a beautiful day today. I'm going to try to spend some time outside and put off doing the newsletter, again. I hope you all have a great weekend!
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Carole - There must be a delay in these postings! I was wondering how you are feeling with the new cream? I hope it's working for you. If you did not have the oncotype dx, would your doctors suggest chemo? From what I understand if the number is low, no chemo, is that right? I hope your number is low.
Fortunate1 - I had no choice but to have BMX...DCIS was found in both breasts after an MRI. I also had other areas of calcification's. Because I had BMX I did not have to have radiation, chemo or meds. My left breast was PR+ 30%, but my oncologist said the meds would do more harm then good. I had a second opinion. I think everyone should consider a second opinion. I think I am very lucky.
Carole - I am a full time volunteer..I am editor of my churches monthly newsletter. I am also their unpaid secretary which is a huge job, but I love it. I'm on the Altar Guild. I collect and deliver baby items to a shelter for battered woman. During the winter months I cook meals for the homeless. I help the Holiday Boutique group make their hand made crafts. I also serve on other committees. It is all fun...most of the time!
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Meg9, what a busy person you are! I admire you for doing so much for other people. My only "volunteer" work is looking after my mother and chauffering her to appointments.
The new cream is softening up the dead tissue around the incisions but so far the tissue hasn't sloughed off, which is the desired outcome. There are no side effects like the headache. My swelling has gone down so that the stretchy little surgical bra has become more comfortable.
Without the oncotype dx, chemo would not be recommended for me. The oncotype has just become part of the protocol during the last 2 or 3 yrs. Before that, women with small tumors and no node involvement were not considered candidates for chemo. I'm guessing that your dr. and Okiegal's dr. did not mention oncotype testing because your tumors were in situ rather than invasive. I'm nervous about my oncotype because my cancer is Grade 3 or high grade. I looked at the Oncotype Roll Call Thread and most of the low numbers are Grade 1 and 2.
You're so lucky to have beautiful weather. Enjoy it!
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Good Morning all,
Carole, good luck on the oncotype score. That was one of my hardest waiting periods. I was turned down by the insurance company over and over. I got their guidelines. They were miss-reading their own guidelines, I was a perfect candidate for the test! Two months of waiting. I worked it out with Genomic Health, don't know how it will finally resolve. My Onc is not happy with Aetna. Before I got my score, I figured that if I had an intermediate score (mine was 20.5) I would opt for chemo. But my Onc convinced me, and my number-analyst hubby, that I was fine without chemo, and that the 5 years of Femara were all I really needed. I just turned 62, I think age plays into it too.
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I also have/had smaller breasts, B cup, non saggy. The PS suggested a bilateral so that he could really really match me, and to get rid of the possibility of sneaky lobular cancer in the other breast. Onc said there was no medical reason to have a bilateral, and I went with that. All those opinions, choosing among them, it's strange to remember. It was all hurry up and wait. Long waits and then fast decisions when I finally saw a doc.
So, 'easy' surgery, no chemo, no radiation because of the mast. (a close call- small margins).I remind myself I am fortunate. And that's only a partial list, you should hear the long one. I kid myself that I won the Lucky Cancer Patient Lottery.
If Carole doesn't have to have chemo, will we all have missed that particular trial? Hope hope hope, and future hope for Renee.
Yes, the breast jumps and dances with almost no effort on my part. Making a pie crust, chopping vegetables, and of course working in clay. So logical, so unexpected, so weird. Hope my students don't giggle. I think I might have more young ones this semester.
Meg- Your work sounds varied and rewarding. Enjoy your beautiful day.
My fun for the day, a great gathering of my local potters group. A potluck (potters have the very best potlucks) to which I'll contribute figs stuffed with goat cheese and pine nuts, broiled to melt the cheese. Apologies to those who think figs are icky.
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I don't think figs are icky. We have a fig tree in our yard and usually don't get any benefit from it since we go somewhere cooler for the summer. Normally. This summer, of course, isn't normal so we picked some of the figs and ate them. They're loaded with calories. I've only eaten figs raw and in preserves. Your concoction sounds interesting, Fortunate1. I would definitely sample it, given the chance! I like potlucks. I can imagine that a group of artists would definitely come up with dishes that don't come out of Better Homes & Gardens cookbook. Surely someone brought a loaf of home-made bread. And maybe some delicious home-made hummus?
ReneeJean, hang in there and keep us posted.
Hope everybody is having an enjoyable weekend.
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Hummus, yes. Lots of fantastic asian dishes, salmon, chicken roulade with cheese, chard, onions and lots of pepper inside, a mango cheesecake with lemon-basil sauce, the silkiest flan I've ever had and a cake/bar made by one member from a recipe of another member that has passed away. Satisfying abundance on every level you can think of from very knowledgeable cooks. (Half the figs disappeared before people even picked up their plates.) A house filled with pottery from around the world, live music, conversation till midnight. It's very good to be alive. This is a group of people that have been incredibly supportive of me during my treatment, and includes at least four survivors and my 'cancer buddy' who is just about to start radiation. She and I make a tiny support group of two. Life is indeed very good, people are wonderful.
Gardening today, and maybe some actual work, too. Hugs to you all.
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Hello everybody,
Okiegal- In your research did you find that "gummy bears" were cohesive gel implants? Just wondering. I think my implants are actually getting a little softer. I have also noticed that an area on my side that has been a concern to me...has been swollen and sensitive to the touch is getter better also. I think it was fluid. Hard to believe that at almost 12 weeks there can still be areas of fluid. I do feel muscle spasms when lifting something heavy and a little discomfort off an on throughout the day. Nothing to complain about...just a reminder that the implants are there.
Carole - I hope your new cream is working for you.
Fortunate1 - I can't remember the last time I ate a fig, but I do remember my mother making them on holidays when I was a child. They were stuffed with something like your recipe. Everyone enjoyed them...especially her. I glad to hear you have a great support group.
Renee - I hope thing are going well. Hang in there!
I went yesterday for my TV ultrasound. Will get my results in a couple of days.
I have a busy, bust day. I hope you all have a good one!
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Good morning all!
Meg9 - glad to hear things are getting a little softer. I know you mentioned that you used to lift weights. I think that might also be part of the problem. Apparently the muscle continues to soften, stretch and thin out. As to whether "gummy bears" are cohesive gel, I think they are the same thing, but I'm not completely sure. Originally, when I asked my PS if I could get "gummy bears" he said "yes" and then called them cohesive gels. I'm not sure if there is something else that's still being studied in trials. It seems that I've read about something else, but I just can't keep them all straight.
What's a TV ultrasound? Hope it goes well.
Fortunate1, your food sounds delicious! Carole, how's everything going? Renee, thinking of you too!
I started another topic about nipple reconstruction...that's my next step in the "one-step" dance!
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Been thinking about you all during the weekend, and hoping all is well.
DH said that he thinks my incision is getting softer. Maybe my scar and muscle will still stretch out a bit. I'd like that so much. I'd love to have a nipple, but am much more concerned about the projection match, or lack of it. Well, maybe I'll eventually have both.
Good day everyone. I think I'll mosey over to okiegal's nipple topic.
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Okiegal, I checked out your nipple reconstruction thread. Isn't it great the way the women on this website share information? A couple of weeks ago I started a thread asking for feedback from women with a similar diagnosis who'd had the oncotype testing. I was/am so appreciative of the responses.
This is purely theoretical since I had nipple-saving mx, but I think I would opt for the 3-d tattoo. It sounds exotic and you could go braless with no raised nipples.
Tomorrow a friend is picking me up to go to an afternoon movie. It will be fun to see her and to get out of the house. I should be developing cabin fever pretty soon. My energy level is fairly low and I seem content to stay here at home and putter around. Tomorrow I go for another checkup. I think for the first time I will drive myself and relieve my dh of chauffeur duty. He has accompanied me on all the previous appointments. I liked having him go in and hear whatever was said and what the instructions were.
Hope everyone is having a good Monday.
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Thanks for visiting my nipple query! I want to keep it alive awhile, so if you can comment or ask a question to stimulate conversation....please do! I really appreciate all of the opinions and comments. Today I am going braless and noticed that I can still see parts of my incisions that didn't heal quite right. I am currently leaning toward 3-D tattoos because I figure it's going to be tough enough just finding a bra that doesn't wrinkle in the center. Adding a nipple seems like it would just complicate things. I'm not sure though. Carole, I like your discription of it being "exotic". I hadn't thought of it that way. Did you know that you can buy fake silicone nipples that you glue on? I even saw one that was pierced, complete with cheap jewelry! A comment from a female bartender on the website said that when she wears them, her tips go up....hmmm. That sounded weird! Guess I could purchase some of those.
Strangely, I'm fighting the urge to be the "A" student and get the reconstruction done. So many conflicting ideas and influences. I'm going to take my time to decide.
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Okiegal - I had a brief chance to look at your other forum and i was going to comment, but my day took a quick turn. I plan to visit it again soon. I hope it helps you to make the decision that is right for you. I did read once about tattoos fading. I haven't had the chance to read all the forum, so I don't know if fading tattoos has been discussed.
Yesterday, I went for a trans vaginal ultrasound. About 2-3 weeks after my bmx I had a little period. Really, just a staining for a couple of days. I have not had a period for 2-3 years. I mentioned this to my PS and OC when I had my appointments...they said I should get it checked out by my GYN. I visited my GYN who tried to do a bbiopsy in her office. It was very painful and she could not get it done. She went me for the T V ultrasound. I have a great PCP who I have all my reports sent to. He just called me and said he received my report and it is not perfect. There is a polyp or something. He said I should be hearing from my GYN.
I can't believe it...here I go again. I called the DH at work...dead silence...then "don't worry...it's probably nothing." I can hear the concern it his voice....poor guy. Same when I called my sister. I feel sick. I know I shouldn't jump to conclusions, but I heard the same thing twice before. It's like instant replay. What's next...I am going to try to keep a positive attitude, but in the end...just like the bc...there is nothing I can do.
Sorry to be such a downer. Have a good night.
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Dear Meg9 - what a day! It's so hard to hold up under all of this, I know you just want to be free and clear and get on with life! I'm very glad you have competant doctors and a supportive husband and sister. If it's just a polyp...then it's really probably nothing to worry about, right? That's usually a benign finding isn't it? I will be praying for you.
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Meg9- I am so sorry, such stress. I know how very hard it is to not jump to conclusions. We are so easily tossed right back into the fear. I'm hoping that instant fear isn't a permanent condition. Know that you are surrounded here by women who understand.
I'll be thinking of you, and true "nothing to worry abouts".
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Meg9 and Stonebrook1 - I am considering the one step and i am also in NY - I was wondering who your surgeon was and what did he/she say the tradeoff was between the one step and the traditional t/e?? I am doing a unilateral after two lumpectomies and am a 32C. Thanks!
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Stonehill108- thanks for the reply - i am in NYC and had 2 lumpectomies with Nowak as BS and consulted with Swistel for BS as well for mx - both at Cornell. Also at cornell for PS, Talmor, Gayle, Latrenta. At Sloan - BS Morrow and PS Bebat Mehrara. Now I have also heard good things about Mark Sultan at Roosevelt for PS. Alot of consult cause I am so worried about the looks in the end! Who knows who is the best artist!!
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