One step implant procedure with Alloderm - Anyone?
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Amadori I am sorry you are going through this. DCIS is a tough diagnosis because although it is considered "precancer" it is still cancer and it needs to be treated. It is tough because you have so many options.
I opted for a single mastectomy with the one step. I had DCIS, Stage 0 and Stage 3 in my right breast; I had comedo cells, which are considered the most aggressive. My doctors assured me that taking the other breast was not necessary. However, this is a very personal decision (to take one or two breasts). I am glad I did not do the simple mastectomy with TEs....from what I am reading of women who have had that procedure, the recovery is longer and you need a second surgery. Check out the June Mastectomy forum. These ladies are amazing! What they are going through is much more involved that the One-Step.
The best advice I received was to educate myself--which I did through appointments with breast surgeon, plastic surgeon and radiation oncologist as well as reading all I could find about DCIS. The forums here helped alot, also.
I healed very well and have no problems 3+ months postop. I thought that I had the best surgeous available, the best treatment center available. Yes, it was scary, that is natural for anyone to feel terrified.. I was very nervous and apprehensive prior to surgery but so, so relieved when it was over. I had a great support system and that helped too.
I focused completely on myself and recovery. It's totally okay to do that. My hope for you is that you will be able to make a decision that you will feel comfortable with. It is very personal...but please know that we are all here to "listen" and support you! Peace to you!
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Amadori, Sorry you have to join this group. I was diagnosed with DCIS, grade 3 in both breasts. DCIS is the early stage of cancer. When I was diagnosed I was scarred too. At first I was supposed to have a lumpectomy with radiation of the right breast. After further testing DCIS was found in the left breast. My BS said I had no choice but to have bmx. Until you have the mx you really don't know what your treatment will be. After my bmx, pathology showed clear margins and no invasive cells. I visited an oncologist who said no need for further treatment and no radiation because there was nothing left to radiate. No chemo because the margins were clear and no invasive cells.
I have a friend who had IDC in her left breasts. She lost both her parents to cancer. She decided to have bmx. She did not want to worry about an occurrence in the other breast. Of course no one knows for sure if she would have cancer in the other breasts, but she did have calcification's. She is happy with decision.
Are you having nipple sparing mx? You said you were afraid of the skin dying? I have not heard of the skin dying with the one step. Some women have experience problems with their nipples healing. I did not have nipple sparing, but one day I will get tattoos. I wish you the best of luck. We are here to help with info and to support you.
Carole, You and DH crack me up. I can visualize your adventures. You can be a reality show. I will try to post the meatloaf recipe later.
Okiegal, Enjoy your trip! I hope you have a great time! I'm going to try the whole chicken in the crock pot this weekend. I have not heard of a race in my area yet. My son is leaving this afternoon to run in a big race upstate NY this weekend.
I hope everyone is feeling well and has a great weekend!
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Good morning all,
Amadori, I know what you are going through and it's not an easy decision. I was also diagnosed at 49 with DCIS stage 0 (left breast) and chose a BLMX with immediate reconstruction with Alloderm. In part, I made my decision out of fear (how do you do otherwise?). I didn't want to have to face BC again, didn't want to have to take Tamoxifen and wanted a "matched set", so to speak. Although my BC surgeon didn't prescribe a BLMX, she didn't discourage my decision. After surgery, my pathology came back with no cancer to the non diagnosed (right) breast, but I did have areas identified with LCIS and ADH. As my profile states, I have a twin sister who has NOT been diagnosed with BC, but is concerned because she has had calcifications and has a diagnosis of LCIS. Only time will tell, but she'll be monitored closely. I think she would make the same decision that I made and that you are considering. So, the fear of breast cancer remains, somewhat. But we are at the very fortunate end of the BC spectrum.
Although there can be complications from surgery such as infection, ongoing pain or poor cosmetic outcomes, the majority of women do very well. I have had some issues with unusual sensations/pain as the result of a nervous system confusion (for lack of a better description), but at about 15 months post op, it has resolved to my satisfaction for the most part. I would be considered as one who has had complications and I'm doing just fine. Although I have second guessed myself somewhat (I'm like that), I don't regret my decision. My encouragement to you would be to take your time, fully consider your options, do research and choose good surgeons to the best of your ability. Also, know that we are here for you and that you can ask anything.
Gotta go. Lots to do today. Hugs to you all!
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Amadori, that's mind boggling that you read all our posts from the beginning! You have the best possible dx--DCIS, Stage 0. Your survival rate is 99 per cent. Whatever you decide, I'm optimistic that you will be fine. I didn't realize that the TEs were safer than the one step as far as tissue dying. Keep in touch and let us know what you decide.
Meg, Dh and I watched the program about bears on Planet Earth last night and really enjoyed it. Thanks for mentioning it.
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hi one step ladies, my name is Jen i was dx with DCIS high grade and have a family history and im 30 yrs old so my doctors felt BMX was the way to go and im glad i did bc final pahtology showed a 2mm invasion! i opted for immediate implants and im two weeks post op and the results look not so great! now im trying to hang in there and not worry since it has only been 2 weeks but the shape is just not normal i thought they would be round? they have a flat appearance in front can anyone tell me how long or if they ever 'rounded' out? my PS assures me that the tissue needs to heal and the skin needs to stretch more and that i still have some swelling and bruising so it just isnt the final result. im a very positive and patient person so i know ill get through this but just wondering if anyone can offer some hope that this does get better and im not being patient for no reason! i also feel they are a bit too small but he assured me that in 4-6 months and the skin stretches we can replace this implant with 100ccs more. he says it is a quick surgery and not as invasisve since hte muscle doesnt really do anything differnet it is a swap out and ill just feel tight but not the extreme soreness. anyway sorry of rmy long post let me know your thoughts though....
thanks, jen
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Jen, I remember when I first worked up the nerve to look at my chest after my bmx/one-step. My breasts looked like two fat pancakes! With time and stretching of the skin and pec muscles, the shape improves but does not become conical. Once you're healed, you and your ps may decide that a revision procedure, which could involve an exchange for larger implants, could improve the final results.
I haven't opted for the revision, but I've been told that the recovery is fast, 2 or 3 wks, and no drains are necessary.
Take care of yourself and let your body recover. You'll look better as you feel better. Let us know how you get along.
Very gentle hug.
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jen, I had the one step with implants, waited six months and had a revision with a larger implant. Pleased with the result. Pain for one week, no drains, just the usual heal time for incisions. Recommend waiting the six months so you can see what other symetry issues you may have when everything has settled.
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ah, big sigh of relief! thanks ladies i feel better already! i just put a small prostesis that i bought at target one of those cup sizes that you just add to your bra so i appear normal but i canthelp but want to shower with a bathing suit top on...i know im crazy but i can handle it all.....until i shower....any suggestions on how to cope until the revision in five months?? i must say though i could tell how they will improve i see small improvements everyday but just wanted to make sure thanks so much for your responses!
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Jen Sorry you have had to go through all this! The waiting is so hard. You wait for test results, for surgery and then for healing. I was very impatient with my body!
I had a one-step unilateral mx with implants. My right breast has the alloderm and the left is my normal implanted breast. At two weeks, my breasts were swollen, high and just not normal looking! I am 3 1/2 months post op. My mx scar is lighter than the implant scar (probably because the implant scar is below the breast and is taking the weight of the implant).
My right looks different from the left because it doesn't have the same projection (it's flatter at the nipple) but I am very pleased with the overall results. As time has passed both breasts have fallen into their position.
Yes, showering is hard--looking in the mirror was hard at first, but that will get better. And it's a relief to know that you can have a revision if you want to do that.
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thanks Speech! all of this reassurance makes it all so much easier! PB22- how much bigger did you go when you did the revision? how many more cc's did you go up and what was the recovery like did you feel like you needed to be out of work for some time or did you feel like your muscle was already stretched that it didnt realize the switch just skin tightness?
thanks ladies
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jp mercy, I went from 375cc mentor high profile round to 550 cc . I was on pain meds about a week and remember right at that time asking myself why did I put myself through this pain again but then recuperated faster and was off pain meds the following week. I remember keeping my hand by my sides for awhile and didn't drive for over a week. I didn't want to ask anyone to help this time and remember driving with my hands to my sides , being able to drive but not comfortable. I had no skin tightness, the PS actually removed some extra skin to give me a lift. It was just the healing incision I had to remind myself to not lift. The first time around I needed no reminding because I was incapable of lifting, the secnd time is tolerable.
I was not working at my second revision, kids off from school, I would take two weeks off from work or one week and then half days if you could get away with it because you don't want to lift just for the sake of not stretching scars.
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Amadori, sorry you have to join us, but you will find a lot of support here. I felt that I was being urged to have a bilateral, but with the support of my oncologist I opted for a unilateral. The oncologist's opinion... "there is no medical reason to take both. The decision is irreversable and could be done later if you become too nervous". I'm happy with my decision.
To Jen as well... as speech wrote, the shape will be different, flatter, not cone shaped. This is a lament found all over these boards with all the reconstruction methods. After a while the muscle relaxes (what an ordeal it has been through!) and the new breast settles in and rounds out. My unilateral results... not an exact match from the side, but in a bra, undetectable. I haven't heard anything about the one-step being more dangerous to the skin, quite the opposite. Get some time with your surgeons and ask all your questions. It's easy to get carried away with speculation, I certainly did. A creative imagination can fill in the blanks in knowledge with a whole lot of bad stuff.
Hello everyone, I am a bachelorette this week, no monosyllabic nephew, just the cat and a whole lot of work to complete. The sun is shining, the work is waiting and the cat wants to sit in front of the computer. Hugs to all.
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Hi Jen, I had the one step with alloderm about 13 months ago. When I first came home, my new breasts were very round and high...looking unnatural. Over time (months) my breasts softened and dropped. Early on this thread we talked a lot about being flat in the nipple area. View from the front, I look fine...view from the side, I look flat. This is common with the one step. We all tried different bras to get that natural look. Okiegal even had a few inventions! I am still flat in the nipple area and do not fill in a soft cup bra. I wear a padded bra and look normal in clothes.
Also, after surgery you are swollen and when the swelling goes down your skin is stretched leaving extra skin. I have a bump of extra skin at the end of my scar on my right breasts. Many have revision surgery to correct these imperfections. It is too early for you to know your results. Give yourself time to heal. You will see these changes over a period of time. Good luck and feel free to ask us any questions.
PB22, Happy to hear you are pleased with your revision surgery! Did you have nipple sparing? I wonder what effect revisions have on nipple sparing mx. I could not have nipple sparing because my breast was too large. My PS said there was too much skin to have the nipple placed properly. I wonder what happens to the placement of the nipple when one has revision surgery for larger implants?
It is beautiful out today... 50's in the evenings and 70 during the day! I mentioned my son was running a race this weekend. Not the race I thought! http://www.warriordash.com/register2010_northeast.php He had fun and came home in one piece! He went with coworkers. DH is thinking of joining him next year!
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i just have to say your all awesome and your responses have made me not worry! time time time right??? anyway yes Meg im here in buffalo and it was a BEAUTIFUL day! just went for a walk with my eight month old baby boy! it was great some much needed outdoor time and time with my baby since in the last two weeks i have not be able to pick him up or get outside much! feeling great today! tomorrow morning appoitnment with onc to discuss further treatment plans bc of my 2mm invasion from dcis.....dreading it but relieved that i will have some answers!
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Jennifer, I'm assuming that cute little fellow in the picture is your 8-mo-old baby. I'm so sorry you're having to deal with bc at this time in your life. Bummer. You may think that you'll never feel "normal" again, but eventually you will get up each day and go about your life with the old zest and optimism. Give your son a hug for us.
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Jen: Welcome and sorry to have to do that at your age. But you have dealt with it now and you have allot to look forward to. Great bunch of ladies here. You will get lots of support.
Okiegal: Hope you have a great trip to L.A.
Meg: Gorgeous here today too. Went to my sister and her DH's hunt camp two miles north of here. Great drive--saw two moose. Lots of partridge. We just shoot pictures.
Carole: Enjoy reading about your travels. Hope you are both well.
Heading out of town for a few days for a course so hi to all and talk to you at the end of the week.
Fortunate 1: You need to get yourself a nephew like mine. I texted him today to see if he wanted to come for supper and his answer was "who is this?" Too funny.
Hi to all. Goodnight.
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Hi Ladies
I am suffering from "weather jealousy"! It's HOT here in Phoenix
. I think it was 109 today....but we are getting a cooling trend later in the week. Yeah, I think it will be 95. What a relief--yes, it's dripping with sarcasm. I shouldn't complain too much--once we get into mid October, the weather becomes absolutely perfect and stays that way until about May. Enjoy your beautiful days everyone!
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Amadori, the tissue dying is a risk and it is what happened to me. At my one-week post-op, PS and I made the decision to address it aggressively and I was back in surgery in two days to address the necrosis. It was not such a big deal, really, just a setback. The benefit of having been able to go forward with the one-step would have been a big payoff had it worked out as now I am looking at the whole fill cycle and replacement surgery ahead of me. I have great faith in my choice of plastic surgeons and I've left it all in his hands. The were not easy consent forms to write up because of all the possible courses of action, but for both the immediate reconstruction after MX and the second surgery to address the necrosis, my PS was prepared to move forward as he saw fit. He had TEs and implants at both surgeries and went forward with plan of action that would give me best cosmetic, medical, and recovery results (not necessarily in that order!) I think to take that path, you have to be able to trust in your choice of plastic surgeons so that is probably your first question to address.
I think the thing to address your concern about the skin dying, just realize it is a possibility, just as having an infection from surgery is a possibility. The reason the surgeons (should) do close follow-up is to recognize any possible complications quickly and address them before they become a medical issue. I had a week and two days with the implant instead of the expander and I'm glad I had the opportunity to test drive my final result, it just would've been nice had it worked out to be the end of that side for me. Hope this helps put your mind at ease a bit. Best of luck with your surgery, I'm sure all will go well and your surgeon will push forward with whatever solution seems to be best for you given what s/he sees at that time.
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Thank you ladies for all of your support and advice. I am still not close to making a decision. I am meeting with a third doctor tomorrow and waiting for the BRCE test results which will aide in my decision.
My surgeon told me she can go back in and do another lumpectomy or a masectomy and I wouldnt need tamoxifen. The second opinion doctor said I shouldnt consider a lumpectomy since there are multiple sites of DCIS and that either way I need Tamoxifen. So who do you listen to? Also, I am very set against taking Tamoxifen. People I know on it said its terrible.
The two PS also had 2 very different approches. One said to do one step with saving my nipple and he would fix the other side to match new breast.the other said to do the TE and he cant save the nipple and wouldnt touch other side.
Can you see why this is all so confusing?
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SPEECH529:
it sounds like you had the same cancer in your left breast as me, stage 0, DCIS. Do you take tamoxifen? Did you have radiation?
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Fortunate1:
If you had just a unilateral, do your breasts match now? Do you have to take Tamoxifen? Did you do the immediete reconstruction or TE? Thanks for helping!!
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Hi Amadori, Yes, it is excruciatingly confusing. I had a hard time with it too. I did the one step reconstruction with Alloderm. All of us here are one-steppers. My breasts are a good but not perfect match. I am a full B, a term I had never heard before all of this. The PS actually complimented me on my "youthful breasts" and said he would not need to do a lift on the healthy one to match it to the new one. So we might be similar. He did tell me what I was going to get, almost exactly. I put up quite a fuss about it before and after surgery. The reconstructed breast is fuller at the top and flatter at the tip. It lacks the draping curve that leads down to a point at the nipple. It is a beautiful match from the front. I was so pleased to have it right from the start, very affectionate towards it, if that makes any sense at all. It is soft and very pretty, just not the same. In a bra the differences disappear. About the skin death possibility... though very scary, I think it is rare. I did have a tiny strip of skin on the incision die. It was easily removed, an in-office procedure, without any problem. I think that even the tiny strip was rare.
I am 63, was 61 at the time of surgery. So being postmenopausal, Tamoxifen was not the drug for me. I am taking Femara and it hasn't really been a problem. My BC was stage 1. For me, a hormone suppressant is the big deal treatment for reducing the chance of a recurrence, and thereby giving me a long life. My goal. Don't be too scared of them. The doctors can work with you to make it easier, and you might be lucky and tolerate it well.
Hope this helps.
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Hello Everyone,
I'm new to this section. Having one step DMX/reconstruction on Thursday. Still a little confused about the size issue. I currently am a DD and would like to go to a C cup. Someone on another board suggested 450cc implants? I'm also having nipple sparing? and was wondering if anyone here has had that? Any tips appreciated! Thank you!
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Robynkk, I had the nsm bmx. I am a full C with a 550cc implants and a rib cage around 29-30. Not knowing your figure its a guess. For me 450cc would be too small because I have acquired some unwanted wt in the mid section with the arimidex and would not want my chest any smaller. If you are petitie with a small flat waist and hips then the 450cc could work for you. I do fill out my C cup. The change in implant sizes are in such small increments and the placement whether high or low in the pocket makes a difference as well.
Meg, that is a good question regarding any change of nipple placement when changing out the implant, I had never even thought of asking the PS that. I have one that is facing outward for my taste but when I looked at the before picture it always had and I never noticed that because I wasn't studying myself so I decided to live with it The PS said it could change as it settles. He did mention to me that scar tissue sometimes pulls the nipple in a direction. PS said moving the nipple to center is easilly corrected in the office, but I am opting not to address it as you fix one thing than you have to live with numbness and scar tissue etc. I also had a painful experience with the seninal node injections so no needles near my nipples although now I'm probably numb. Some day I'll get brave and post pics for all to critique.
Okiegal, I think you ladies were discussing shaving under the arms and how difficult it is and how worried about cutting one self. I recently had the laser hair removal for that reason. Didn't feel a thing probably because I'm am numb and compared to what we all been through it was a walk in the park. So now I don't have to worry about the cuts.
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Upcreek, that's not fair that you saw TWO moose! I travel all over the country looking for moose and you drive two miles north of your home.
We're in the eastern UP at Cedarville, MI. Our rv site gives us a beautiful view of Lake Huron. Today we did a day trip to Drummond Island, which is very close to Ontario.
Either tomorrow or Wed. (depending on the weather) we'll start moving south. Next stop is Holland, MI. This is the Visit DH's Family part of the trip. I'm starting to get excited about going back home.
Wishing everyone a peaceful evening. Hope the NO Saints win their game tonight!
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Well I meet with the PS tomorrow to see what he thinks about doing a revision surgery. I have one side that the pocket it "tighter" than the other so the implant has not settled. Of course after 5 months I think I like the higher one better
I am also going to tell him I am not happy with my projection and want him to exchange out my implants. I hope that I am able to say it that bold at my appointment. I am nervous about insurance covering it but I am a worrier. I will update after my appointment tomorrow. Everyone have a good evening.0 -
Hi friends, sorry, I have to yell a little bit. I saw my Onc today, the usual checkup, and he is still not happy with the lump on my reconstructed breast that was biopsied in June 2009. It is apparently a bit bigger and though he says it doesn't "feel like cancer" he wants it looked at again. Really he wants it out. They will look again, and as before, say that it is fibrous scar tissue. I don't know why it upsets me so. He, the Onc, is a lovely man charged with being my watchdog and keeping me healthy. But, I am a bit ashamed that after almost two years I am once again tossed back into fear. Hate this damn disease! I can wait until my mammo in November, or do an ultrasound soon. I think, soon.
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fortunate1 We are all here for you and one another! You've been through so much--it's very normal to be afraid. I am sorry you are having to worry about this now and hope your Onc will order a test right away. (((big hug))) Keep us informed, of course!
amadori Yes, I had DCIS, stage 0, grade 3. My lesion was relatively large compared to my breast size so after a lumpectomy with too small margins I opted for MX with immediate reconstruction rather than more excision + rads. I saw an Onc in August and he wanted me to go on Evista (for post-menopausal women--I had a hysterectomy 3 weeks before my MX). I was in doubt about going on this medication (it's chemically similar to Tamoxifen) so I have another appt with a different Onc on Oct 1. I am not keen on taking Evista or Tamoxifen due to the SEs.
robynkk So sorry you are facing this! I had a nipple sparing MX. I guess it is not very common but I was fortunate to have everything line up--skilled surgeon, lesion not too close to the nipple. My breast looks great except for the lack of nipple projection, which is minor. During the first two weeks, I had some very dark discoloration on half of the nipple; the doctor was not worried, said it was part of the healing. Over time, it scabbed and eventually revealed very nicely healed skin underneath. I had some slight bleeding during this time, but it was all part of the healing. We will be thinking of you on Thursday.
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Hi to all. I'm back. After my chemo I just kind of wanted to take a break from anything cancer related for awhile. Well, break is over. I had my one year mammogram today and now I have to wait for the results. I was going to wait to post 'til after my test results were in but Fortunate1's post kind of struck a chord so here I am to say "I'm right there with you, dear; tossed back into fear." As I have moved through my DX / MX /TX it has come to my attention that anyone can give me good news but I have to wait for a doctor to give me bad news. My mammo technician was decidedly noncommittal as to what appeared on the screen today. All she would say was that I should keep positive. Rats.
Okay, now for some ACTUAL positive stuff: Chemo went fine. No neuropathy. And I did keep my hair by using the Penguin Cold Caps. By the way, UCSF in San Francisco is looking for 50 participants for a clinical trial of cold cap therapy.
I have been back to work and have worked on a couple of major shows. I won't say that I'm 100% but I'm pretty darn close.
My slow healing nipple is finally OK. It did take months but as some of you may recall, there was some doubt that I would be able to hang onto it. I'm so glad my PS is a patient man. I'm also glad that Silvadene creme isn't expensive. I must have gone through a pound of that stuff.
Even more positive stuff: I put my uni-reconstructed self in a bikini and did just fine at the beach. And that's without any revision surgery at all. Yay for the 1Step!
One more bit of positive stuff: I am no longer a NewBride. My husband and I celebrated our 1st anniversary in July. Do I have to change my name now?
Well, that's it for now. I will say in closing that I have missed all of you and I will be around more often from now on. Also hello to those who have joined since my last post and feel free to ask me questions about the 1Step reconstruction, nipple sparing, or chemotherapy.
Bye for now.
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Thank you both for your replies. I'm thinking 450cc's will be too small now. I go in tomorrow for all of my pre-op work and am going to talk to him about size. I'm 31" around the ribcage, 5'6" and weigh 145-155 depending on the month
speech529 I think I will be too scared to look. I had asked my PS if he could make my aerola? smaller and he said no because it would kill all of the nerves and high chance of discoloration? I'm honestly not expecting great cosmetic results just wanting them to get all of the cancer. The dr.'s at USC are supposed to be the best, we'll see? Thank you again for your advice and encouragement! Robyn
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