Nipple Sparing Mastectomy with immediate reconstruction
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Thanks TinaT
I have access to the picture site so will post there too.
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I finally got my surgery date. Will be March 20th. Will have Nipple sparing bilateral with TE placement. Starting to feel real now.
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joy- As you're healing from exchange it is really important to wear a good, very supportive bra. Some even recommend wearing it 24 hours a day. This ensures that the implants remain in their pockets as they are healing. An underwire bra is best as the wires actually support the implants in their proper position but it's really important that you wear one that is the right size and style. (You don't want the wires pushing on the wrong place.) It's usually a good idea to have a professional bra fitting with a fitter who is trained to work with MX patients who have had recon. If you have a Nordstrom's in your area they are wonderful. Just make sure you make an appointment ahead of time as not all their fitters have this training. Let them know you have had recon. If you don't have a Nordstrom's you can find a MX bra shop. (Once you know what size you are, and what style works for you, you can purchase the bras anywhere.) Some insurance companies will actually reimburse you for the bras and Nordstrom's will handle the billing for some of these companies. There is a great thread on here regarding bras post exchange that has some great advice. It is called "Bras 101" The Great Post-Exchange Debate". Here is a link-
http://community.breastcancer.org/forum/44/topic/753120?page=103#post_2787597
Sherry- With a date on the calendar it is probably feeling pretty surreal right now. I remember what that feels like. The good thing is you really have time to do a lot of research to prepare. There are some great threads on here on what to do ahead of time to make things much easier- what to buy, pack, etc. Here is one called "Shopping/packing/to-do list for surgery + recovery..."-
http://community.breastcancer.org/forum/91/topic/699896?page=17#idx_492
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Thanks Kate, I'll check it out. All these threads have been so helpful. I have had lot's of time to research and I got three PS opinions before deciding on who I was going to use. Whippetomom has been a huge help over the last few months to me. I wish I could do it sooner but my PS wants me to wait until one year post rads which is the end of Jan and then my boss is out until mid march. so it is nice to get a date and know that I am moving forward.
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kate It's funny that the PS never mentioned that a bra was important, he has been so vague post-op in answering my questions about exercise, sleep positions, etc. His attitude is "if it doesn't hurt, go for it"! I had immediate implants, not exchange, so I'm not sure if that makes a difference in use of a bra. I'm back in the States next week, and Nordstrom is close so I'll make an appt. for a fitting. I think that at this point, the left alignment may not be fixable, but a supportive bra at the minimum will make things more comfortable. Thanks for the advice.
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Joy,
Each ps seems to have their own opinion on bras after surgery. I also had one step implants, no TE's, and after the drains came out was told to wear a sports bras. I was told very clearly NOT to wear an underwire. At a check up about 3 months later, I was told I could wear any type of bra I wanted or no bra at all. I usually wear stretchy Coobie bras but I have a couple of "good" bras. They are 36 B, La Mystere Tisha underwire. The wires fit easily around the implants and are comfy but I often go bra less.
Caryn0 -
Sherry- I know it's probably hard to wait but the long you do the best your post-rads skin will be so it's definitely a good thing. Your PS is smart to have you wait.
joy- It seems a lot of things we learn about on BCO through trial and error as there doesn't seem to be much consensus, or information, from our PS's most of the time. I think the reason some PS's are leery of underwires is the concern of the wire pressing on the wrong spot which is why they should be recommending a professional bra fitting to anyone who has had breast surgery- even augmentation. As the breast is healing a capsule is forming around the implant and you definitely want to make sure it's forming in the right place. Also, without breast tissue, some women have issues with the implants wanting to gravitate towards the armpits. Keeping everything in the right place as it's healing will help prevent that.
For others who are just out of surgery- joy is 2 months out, but if you've just had surgery, and your incisions are in the fold beneath the breast (IF) you should wait on the underwires until your incisions are somewhat healed. You definitely don't want wires pressing on fresh incisions. You should find a really good supportive sports bra though.
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Thanks Kate. I'm still leery of trying underwires, seems like it will be uncomfortable. My incisions are keyhole, towards the armpit. But I'm willing to give it go and get a professional fitting. The capsular healing makes sense. I'll ask the PS about it too and give feedback on what he says. I have a feeling that a revision on lefty's alignment is in my future, though.
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joy- Prior to MX/recon I never wore underwires and never understood people who did. I thought they were torturous! LOL! I left my very first bra fitting, 2 months after exchange, wearing one feeling incredibly comfortable. It it's uncomfortable it's not the right size or style. It can be tricky finding one that works post recon for some reason. Maybe it's the lack of breast tissue but reconstructed breasts don't always fit right in a lot of bras so it's great to get some advice from an expert. Hoping you don't end up needing a revison but, unfortunately, it happens more than we realize. Good luck with your PS appointment!
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kate How funny about the underwires! I was an underwire devotee before, even though I was a B cup. Now I cringe at the thought of getting into underwires again! LOL
One more funny thing and I will ask at the PS office at the upcoming appt. I swear that the left implant is bigger than the right! Is this ever done? Maybe it's swelling on lefty but I don't think so. Lefty was a little larger before surgery, but this is noticeable and strange!!
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Hello laides, I'm new to this thread. I'm scheduled for my NSM and same day reconstruction on 2/22. I meet with the PS on 2/3, this seems awfully close! I'm a single mom and trying to prepare as best I can physically and emotionally for the big day. Any advice would be greatly appreciated!
Thank you all for sharing...you have no idea how much it helps to have lurked around these boards weighing the options and knowing that this amazing community is here.
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MammaShells, so glad you got your surgery date. The pre-surgery check lists were very helpful to me last year. It seems like your brain just goes on vacation once you hear the C word, I know. My best advice is to rely on your support group, both locally and virtually, especially as a single mom. Don't be afraid to tell someone *how* they can help. Many people will offer to help generally, but have no idea what they can do. Ask them to pick up food, or pick up some items at the store, or give you an hour to fold your laundry, or whatever. Hang in there! I hope everything goes smoothly for you.
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MammaShells - When you say you're having reconstruction on the same day do you mean immediate placement of implants or are you going the TE route? If you haven't already done so you can check out the Implant Sizing 101 thread if you're having doubts about what to discuss with your plastic surgeon.
As supersally mentioned, I had friends and family who kept offering to help. People really do want to be of assistance, but often don't know what to do unless you tell them. I found that asking for very specific small favors (like picking up a prescription or driving me to a short medical appointment) really helped me and my husband and the friends really seemed excited to be able to do something to pitch in.
Best of luck to you. Please keep us posted!
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Hi, thanks SuperSally and TinaT. I'll check out the implant sizing 101 thread, I'm a 34D right now and want about the same size. I am having immediate placement of implants, they say I can have immediate implants if they are the same size or smaller. Also, I can't track down the Pre-Surgery checklists on this board, any suggestions?
Thanks again
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MammaShells- Not sure if this is the one you're referring to but if you scroll up to my post on the 6th, on this thread, I posted a link to a thread that offers advice on what to buy/pack/etc prior to surgery.
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Hi ladies I will be having a NSM on both sides January 31st with immediate reconstruction with TE's. Can anyone tell me how to find picture forum? I'm very confident in both BS and PS but as surgery date gets closer I am starting to get a little scared:(. I have appt 1/24 with PS nurse so I guess I can ask any questions I forgot to ask PS, any advice? Thxs so much ladies these forums always make me feel better when I start getting scared!
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Jenn- The picture forum is actually a completely different site that is run by some BCO members. In order to get access you have to send a private message to one of them. They only admit BCO members who have posted quite a bit on here. This ensures that the posters are legitimate and to protect the privacy of the women who have posted their photos on there. I know you are probably anxious to get access since your surgery is coming up so quick but your post count is quite low so not sure if they'll approve it. I would suggest posting as much as possible. When your count is higher you send a PM to Lilah, Estepp or Dawn-Hope and request access. In the meantime, if you have any questions any of us would be happy to help! I know how nerve wracking this time is right before surgery and it's normal to feel some fear. Just know it can be tough in the beginning but it does get better and we are all here for you! (((hugs)))
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Thank you Kate
I will definitely post more I think I read more hear because it helps me to feel I'm not alone and everyone is so informative and brave it renders me speechless at times. Thank you for your support. I do have a question though, I am having injection for SNB on 1/30 a day before surgery, did you have that and was it painful? Some people on other forums said it was.Tina, thank you for replying also, I did check out that forum also, there are so many forums and so much info I get confused at times but thank you for your support:)
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Jenn- I hadn't heard of that. Everything for my SNB was done after I was under during my MX so I can't help you with your question. Hopefully, someone else on here will have some experience with that. If you don't get an answer right away don't worry. The boards are very slow on the weekends. You can also put SNB in the search box in the upper right and look for other threads or just start a thread of your own with your question.
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JennL - I was awake for the SNB injection. Yep, it really is a stinger. However, the pain is very brief - maybe 6 to 8 second for each injection. They injected in 4 quadrants on my breast around the nipple. They had put an anesthetic cream on prior, but it didn't help much. It's just one of those things you have to bear, but it is over very quickly! I hope not to scare you - it truly is bearable! However I wouldn't want to lie to you and tell you it is nothing, and then you not be mentally prepared. You can handle it - it's done and over before you know it!
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Jenny,
I had the injection for my SNB the day before surgery. It didn't hurt a bit because I asked my bs for a prescription for EMLA cream. Slathered on my nipple/areola about an hour before, covered it with plastic wrap and I was totally numb. Additionally, the injection contained some lidocaine. Some people find the procedure painless, others think it hurts. Me? With EMLA, it wasn't an issue.
Caryn0 -
Interesting - don't know why the EMLA cream didn't work on me. It may have been the lidocaine piece that was missing in my case. They told me they don't use lidocaine b/c they felt it interfered sometimes with the mapping. The other thing is, I had the EMLA cream on only about 20 minutes before the procedure. So, these are all things to ask about Jenny! Hopefully putting my story and Caryn's story together will mean you can have a painless SNB!
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Thank you dancetrancer and Caryn!!! I will definetly look into the EMLA but knowing it only hurts a few seconds really helps so thank you for the honesty I would rather be prepared, I do have a pretty high tolorance for pain so fingers crossed:) I can't wait for the surgery to be done so I can be on the road to getting well!! Hopefully not in the lymph nodes and oncotype dx test comes back good so I don't have to do chemo!0
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Jenn - You will find that everyone's experience is a bit different and each facility seems to have a different protocol. I had both nuclear and dye sentinel node mapping. Forgive the lengthy post here, but sentinel node mapping ended up being a big deal for me...
The nuclear medicine mapping is sometimes started the morning of surgery, but often the afternoon prior to surgery (especially if it's an early am surgery time) as it can take some time for the tracer to migrate. It is usually done in the nuclear medicine department. I had neither the numbing cream or lidocaine and tolerated it very well. This particular nuclear medicine doctor feels that the lidocaine affects the movement of the tracer and doesn't use it. The injections were like quick little bee stings for me (honestly), but everyone's pain tolerance is different. As you will read, many women find that the numbing cream helps so if you're concerned you should ask about that ahead of time. Sometimes you remain in the nuclear medicine department while they watch the movement of the radioactive tracer. They may use heat and/or massage to speed up the process. If they do scan you they will mark your skin when they find the sentinel node. At surgery your BS will use a little probe (like a mini Geiger counter) to exactly pinpoint the position of the node.
I also had methylene blue dye localization. This is typically injected by the BS after you are under anesthesia and is a visual method to find the sentinel node. Luckily, in my case both methods led to the same node so only one had to be removed. Yay!
My BS likes the "tried and true" blue dye method and usually doesn't use the nuclear tracer unless the patient requests it. She initially was going to remove 3-6 nodes. However, I requested the nuclear method as well and she was very agreeable. After surgery she said she was pleased that we did both because she felt good about just removing one node.
I had a very rare reaction (first and only for my very experienced BS) in the area of the blue dye injection which caused tissue necrosis. I had a lengthy touch-and-go healing process and a delay in my reconstruction. BS and PS feel the reaction was exacerbated by the fact that the circulation to the skin and nipple are disturbed and compromised by NSM. Would I still choose NSM and sentinel node localization if I had to do it over again? Absolutely! It hasn't been a perfectly smooth ride and I've got a ways to go, but my results have been well worth it.
There....way more than you ever wanted to know!
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Mamashell,
I am a single mother who had a ns bmx. My sweet sweet baby boy is 11 months. I did the bmx so I could dance at his wedding. I am blessed with a best friend who stepped up and substituted for me on the physical aspect of mothering. If you have any questions, please feel free to pm me!
Jennl, they, the gatekeepers if the picture website, do protect the women who have posted their pictures. I asked and was told I didn't have enough postings.0 -
EMLA needs at least 1 hour on the skin to be effective and the area needs to be covered by an occlusive bandage or plastic wrap. I did this in the bathroom at my school. Can you imagine if anyone had walked in? Caryn
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LOL Caryn! Oh what we do! Good info to know about the EMLA. No wonder mine had no effect. Oh well, I survived!
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Hi Ladies i just wanted to give everyone an update..I seen the ps on Thursday my best bet is to go with TE s no big deal ..I dont have enough tissue for a flap ..Surgery is gonna be in March..Ill have my Total hystorectomy Feb 21st. Let the journey begin
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shawna- The TE's are definitely no picnic but it's probably the most conservative approach when it comes to trying to save your nipples. It puts a lot less pressure on them in the beginning when the blood supply to them can be kind of fragile. The good thing is the TE process is usually only a few months long. And since your NSM isn't until March you will have losts of time to prepare. Let us know if you have any questions. (((hugs)))
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