Nipple Sparing Mastectomy with immediate reconstruction
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I am a firm believer in listening to that little voice inside......
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Lisette- You should feel very proud of yourself for fighting for what you wanted. I think you'll be so glad you did. Just sorry you have to go through the whole lumpectomy thing but it will all work out.
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Shawna32,
I had BMX nipple and skin sparing on dec27th with direct to implant immediate recon, my ps does not use Alloderm . I am 9 weeks post op and very happy. If you want more info pm me.
Karen0 -
hi to all,
new to all this. just diagnosed with LCIS and my surgeon said i am a good candidate for NSM. i am trying to research and am so frightened about pain and recovery.
any words of encouragement would be appreciated...
god bless...
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Welcome shabby6485,
I sent you a PM - the pain isn't bad - really!! It was a pain not being able to lift or raise arms above head for 6 weeks.
Hugs, Valerie
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shabby- So sorry about your diagnosis. It's so overwhelming in the beginning but it does get better- I promise! The good news is you found this amazing site and it, and the women on it, will help you through the whole process. The other good news is you're a candidate for NSM and that will help so much. There will be changes in how you feel- physically and emotionally but NS really helps with all that. NS is a lot less disfiguring which can help with accepting the MX. One thing I would ask your surgeon is where they will be placing the incision. Some place it under the fold of the breast (IF) and it's barely visible. Some still insist on taking it straight across the center of the breast which leaves large scars. Unless you are large breasted the IF incision works for most but not all surgeons do it.
Let us know if you have any questions or if you just need to "talk". We're all here for you! (((hugs)))
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I so appreciate you ladies taking time to assist me. The strange thing is that I am actually relieved to be getting off this crazy regiment of 6 mos. screening. I had 10 biopsies in 4 years!
So, not struggling too much emotionally with the decision. Just more concerned with outcome and recovery/pain. I had two "deep" excisional biopsies last wedesday and I am still in some pain so I cannot imagine what this surgery will be like
I am 47 years old and still quite vain so I am hoping for a decent result. I really do appreciate all input.
It sounds like most NSM ladies have been happy with the outcome so that makes me feel more comfortable.
Thanks again!
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shabby- If it helps the pain of the MX was no where near what I had pictured in my mind. (Maybe it's just all the good drugs- lol!) Not to say you won't have a few bad days but no where near unbearable status. My only advice would be to be as active as possible afterwards (following doctor's orders, of course). I think I babied myself too much and payed for it down the road.
One thing I would recommend for anyone about to have MX, or even those who already have, ask about PT. I think this is something that should automatically be ordered for anyone after MX but it's not. You have to ask for it. I'm been having ongoing issues with my shoulders and my pec muscles and am just starting PT even though I'm 2 years out. Another member on here recommended a program in my area called Breast Cancer Rehab and I'm starting it in a few weeks. I would look for something in your area. I did find this website with some good info and there's a book you can order. The woman who started this program was a BC patient who unfortunately passed away from complications of her treatment. Just wanted to pass on the link-
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Went for my pre-op yesterday, had lab work, EKG and got my pre registration for the hospital done. Now just waiting until March 26th.
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Hello All,
I have been around, reading but have not had the time to ask all that I would like. I just finished my last round of AC surgery scheduled for 4/3/12 BMX with NSS immediate reconstruction with Allo Derm and implants. I have not seen anyone as of yet who had AC first then surgery. Has anyone also had the Taxol after? I just don't want to go there. I was luck with the AC, but probably won't be with the Taxol. I would also like to know about bathing when after surgery? I am excited to get this over with but at the same time scared of the pain and the unknown.
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Chase- I can't answer the AC or Taxol questions but as far as bathing- I was able to shower when I came home from the hospital. (I don't think you can have baths until your incisions have healed.) You will have surgical drains and I found the easiest thing to do was to have a lanyard around my neck that I could safety pin the drains to. Then just be extra careful as bathing. I have to say that first shower felt so good.
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Chase, I recommend you check out the Taxol chemotherapy thread for your chemo questions. Plenty of gals on there with experience with that.
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Hi! Anyone with a NSM for prohalytic masectomy? Do they check nodes? What about pathology? I am nervous that I go in for LCIS and they find cancer. But, I guess than I would be ahead of the game. I should not try to get ahead of myself but it is hard...
My big question.. after reading many nsm stories it seems that alot of ladies are not comfortable with the actual implants. Will these "breasts" ever feel like your own? Do they feel like a part of you? Do you eventually become comfortable in your own skin or do they always feel foreign?
thanks!
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Shabby,
I was dx with DCIS in my right breast in Sept of 2011. I had a previous BC in my left breast in 2004. in 04 I had a lumpectomy and chemo and radiation and tamoxifen. So in Sept I opted for a bi-lateral MX with reconstruction hoping that this will be the end of cancer for me. I decided to take my left breast just to try to avoid BC a 3rd time. I had a BMX with skin and nipple sparing. My incision is along the top of my areola. I am very happy with the result even though my left nipple is a bit smaller and not completely even with the right (my left breast was radiated 8 years ago so this is expected). I had TE which were painful to me but tolerable. I had my exchange surgery January 23rd and I'm very happy with the my implants. Exchange surgery is much easier and not as painful. I like my implants and in my bras and clothes I'd say my silhouette is much better than before surgery as I went bigger. It's crucial that you try to find the best breast oncology surgeon and breast plastic surgeon that you can. Only some surgeons are trained to do nipple and skin sparing surgery and you want one who has performed it many, many times. Ask to see photos of their patients and also ask to talk to a recent patient. This should not be a problem. If it is find someone else. What city are you in? You can ask for referrals on this site. And most of all try to stay positive.
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Just passed the one-year mark since NSBMX and the six-month mark since exchange so I updated my thread on the picture forum.
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Tina- happy (???) Cancerversary (though I'm never sure if that's the date of DX or the date we get rid of our cancer. Either way it's a milestone. Some of us get very emotional on those days. I know I did. Hope yours was good. (((hugs)))
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Tina - checked out your pictures - AWESOME!! Glad you are doing so well!!
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shabby Just chiming in on NS BMX. I am five months out from surgery, and am fairly happy with my silicone implants. I had BC surgery on one side with a node biopsy, and a prophylactic on the other side without nodes removed.
Most of the time I don't feel a big difference with the implants, unless I really think about it. That being said, there is still a lot of numbness at the incision site, the outer portion of both breasts and both nipples. This for me took some getting used to. But as I go about my day, I'm not always thinking that I have some foreign objects implanted on my chest.
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Shabby--I had prophy Bi-lateral NSM for LCIS ...100% feel it was the best decision..quality of life changer when you are not stressting over biopsies, mammos, mri, sonograms, etc every 6 mos. And honestly--I physically look significantly better now than I did to start (I went from a droopy lopsides A to a very full
, The scars are underneath, I was fortunate and had no complicatons. If you are on picture site, I have the whole journey there. My BS and PS were both fantastic and supportive of NSM from the start.I had mx Dec 2010 with TEs, was back at work after 3 weeks and travelled out to Park City for work on week 6...TEs filled very slowly over several months, so fills were uncomfortable for a day but not painful. I had the exchange to implants April 2011. They did not settle evenly (looked fine in clothes but a definite ridge and uneveness bothered me). My PS did a revision this past December to even things out (bigger implant, some fat grafting). The surgery was only an hour or two and I took a week off of work. For me, NSM was a miracle. These boards were a God-send too--everytime I had a YIKES moment, somewhere was able to give good solid perspective and advice.
Ilene
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Hello ladies! Just checking in to thank all of you on this thread who provided me with advice and support prior to surgery. I am two weeks post op and doing GREAT!! The NSM with immediate recon went very well and my nodes and pathology came back with nothing worse than lcis, adh, and alh.
The advice on questions for my surgeons and preparation were so incredibly helpful. My body and head were ready and my best friend drove me in for the morning of surgery with the radio blaring some strong girl tunes. Not gonna lie...I even flashed the girls Mardi Gras style on the car ride to the hospital! Something I have NEVER done before, but somehow it was fitting. A funny and light farewell to my former self.
The new girls are healing well. I have no idea what they will look like once they settle, but already they look fine in clothes. They are numb and still pretty sore on the sides but completely manageable. My nips looked pretty scary a week ago, but they are coming back and I'm very relieved. They do feel kind of "muscular", will they soften up? Any idea how different they will be size-wise down the road? I'm sure they are still quite swollen, but they are close to my former size now and I'm hoping that they don't shrink too much.
I'm praying that my nips continue to heal and that I steer clear of infection, I feel really good and incredibly grateful0 -
MammaShells- OMG, I love your flashing story!!!! It says a lot about your spirit and attitude and that definitely gets you through all this! Only wish I had thought of that! lol! Really glad to hear you are doing so well. The nips should soften up over time. They can get rough and sometimes scab over but it gets better. The swelling can sometimes take awhile to go away and it's so gradual you almost don't notice it. The only change to mine is the "headlights" are on all the time which can make certain clothes challenging (unless I'm going for the trashy soccer mom look). The swelling can sometimes take months to go away and it's really gradual. Then one day you look in the mirror and realize it's all gone. Sounds like everything is going great for you, though! (((gentle hugs!!!)))
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MammaShells - "Girls Gone Wild".....I love it! I think most of us have gotten so used to lots of people looking at us after surgery and during reconstruction that we don't think twice about popping our shirts open. But, also wish I had thought of a good flash on the way to the hospital...hilarious!
I had significant healing issues with one nipple and surrounding area, but even that did eventually soften up so I think you'll be good. As far as NAC size, I think that depends on how your implants ultimately compare sizewise to your native breasts. If you look at breast augmentation "before and after" photos you'll notice that the nipples usually look larger because they've been expanded from behind. If you stayed about the same size the nipples will probably look about the same. If you go larger the nipples might look a bit larger.
Unlike Kate, my completely intact nipple reacts just as it did before BC (the other is only a little nubbin now so it's hard to tell). It is typically soft and relaxed, but responds to temperature and touch even though I don't feel it anymore.
Sounds like you're doing great....keep up the great attitude and keep us posted!!!
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Hi Ladies,
I am currently in the process of consulting for a double pmx for LCIS. I would like to get at least 3 consults.
Is there anybody from New York City that would recommend their surgeons? I am hoping for a one step nipple sparing. Not sure if the one step will be possible as I am a d cup.
I appreciate any assistance~
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shabby- I don't know of a BS but have been hearing wonderful things about PS Dr. Christina Ahn who is in NY. She can create entire breasts using just fat grafting (lipo) so no need for implants or additional incisions like with DIEP and other flap surgeries. (She does do those too, though.) The advantage of fat grafting over implants is no foreign object, nothing to replace down the road, more sensation is retained and there's no need to alter your pectoral muscles like they do with implants. It can be a lengthy process but I really wish I had known about this before choosing implants. I'll post a link to her site-
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Hey Shabby-
Shabby-I am in NYC, had LCIS and NSM. I used Dr Swistel at Cornell as my BS and Dr Sultan at St Lukes for PS (they agreed to work together). I had a great experience/ great results. I went from A to C, so our situation is different in that respect. I know NSM is often less complicated with smaller breasts. Also-my docs, (particulary Sultan) were not fans of one step. I kept asking and he kept saying it would not be the best result. He was right-I am really happy with the outcome. Swistel has prob done more NSM procedures than most docs in NYC (or the country from what I understand)...and he is kind and compassionate and answered all my nutty 3am emails (albeit with very brief responses!). Sultan is meticulous,has an unbelievable eye and really goes for a very natural look. A friend of mine also used Dr. Swistel for her mx (cancer)--she was a D cup and he did NSM. She used a female PS he works with at Cornell. I saw her results, she looked fantastic. However, she also did not have One-step. Dr, Swistel should def be on your consideration list.
Ilene
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Thank you guys for the recommendations...
kate33 does dr. ahn also do nsm with implants? i was told by another dr that i may not be a good candidate for flap because i don't have much fat to work with. thank you.
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shabby- I'm not sure if Dr. Ahn does implants since it's not listed on her website but I would call the number and ask her staff. NSM is listed on there, though.
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Dr. Ahn does perform implant reconstruction, but her specialty is flap reconstruction along with fat grafting. She works with several BS's who perform the NSM.
Shabby, if you're considering the one step as well, Ashikari/Salzberg are considered top NY surgeons with immediate implants. They are located in Westchester. I consulted with them several years ago, but chose NSM / expanders since i had large breasts.
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Bumped for Diane.
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Im new here and hoping to hear from people who are happy with their implants. I am scheduled for MX on april12 with immediate implant. I guess Im not a great candidate for a flap surgery because I am not heavy enough? or just short to begin with and dont have enough to work with. I certainly dont think of myself as thin but dr recommended implant. Im in Boston at Mass General. I have 5 and 7 yo children so I guess I dont really have the extra time for recovery that the flap surgery takes. Anyway, I would love to hear from anyone happy with their implant. Im a C now and hope to go down to a B and then get the other side reduced/uplifted to match.
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