Nipple Sparing Mastectomy with immediate reconstruction
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Kate: sooooo glad to hear that!!!
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Dear Brave Ladies, Courageous Women, & Valiant Chicas,
I had BMX on 16May with immediate reconstruction with silicon cohesive implants. I could do nipple-sparing on my left side but not on my right side. I couldn't have it done on the right side NOT because of cancer being too close but because during my original lumpectomy on 11April, my BS wanted to also remove a benign lump and to access it, he made an incision on my areola. This compromised the blood supply too much and thus they thought it would not be worth the effort to try to save that nipple. (Makes me furious to think about it! However, trying to be zen and accept all that comes my way....) Anyway, my PS reconstructed my right nipple-areola complex NAC with excess breast skin (I was 34DD pre-BMX and wanted to go smaller. I am now small 34C and love the size so much!). The areola healed well but the nipple necrosized and had to be scraped off by PS. So it is all healed but flat. I really love having kept my left NAC, but the nipple projects a bit and shows through some bras and clothes, bathing suits, etc. My right side is totally flat. I would like to have a symmetric look and my PS said now is the time to go back to him (6 months post-BMX) to do it. He said it would be an office procedure. I also have to get color tattoos on it, eventually. But before I go in to see him, I want to have a clear idea on what I think would work best (he hates that, but I don't care). Questions: where do you think I should suggest he get the extra skin for a little nipple? Which would have the best chances for survival in your experiences? Please point me in the right direction! I am going to post this on several threads. Thank you in advance, dear info sharers!
Fearlessfoot
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As a newcomer to these boards I have to say that the info here is amazing. Its a lot to sift through and my only complaint is that it sucks you in and I now have to limit how often I come here! Thanks to all.
I had the nipple sparing procedure done four weeks ago and am amazed at the results. Great surgeons, one night in hospital, three days on percocet and then mega doses of motrin. From the beginning I made a concious decision to push myself physically hard to fight this disease. Since day three I have been walking two miles a day, I started doing physical therapy at two weeks and am planning on picking up my tennis racquet next week! I had my first inflation yesterday (40cc in either side) and it didn't hurt at all. I am off the pain meds as they dont seem to help the burny pain that flashes across my chest at random and as I can sleep well, why bother. Sadly, the pain is one of those "just suck it up" numbers and if it means nerves are growing then I can deal with it. Has anybody tried accupuncture?
Next step is oncologist who has all the results in and will present me my treatment plan. Scared shitless.
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NYBubbles. I've done accupuncture for my sciatica and it worked wonders so imagine it would be a big help here. My BMX is on 11/6/12 so thank you for reporting the good healing experience. Phew. :-)
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Welcome to any and all new women on this thread! It's so encouraging to see more new names here, that means nipple-sparing is becoming more and more available. Sad to still read sometimes that some don't find out about it until after the fact
As of 1-1/2 years ago a local PS strongly discouraged it for me, saying that it was too risky and experimental. So happy I persisted and moved on.My surgery didn't go exactly according to plan and it was a struggle for a while, but I wouldn't have done anything different in retrospect. I credit NSM in great part for how well I've done with the surgery aspect of all of this.
Best wishes!
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gunner
I don't know much about sub acute, I'm a cardiac RN. Don't give up i hope a position opens up for you soon.
I can only imagine the lost of your friendship. Maybe you valued it more than she did. Could it be she was just upset with you? Friends get mad and make up all the time.
Hope you guys can work it out.0 -
TinaT, I just posted on the picture forum. I thought it was on one of your threads but now not so sure it was you? Lol, there may be another confused Tina wondering why Im directing questions her way.
Gritgirl- so glad your avatar is rightside up now and I can see your beautiful smiling face! Best wishes on your upcoming surgery. Best items I took to the hospital was a telescopic back scratcher, and sleep mask! I'd also recommend a hand held fan, worked great with the nausea. I was so itchy from the pain meds, and also used the scratcher to reach things too!0 -
So I'm almost 4 weeks out from my exchange and tonight I discovered a little small bump in my armpit. Ugh, just when I thought I saw light at the end of the tunnel. Now I have to ride the worry train once again. Hopefully I can see my doctor to tomorrow. I don't know if should see my MO or BS for something like this...I honestly don't know when it appeared. My underarm has been weird since the BMX, and the TE, and then implants. I don't even know if it was there right after the bmx.
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Maybe it is from the drains or something post-op?
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I didn't have drains with my exchange. I only had drains with my bmx, but the bump is no where near that incision. So I don't know....
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Kate- congrats!!!
Tlew- I would see the breast surgeon. I had a small one that turned out to be a lymphocele(sac of lymph fluid). It was checked by ultrasound and required no treatment. Good luck!0 -
Kate! AWESOME NEWS!!!!!!!!!!!!
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Fearless, Your post made me think I should post (in case someone researching our thread) that I also had the bottom half of left areola cut along outside edge for lumpectomy of dcis, but they went ahead with nipple sparing --- even with the compromised blood flow. I had absolutely no problem with healing on that side.
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KellieDenise66 - I think there are three of us named Tina that are posting on the same threads. I do have a thread on the picture forum and I did see your post there. I'm not sure now if you meant it for me, but I responded
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Beckers: Thank you so much for posting that about your successful NSMX despite having been cut along edge of areola for earlier lumpectomy! If only I had known it was possible and could have advocated for it! But my PS told me his decision on the day before the BMX and all I could say was compliantly okay (I had already pushed for so many other things). I just wish that all women facing lumpectomy (and doctors performing them) could be made aware of these issues that could affect their future reconstruction if it turns out they must have MX.
Question: Do BS'es and PS'es ever read these forums??!!! Are they allowed on? Have any of you ever found reason to suggest it to your BS or PS? Do you think they would be interested? Maybe doctors should be allowed to lurk but not post! LURK, so that they could LEARN something about OUR perspectives and what other docs do, but not be allowed to POST because they should NOT be giving their opinions or criticizing anyone's decisions or procedures. Well, oops, maybe we wouldn't want them really to see what we write about them sometimes, I guess. Of course, some BC survivors ARE physicians, so they are surely on here! And some of them might be BS, PS, or oncos. I am curious whether they find any professional value from the forums.
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mgdsmc: gunner here out of curiousity why you on Tamoxifen, I got that lovely blood clot from Tamoxifen now I have more surgery to go thru ooph or hyst , Tamoxifen messed with my uterine wall, going for Ultrasound Mon at UCSF my 2nd home, having breast cancer 2x I think has put me in PTSD I have come to realize. I have bouts of anxiety and have Xanax for that. Sub acute where patients go for rehab after hospital. I live in a small hick town not much quality nursing here, quite scarey. No I wont work off the clock, no I do ot do short cuts, and yes my license comes first. Im really burnt out with nursing, ever since my cancer diagnosis my jobs have suffered. Well have a peaceful
day all. Elizabeth0 -
Hello ladies
I'm having BMX with free tram 10/26/12.
Since I'm having 2 breast done without implants my breast are going to be A cup but he will try for a B cup, I'm a D cup right now. It's going to be so weird having tiny breasts never had them in my life. I'm keeping my nipples but he keeps saying I won't get sensation back. They told me the same thing when I had my reduction but it did come back in about 6-9 months. I will take my chances. Has anyone sensation returned?
I will have to have fat grafting and liposuction to fill the extra space in the pocket later. I forgot to ask if it will be before or after radiation. He said my radiation should be easier since no implant. More importantly he said if I'm not happy with my breast I can always get implants later and all covered by insurance.0 -
I havent read all of the recent post but i wamted to share that my girls loved shaving my head last night. I'm pretty sure my husband and son did too. First my girls used scissors and then they all took turns using the clippers with a number 8 guard. This morning I went to get my labs (as I do every week) and they went up some but are still low. I go back in Tuesday to get them drawn again and to see my MO. Wenesday I have another surgery to remove the parts of my nipples that are open and raw. He is going to stitch them closed too. I'm not looking forward to another surgery but I am looking forward to not having any open wounds.
After my labs this morning, I went to pick up my wig that I ordered through a local non profit (Pinkheartfunds.org) and the founder of the organization buzzed me to the scalp. We had fun though. I let her shave a cancer ribbon in the back and then a heart on the side. It was fun actually. Then 2 friends and myself played with all the wigs.
It could have been a very hard day for me but it really wasn't. I enjoyed being with my friends and playing with wigs. It may hit me soon but as of now even though I don't like it, I've accepted it.0 -
Howdy MrsCich! I am glad that what could've been awful, instead, became a "bonding family" experience. My husband and I giggled our way through shaving my head. I never wore a wig and rocked the bald look. Where I live, I don't think anyone really cared all that much...there are much more unusual people to be seen than just a bald girl!
Good thoughts for your upcoming surgery from one Long Beach (CA though) to another!
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mgdsmc-I had NSBMX with 1 step immediate to implants in May, so 5 months post op. now and still no feelings around my nipples. I've had some feelings back around my breasts but not the nipples and my doc said I won't get back 100%.
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Soyaandpepper
Thanks for the reply. Nice to hear you have some sensation. I know it won't be 100% but any amount is better than none. I can't remember how long it took for me to get all my feeling back but I think it was about 2 years. Nipples were and still are erect most of the time. Took awhile to get use to it.0 -
mgdsmc - I also had NSBMX with immediate to implants in May, so 5 months post op. now. My nipple areola complex had to be moved up, so all nerves are severed so I do not expect to ever get feeling unfortunately. I had 34DD breasts and went to smaller implants which I am very happy about. I asked for B cup size, but I am actually fitting mostly into 34C cups. I love being smaller and not floppy like I was before. However, with my silicon gel implants under the pectoral muscle, my new breasts are quite firm and do not feel very soft or squooshy like real ones. Sensation has returned almost completely to the back of my arm and underarm after sentinel node biopsy, so I am thrilled about that.
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Scheduled for a NSBMX this coming Thursday (Oct 18). If I understood correctly, my incisions will be along the outside edges of my breasts. I haven't seen posts from anyone that mention that location for the incisions. Anyone know about this? I did find some info online about it, but have not been in contact with anyone who actually had it. The photos I have seen afterwards look great (Of course, anything on line will probably show the best results!).
Maybe it has something to do with size? I am about a C cup.
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Fearlessfoot-Glad to hear that you got back sensation underarm, I got back most of my sensation underarm as well after SNB. I feel the same way about my implants since mine are also mentor Cohesive ones (gummy bears). Did you doctor tell you whether they will ever get softer? I mean I don't expect it to be like regular ones but a little softer than now (5 months post op). My doctor said it will soften in time but I don't know if it'll ever get the drop and fluff effect.
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Powermom, my NSBMX had upside down T incision. Horizontal line along the crease of my breasts and vertical incisions up to my nipple.
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Has anyone had the procedure with a flap without implants? Did the PS mention reconnecting blood vessels to reroute blood flow? I'm just wondering if its different without implants.
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powermom - When you say "outside" do you mean the side (as in under your arm) or do you mean the periphery (as in the inframammary fold under the breast)? If it's the latter there are quite a few of us here who have had that type of incision. If it's along the side will that put you at greater risk of lymphedema? You're right, I don't think that type of incision is usually used.
Best of luck this week. Keep us posted!
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Fearless, glad to hear sensation returns. Initially I was glad my underarm was numb because the SN biopsy was quite painful on the other side. I have a pain sensation on the backside (tricep) area of the arm. Did you have pain too? I'm hoping it goes away.
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I am in the waiting stage for my NSBMX which is scheduled 11/6/12. I thought that by scheduling ahead, I'd be able to get all the paperwork in place early. Ha!!! More of that powerlessness thing.
So I've been doing what I can which is buying slippery sweats and pajama bottoms to help me slide out of bed (hope I don't slip on to the floor). A big thanks to Sheli for sending me her pre-op prep list. That was a huge help.
I think I'll do okay. I am 4 months out of chemo and have been building my strength up slowly but surely. Been working with resistance bands and doing squats to build my muscles up (I was incredibly weakened after 5 months of Taxol).
Mostly I have moments of rolling anxiety that just pop up out of nowhere. I'm here talking about it with the hope that I'll chill. I have been listening to a surgery meditation tape that a few folks recommended. At least it puts me to sleep. Oy. So here I am. Just venting that anxiety. Just doing my best to take it one day at a time until the surgery is done and over. I fought like heck to get this BMX so I ain't backing down. Just dealing with the anxiety.
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Well, I have my Onc appt and labs tomorrow morning and then another surgery on Wednesday (to remove parts of my nipples), 2nd TC on Friday. Phew...I'm beat from thinking about it. Not to mention I have plumbers at my house using jack hammers on my floor because of a busted sewer line. So much for a free day to do nothing. I've already filled up on ibuprofen due to the noise.
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