Nipple Sparing Mastectomy with immediate reconstruction
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Oh: and one more thing keeping me busy: I finally got the courage to try dating again and have met a great guy who I've been seeing quite a lot of....big BIG step after all this, thats for sure!
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Fairport- that's great!! I'm so happy for you, I remember your posts a while back when you were so worried about dating- what a great update!0
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I will be done with my Chemo Sept 16th but have to continue having Herceptin until April. My NSM is going to be in Oct., and I was debating having the port taken out if it is going to make the fills more uncomfortable. Has any one had their port still during fills? Also, where are most of the incisions made for the NSM? I would prefer not to have an incisions across the front of my breast if I don't have to.
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PB22-thanks for the encouragement. Great tips. I think your right about the gap and I need to confirm how he will fix that. I think your right I should go a little bigger especially if he uses a wider implant which he did mention as a way to bring them closer together. he did mention the final implants will not be so full at the top and I think I may lose some projection. Also I think final implants will change the distribution on the body and it probably won't look so big. I have an appointment next week and I am writing down all these questions. I appreciate all the input because when I get there I know exactly what to ask.
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I just got back from vacation and I'm so far behind! Yikes! Thank you girls for keeping the site going! It is going to take me awhile to read all of your posts and get caught back up! lol
Love and well wishes to all!
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How does one go about viewing the picture forum?
Colleen
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fairport- Thanks for the reassurances about the lump. I babied it over the weekend and it does seem to be smaller now. I'll see what the PS says on Wednesday when I see her.
Good news that you've met someone. You are so brave and I really hope it works out for you! You deserve it. Hope you have a great time in LAS, too. I'm still kicking around the idea of going.
Robinlea- My incision for my NSM was beneath the fold of the breast so it's barely visible. The initial incision is made by your BS so you would need to discuss it with them. My BS told me she always does it underneath unless the breast is larger. With a larger breast she said it is harder to remove all of the breast tissue from the lower incision site.
Colleen- The picture forum is kind of in flux right now. The woman that runs it is debating whether she wants to continue operating it or not. Hopefully we will get a definite answer sometime soon, or maybe someone knows if we have already do or not, but if it stays up you will need to PM a member called Timtam and ask for authorization.
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TN we are all holding down the fort.
Fairport, we were all wondering how the dating life was going. Good for you. There is a life after this.
Sweetie what look are you going for. I like hurley girls photo up top.
Robinlea it depends how big you are, if they have to remove skin or not. I had a lift/reduction, not that I was big but breast fed and age so my scar goes from the areola straight down so they could pull skin together to give the lift. Some goes on the side and others are underneath.
cmksocal you would have to look up under member list a Timtam. You pm her and ask her to enter the site, she will pm you the access code. For confidentiality she checks the posts to make sure that you are a legit. member and doesn't grant access to those who have not been established here. The process will take a week for her to get back to you.
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robinlea...my incision is across my breast from the areola to my armpit..but to be honest ..it's hard to see. I even had my TE replaced two weeks ago and the PS went in the same place. It actually looks better now than before. I am happy with it. My BS told me he prefers to use that entry for a NSM so he can scrape under the nipple very close and ensure good results. My nipple looks FAB..although it doesn't really do anything...lol
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Twiriandcurl
Do you have any pics after surgery? How long did it take you to heal? Did your PS do a lot of NSM?
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oh yes..I have lots of pics. My PS was the first person to tell me about NSM. He called my BS and asked about my mammo's/ MRI to see if the cancer was far enough away from the nipple to keep it. Both agreed I was a good candidate for the procedure... Even told me.."carm-if the nipple doesn't hold up..I'll make you a new one". would you like me to PM some photo's ??
healing- after MX about 10 days..after TE revision about one week I picked off glue..looks wonderful
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PB22...for some reason I didn't realize that you had 375's as your finals. That is the number Kate went with and I am thinking the same. Were you happy with the 375s?
Ladies, I have to tell you that playing golf with these expanders has actually only been good luck! I beat 3 people at golf yesterday...2 of them were men!!
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Hurley Girl, I had 375cc mentor high profile put in initially and although was pleased with it at first as it settled I had too large a space in between and not enough on the upper pole. I did not have expanders it was a one step that turned into two. I had them exchanged out after 6 months of settling to 550cc. The space between the two is much better and the cleavage is much better. Your pic is perfect.
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Yes thank you. I would appreciate that. I have seen some nipple reconstruction and it looks real!
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PB22, I don't know why I didn't remember that you started with the 375s..my memory must be fuzzy! Thanks for letting me know. I go back in a few weeks to schedule surgery. I can decide if I want cantelopes or watermelons. LOL
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I do think if it is possible to have this procedure it is worth it just to not have additional procedures later down the line. Afterall, the whole goal of reconstruction to start off with is to look somewhat "normal" again at some pont, so you are going to do whatever you need to to get there.I am of the mind-set that less surgery is better. That's why I first tried lump. And I'm a uni!
Fairport: good to hear from you! Glad to hear you are are getting back to living a nice life! I am actually trying to get mine to move BACK home since he hasn't found a teaching job yet, but he's convinced he'll just move off somewhere (he knows just one person) with 2 big dogs and no job and be fine. Of course we never stop worrying about our kids!
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bc in colorado, you did the logical progression of being conservative. We all want to avoid addtional procedures down the road. My first step put me at totally normal and extremely greatful this procedure could be done in comparison of the radical back in the 70's, total elation. Speaking only for myself, as I felt better, I got "picky" and felt that if I had to go through the pain of the bmx, and PS visits that I wanted it to look even better. I'm not a vain person. I felt why shouldn't I look like this or that when I learned what could be done and found a PS I trusted. Being more specific, is if I went through all this I should be able to wear a cammi without a bra, or a workout top without a bra under it, thus the lift. If I lived up north and dressed all covered up all year this probably wouldn't have been an issue. So I think its even regional. In Fl due to humidity we are all skin all the time. halter tops, cammi's etc. where the divots will show. I think one should go into the one step expecting two steps. LOL. Hurley wants to look like she does in her pic once the expander is out and its not knowing how your implants will settle in. I am wondering if the expander whose purpose is to stretch that muscle makes for a looser muscle where us one step immediate to implant could have a tighter muscle pushing on the implant flatter/tighter????
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Hi all. Did everyone have to pay the GS an additional fee above and beyond the insurance co-pay and percentage? My friend's GS wants a few thousand dollars in advance and in addition to the normal payment. He says there is no code for NSM and it takes more of his time and he needs to be paid more than what he gets with the normal mx code.
Did everyones PS take pictures? Her PS barely spoke to us. No photos were taken. He just measured her breast and told the assistant to have two of each; 300 350 and 400 for the surgery. As he was running out. I asked what type of implants are they. He said memory. My friend is a double D according to the PS. She was warned by the GS that this PS makes everyone look like Dolly Parton, so tell him to go smaller. So she told him she would rather go a little smaller. But now reading PB22's post about going back for bigger ones. I now wonder if one step is the way to go.
Is one step the way to go? No other option was presented to her by either the GS or the PS.
I can't believe how they are making her wait 2 months from diagnosis because of the BS and PS schedules. Shes beside herself with worry, plus now she has pain in her arm and numb fingers. The GS says its just stress. I think its a pinched nerve.
If there is a code for NSM please PM me or post it here.
Thanks and what a valuable forum.
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Hurleygirley-thanks! I think you are looking awesome too. I can't believe how good your TE's look. Do you have Shawn or Christen (Nip-Tuck) as your PS?! --would be nice as their work always came out just so perfect on that show! I can't wait to talk to my PS next week as you girls have been giving me great tips on what to ask. I think I may have to expand a little more to get the same look and I'm sure the final implants will look at lot different than the TE especially if I go with gummys, which I seem to change my mind about almost daily!
Twirlandcurl-I have the same type of incision as you had and my Dr's said the same thing about it, but I did have IDC and some ladies who had NSM didn't so I could see why an inframamory incision would be more feasible for them. I wish I could have had that type as you really do not even see the incision, but never the less I'm still grateful I could even do the NSM. Your fortunate your Dr. offered it to you. I had to seek it out and my Dr's just started doing them a few months earlier.
PB22- I think I want to be full and natural but not too big for my frame. If you saw my pics on the forum I would want to stay around the size I am now in the TE. Not sure how much more he has to expand to achieve that. Yes like how Hurleygirley's fit her frame and look natural yet full and perky.
Delray-that doesn't sound right. I didn't have to pay anything extra. The insurance covered it all and the Dr. would get paid for his extra time and effort from the insurance company. I haven't heard from anyone on here that they had any problem with it being paid and had to pay out of their pocket except for their normal and standard co-pays or deductibles. I'd questions that.. My PS took one before photo. He went over the reconstruction process before surgery but he goes more in detail as you go along. It's common to have to wait for surgery depending on the schedules of the PS and BS although I understand the anxiety of having to wait. I found the lump in Jan and had surgery the end of April but I have heard of people waiting longer.
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Delray- First let me say, what a great friend you are for going along on her appointments.
I'm not sure what type of BC your friend has, but usually a few months wait is not a big deal. I was diagnosed in December and did not have surgery until March as it took me that long to find a surgeon that did the nipple sparing. I agree with Sweetie, I have never heard of a surgeon requesting additional money up front. That sounds very wrong and if I were her I would be calling my insurance company. As far as the photos, I had to fill out a lot of paperwork at the PS's office. One form gave permission to take photos, to use the photos for teaching or websites, etc. If your friend's PS had the same thing, and she marked that she did not give permission, that may be why they didn't take any. I would be concerned with how rushed he was, though. If you friend doesn't feel that all of her questions were answered I would definitely request another appointment and have all of her questions written down in advance. Or another option, which my PS did, was I could e-mail any questions I thought of to her assistant and they would e-mail me back within a a day or so. Check with the PS's office to see what they prefer. Good luck!
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sweetie- If the scar bothers you they can now laser them to make them less noticeable. My PS offered me this option for a scar a previous BS left on the top part of my breast.
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Delray, who are your friends doc's? pm me if you'd like. your story sounds familiar especially regarding the go smaller, dolly parton comment and your experience at the PS.
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Delray, it would help to have more infomation regarding your friends dx. and her size. What size is the rest of her, meaning double d's with little waist etc.
Did you mean mentor when you said memory for the implant.
A 400 won't make her the double D she is now.
The payment up front, wouldn't surprise me. I just had to give a credit card authorization to my sons oral surgeon in the event we don't show for the scheduled wisdom teeth extraction. Let us know what her insurance is. My surgery took 5 hrs so it does take more time.
2 months is about right. I was dx in Oct and had surg. in Dec. Takes that long to get all your tests in order and consults done. Also if its DCIS its not going anywhere. The GS and PS most likely have one day per week they coordinate together and with it being summer the PS is probably booked.
No photos were taken with mine until the week before and everything was scheduled. He probably figures she's still doctor shopping.
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I'm not sure who originally asked but re: incisions, I had the inframammary fold incision despite having an invasive tumor, and my B surgeon is top of the line, well known in the research world, etc- she would not have done it if it were not safe.
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Good AM ladies, Sweetie, can you PM me the name of your PS in CT? My PS here doesn't do NSMs at this time tho I sure am hoping he will....I called last fall and all that they would say is that he needed time to think about it and that they'd get back to me....I'm hoping that he went with training in this procedure!! Kind of scared to call and find out he did not....I may not even be a candidate, but am hopeful.
I had invasive BC but I had the "apple core" technique. No scars, but I did lose the nipple and have a Barbie boob.
.love to all sisters!
xox
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PB22: That is an interesting thought about a one-step procedure vs TE being done first. I know I was sure expanded a ton compared to my implant.
Delray: I had "mug shots" done a few times now at my PS office. Definitely not my favorite thing to do since I'm kind of modest. Of course you would think by now after everyone seeing them so much it wouldn't bother me, but it does. I don't know a code for NSM but I could try to ask since I have a PS follow up tomorrow and will let you know if I can find out something. I sure didn't have to pay anyone extra money out of pocket. Just my insurance deductible stuff and I got billed seperately for that.
I was dx in August and had first surgery end of Sept and then again in Nov (both lump) and then the mx wasn't until January. If it isn't an aggressive cancer there isn't a huge rush, even though our instinct is to "get it out" and be done with it fast. I have a friend who is a nurse who has ILC and a teenage son and knows she is going to need double mx. She isn't ready to deal with that in her life right now and talked to her docs and just started taking Tamox to keep hers from growing and spreading.
I was told that mine was growing in me at least 7 years and it would have been 2 or more before I could have found it on my own! So waiting a few months for most of us is not going to affect our long-term survival rate.
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Kate33-Really? I'll ask him Thurs. It's weird how sometimes Dr's don't tell you about what they can do unless you specifically ask. I'm getting more used to my bigger size but think I'd be happy right here. Going to ask him how much more I need to go to get this as my final result.
How are you feeling?
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Sweetie, Kate, PB, and Colorado. Thank you for your responses. I will call her insurance in ref to this upfront additional charge.
PB I PMed you and also provided my phone number. I'd like to know which surgeons you used. She has invasive DCIS with 2s and 3s, ER positive. I'm sorry I'm ignorant of all the terminology and went into shock as the surgeon broke the news on June 1st.
I'll get the name of the implant. I thought it was memory gel. I asked the PS if she will be able to get mammograms with it or will she have to start getting MRIs or ultra sounds. He said she can continue to get mammograms. Today at lunch my friend was reading the huge contract the PS wants her to sign, It say that mammograms can rupture the implant. It also said the implant is only good for 10 years and something about the need for more surgeries. Thats not what the PS said in his office.
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Kate 33 thinking of you: how did you make out today?
I was interested in laser for scars, thanks for mentioning it, I didnt know it was an option...I dont like mine and would consider it. Anyone done it?
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Delray,
The PS uses the same consent that an augmentation patient would sign so it mentions mammograms. Most likely if your friend is having bmx she won't have mammograms anymore.
Implants aren't forever, they may need to be changed out someday.
in the consent is information regarding more surgeries possible either from scar tissue healing and forming a tightness called contracture. This is mentioned in the mentor booklet they give you as well. Also there could be asymetry as things settle it could be uneven etc. The good news is that most problems are fixable but by another surgery, infection, scar revisions etc. Its all so scary but not scarier that the dx itself.
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