Nipple Sparing Mastectomy with immediate reconstruction
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Thanks to all for the encouragement. Best of luck to us all no matter where we are on this journey!!!
Diagnosis: 12/8/10, Left infiltrating lobular carcinoma with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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Thankyou for the great answers ladies! I really appreciate you taking the time for me. If anyone else would like to add I would be grateful too. Bit scary because my plastic surgeon said he does it by cutting around the nipple and then across...I must admit I was surprised because I thought the best spot was under the breast. Guess i have a few emails to send to him over the next few weeks. So am I right in saying that essentially everyone is happy with the look they have from them? I know I am being vain and probably very unrealistic but I am having a real problem facing being disfigured unnecessarily ( well necessarily but you know what i mean).
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May I jump in? I'm very newly out of this surgery (tomorrow will be 2 weeks). When I take of my shirt, I don't grin and say wow! But I also don't cry. I still have bruising and some swelling and a small bit of nipple scabbing....all those things sound terrible (thanks to Kate I expected them) but if I can be candid- today my husband said to me, "Even if you never got the exchange surgery, I'd be really happy with these, wouldn't you?" And I had to agree. As Megan said, it's a new you to get used to, but you can get used to it. Also, my neighbor who knows nothing of this said to me yesterday, "What have you done? You look 10 years younger?" I know this is not the removal of my breasts but the removal of the many months of stress! Another silver lining. I'm still very needy of the valium at this point but not the percocet.
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To all of you ladies who are new or in the early stages of this unwanted path...you will make it through. I am 7 months post unilateral NSM (one-step alloderm). I am very glad I made the decision to remove the breast tissue and to do the recon. I have adjusted to my new body and I like the new me as much as I liked the former me.
Kelly I had the same statement made to me by several people--that I looked so much younger and so happy (after it was all over). I had no idea how the stress pre-surgery had dragged me down.
I remember feeling more discomfort and stiffness after surgery. The only pain I felt was from the stretching of my pecs (my recon was immediate...no TEs) and that was pretty difficult. I was sore from my nipples to my rib cage.
Take care!
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mumorange: Sorry to see you here and hear of your history. To respond to your questions:
1. How long did you have pretty much laid up? I was a small A cup prior to surgery. Everyone is different with recovery. Positive thinking, plenty of fluid, rest, and getting yourself moving all help a great deal. Also use pain meds, but wean off asap if you don't need them. I moved pretty slow for the first week, then progressively got better. I had drains out in I believe a record 4 days, and on that day I put on a regular pull over t-shirt and slept in my own bed that night. It wasn't pain free, but once I got in a good position, it felt really good.
2. How long before you could drive? I started driving after drains were removed... I think the fifth or sixth day. It wasn't easy. Make sure you can turn your head to see if you need to switch lanes.. that was a bit painful. So was turning the steering wheel. I never knew how many muscles I used from the chest area to do those things!
3. Pain level? I weaned off pain meds before a week out. Pain meds have side effects too, so I tried to take as little as possible and used tylenol. It helped with the fog of everything too, since pain meds cause me to feel "not all there". I hate that feeling.
4. Percentage wise how happy are you with how you look compared to before all this started. Do you feel you look better? Worse? The same or just different? I can't compare myself before to after really. That's hard for me to do. I didn't like being small breasted, but I would have never had surgery to correct my imperfections and I grieved for the loss of my breasts prior to surgery. But... they were trying to kill me and the grief stopped when I realized this. Visually, I don't look like the same person, but I can't say I look worse except for scars. I still have TE's and waiting for exchange so not real comfortable right now. I have way more cleavage and I fill out a bra now, probably a C cup, so that's really cool. I had nipple sparing, no radiation, and I have feeling in one nipple, so that's really cool. I hate the lingering numbness, but have gotten used to it for the most part. Based on the fact that implants will be much softer and I will look way more normal than I do now, I'd say I expect to be 90% happy with the way I will look compared to how I did before. That's just "looks"... mentally speaking, it's been a roller coaster, but that's a normal thing with BC.
Try to do gentle stretches as soon as they permit you. It will hurt, but stretch a little more each time and you'll get there soon. Drink lots. Everyone heals differently and pain is different too. Based on what you've said, I think you're making a good decision.
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Kelly, Speech, cc4...thankyou so much. I am going to send a list of questions to both my oncologist ( percentage benefits) and PS ( where the cut is etc) and make a decision from there. I have to say everytime I read one of your responses I feel so much better and it seems so much more do able.
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thanks to all of you who have reminded us all to HYDRATE!! This is always something that i seem to forget and can go all day with a cup of coffee or tea- not good for healing. So today I embark on a new mission to stay fully hydrated.
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mumorange- Do you have access to the photo forum? There is a section for NSM and you may be able to see both kinds of incisions. Personally, I don't know why a surgeon would take the incision through the center of the breast since the whole point of NSM is to make us feel and look more normal afterwards. I do know that if a woman is large breasted they have to do this to access and remove all the breast tissue. I would definitely consider trying to find a surgeon that does this type of incision if I were you. I do think you'll be much happier afterwards.
Kelly- Thank you for your words of encouragement to the new members. I think it means more coming from someone who just went through it weeks ago. You have a great positive attitude and I think that goes a long way towards healing. (Though hydration can't hurt, either! LOL!)
And, yes, everyone, I am the hydration nag. Anesthesia and pain pills will seriously dehydrate you. Just keep something next to you at all times and take some sips every time you can. When I watched t.v. I took a few sips at every commercial! For those that don't like just drinking plain water the Vitamin water at Costco is delicious. I went through cases of it!
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mumorgange,
I wanted to let you know that my PS wanted to go in at the bottom of my breast, but my BS wanted to cut around the areola. She said she wanted to have the best access to where my DCIS was originally located. My biopsy scar is at 12:00 on my breast, so it must have been towards the top of my breast. The BS did the cutting, and she cut less than halfway around my areola and about 2 cm towards the outside of my breast. It seems to be healing nicely.
I was able to get around quickly after surgery and do most things for myself within a couple of days. I'm 13 days out today. I drove on Monday, but it was hard. I had to turn the wheel slowly by just turning a little bit at a time. We've had snow since then, so I don't think I'll drive again until the streets are clear.
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Where is the photo forum I have not been able to find it but see several people reference it?
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Sherry- The picture forum is a completely different site. In order to access it you need to PM any of the following members- whippetmom, Estepp, Lilah, MBJ or Timtam. They will PM you back with instructions. They base access on how often you have posted here but you will have no problem since I see you've posted a lot.
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Thanks kate
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Hi everyone. I'm so tired that I can't go through the whole thread right now so forgive me if this has recently been discussed. Went to the PS today for my 15 day post op. Got the last drain out- hurrah. But the breast that has been drain free for a week or so has built up fluid around it, quite noticeably. PS said this is build up not a seroma. Can someone speak to the difference? He said to do nothing different, that he felt the fluid would reabsorb by the body. Just to be sure he has me coming back on Monday. What can I expect? Is my body rejecting this TE? So many questions that I somehow didn't get out at my appt. today. On a positive note, both PSs that saw me today (chief and resident) felt really good about the skin and nipples of both breasts. thanks for your thoughts, Kelly
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Kelly, can't give you any feedback on the swelling as my NSM is scheduled for next week. However, I'm so happy that the skin and nipples are looking good so far. That should be very encouraging for you....I know it is for me! Best of luck!!!
Diagnosis: 12/8/10, Left ILC with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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Kelly, I had swelling/buildup after drains were taken out and I worried, too. I was told it would go away and be absorbed over time and it did. I thought it felt a little lumpy and weird. I was sooo worried not knowing if it was a "bad" thing. It seems to be normal from what I've gathered and the fluid (usually) reabsorbs into your body. I cannot tell you about seromas, other than if that is the issue some Dr's will extract the fluid. Good thing you are headed back and being watched, always good to know the Dr's are being thorough!
p.s....Yay for healthy nips! :-)
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Kelly-my PS took my drains out when I was still draining quite a bit. I did have a boggy spot on my skin that my body did absorb. I was so worried that he would have to needle drain it but it ended up to be just fine. Our bodies are truly amazing. I had a nipple and skin sparing MX. I am happy to hear your doing so well.
Drain free is wonderful!0 -
Mumorange, I am 10 days out of my BMX with TE's. Today was my first painfree day and first med-free day (besides antibiotics). I still feel some pain in the ribs, but nothing that tylenol can't take care of. I had a minor infection on the cancer side which required more antibiotics and I still have the drains in and think I will have them in for a few more days since the fluid has not really decreased. I went out twice since my surgery. Once to the hairdresser to get my hair washed (6th day) and to the doctors (7th day). Both days I was in a fog because of the pain meds - so glad to be off of them!
I have a hard time looking at my breasts. My cancer side is still covered with gauze because of the infection and my lovely DH has been cleaning the area and applying the dressing - I can't quite get myself to feel my breasts or look at them. I have to remind myself that this was a life saving surgery and this is not the end result, but it is still hard to look and feel the breasts. There is numbness in both breasts and hypersensitivity to the touch. I hope this decreases over time.
My one uncovered nip looks all sunken in - the other nip was removed, cored out and grafted back on. Because my cancer was so high up, I have incisions under the breasts and right around the areola of the cancer side.
I still have not really left the house and am taking it really easy and being gentle on myself. This has certainly been an eye-opening and life-changing experience.
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Hey Everybody, wanted to jump in and add my opinion and experience. My SP BLM was performed on 1/31/11, Nine days ago (didnt want to attempt to keep nips). I am feeling great. I dont really understand my mental state, I assumed I would be a little less " ok " but as I tell my co-workers who keep calling that I am 100% back to normal emotionally and mentally, and about 75% physically. Within a week I was off the pain meds and driving, I have full motion of my arms with exception of having a slight problem putting my hair in a ponytail, the only other pain I have is when I am trying to sleep at night, I dont really understand that, and NO meds help, so I guess I just have to bare it until it goes away but at least it is not constant.
Before surgery I was DDD which was WAY to big for my frame so I am looking forward to being smaller (want to walk away a D cup), Doc's at the Mayo clinic here in Az intended to go Direct to Implant, however that didnt work out due to the tightness of my pec muscles so I went directly into TE's filled to 400cc, I am somehwhat of a picture hog, and this helps me immensely. I took pics on the 3rd of Feb and then again on the 10th, and the difference between those seven days just leaves me bewildered and full of hope. I didnt know you could drop and fluff with TE's but to be able to compare the difference between one week is just crazy. I intend to continue to take weekly photo's until this process is over.
Followup appointment was on the 10th and they removed 2 of the 4 drains, docs said I looked good, the incisions made were Inverted T's (upside down T). They are actually very nicely shaped right now.
While I do think that I am doing well, I do recognized that I still get winded and tired very easily. So I am remembering to take it easy and allow myself and my body the time to appropriately heal itself before I push to hard, so I am taking it slow.
Emotionally I have been fine, however I did feel a "twinge" of sadness yesterday when my BFF came over to spend time with me and told me we would need to go on a shopping spree because none of my clothes would fit anymore. Naturally I am a size 10 on the bottom, but had to get XXL shirts, 14 in dresses and things of that nature to fit the "girls".
As far as how happy I am, man I dont have the answer to that question 10 days into it. I will admit that is hella different when I looking in the mirror fully clothed, I am sure others can relate, but my natural boobs were so big and basically "right in my face at all times" LOL. So it is a little strange that they are not there. I never believed that I was a woman that lead with her breast, I am having a little anxiety about what I am going to do when it is time to return to work in a couple of weeks. I am a very private person (except with you guys LOL), I dont know if I should fill a bra, buy prosthetics, just go with what I have in TE's at the time? I in no way feel as though "I" was my boobs, But my clothes wont fit and I dont know what to do from that stand point :-( . But I am also struggling with being dishonest with myself if I fill a bra. I dont want to deal with the questions and or the whispers behind my back. My friends and family I feel comfortable with, it is just my job that is giving me a little apprehension.
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I had a right NSM 9 days ago, and got the dressings off yesterday. I have a question for you ladies that have been through this about showering. I took my first shower today but I was afraid to get the nipple area and glued incisions underneath really wet or at all soapy, so it was a real shower for the rest of my body and a mini-shower for the breast area. How did you guys go about showering the breast when your dressings initially came off? I am worried about ruining/infecting my nipple graft or the upside down T incision that was glued closed. Thanks!
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sunny321 - as soon as I had the drains out - I could shower. I could get everything wet, I just didn't soap up the boobs for a few days, just let water run over gently. Then pat dry. You can always call your doctor and ask them. Sounds like you are feeling good - glad to hear.
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sunny321- my docs said showering is fine but didn't recommend getting really soapy (just letting the water run over you) and no immersion of incisions or nips (meaning no baths).
thank you everyone to the quick response to my fluid build up question. such a relief to hear other stories. sending my happiest thoughts to you all.
kelly
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Here is what I did for showering the first few times. I filled a small spray bottle with some water and a few drops of shower gel and sprayed that on my breast area that I didn't want to touch! Then I used the hand shower to rinse off. That way I at least felt like I was getting a little of the stink off! It wouldn't take off the stuff they had put on me in surgery, but there was no way I was going to scrub!
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Forgot to add that I also took one of the kids old plastic step stools in the shower with me so that I could reach the hand shower and didn't have to leave it flopping around while I sprayed myself down.
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For those just coming out of surgery and having emotional ups and downs, know it's perfectly normal to feel what you're feeling. It takes time to heal... physically we heal quicker than emotionally (IMO). You'll know when you're ready to look at the result, and when you're ready to touch them. We've all been there (at least my part has), and when I was ready to look with an open mind, realizing it truly wasn't the end result, it made it easier. If you haven't been to the picture forum, I urge you to do that. Many of us have posted our pictures there, and it may help you to look at how we appeared right after surgery and how we look after exchange, or getting ready for exchange as I am. The sunken in look will go away as you are expanded. If nipples turn black, don't assume you're going to lose them as several women here have had them turn black and scab over. The numbness DOES get better. It may not completely go away in places, but amazingly either it goes away or it lessens to the point that you really don't notice it. Plastic surgery is an art. We are the "work in process". Just give yourselves time to heal in all ways. Stay hydrated, stay moving, keep your mind as positive as possible, eat well, get rest. And... take ... one... day... at... a... time.
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Thanks for the shower replies! This morning when I showered not all the neosporin my DH had applied the night before to the nipple area and incisions came off (I was told to apply Bacitracin/Neosporin twice daily), but I didn't want to scrub or pick it off. Hopefully it will be fine with just running water every day.
Where do I find the picture forum? I looked for it with no success. It would be nice to see some positive after-pictures.. looking at my breast yesterday was a depressing tearful experience. I was a litle more optimisticabout it today.
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Meekone ~ regarding going back to work and fitting in your old clothes. Granted... I was MUCH smaller than you ... I still felt self conscious that people would be staring at my chest. What worked for me was layers and scarves! Thank God scarves are in! And I did "stuff" for the first couple weeks depending on what I was wearing.. just so it wasn't so flat. For me.. after a few fills I look pretty much the same as I did before. 0
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sunny321- The picture forum is a completely separate site that is run by some members on here. To get access you have to send a PM requesting admission. They will allow you in based on the number of posts you have done here. Since it says that you have only posted 2 times they probably won't allow you access. It's nothing against you but they feel that the more posts you have here then the greater chance you are a legitimate poster. They do this to protect the women who have posted their photos. I would suggest you try posting a lot on this thread and others and try to get your count up. The members you PM are Timtam, whippetmom, Estepp, MBJ or Lilah.
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Ok ladies, I am just about 11 days from nipple sparing BMX. My PS says my boobs look pretty, have about 240 ccs in the TEs, still kind of A, concave-ish. Not the word I'd use to describe. I call the right nipple "raisinette" because that's what it looks like to me. I know they scab and hopefully it will be pink and healthy underneath. When should I be expecting that? It seems that the raisinette may be held on there by some of the glue that was used when they closed the incision but he told me to lift the raisinette and put bacitracin under it. I tried to look under it, but I'm afraid I might pull it off if I do too much... sorry if TMI
Good news, leftie just looks bruised and beat up, not raisinish.
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Barbara, yikes, I too have both nipples scabbed over in black. When I shower tiny little pieces of the black fall off and reveal pretty pink. But it's not happening over night and the PS said to not put anything on it, let it come off in the shower over time. They had me do the bacitracin for a few days only, now he says to just let come off naturally.??? don't know. Different docs sure have different suggestions. Hang in there.
Kelly
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