Nipple Sparing Mastectomy with immediate reconstruction
Comments
-
I agree with Kate33. I have a BMX and the side that did not have cancer had the nipple and areola saved. That side looks like an 11 year old boy, but after the reconstruction, I will look like my normal self. The cancer side had the nipple removed, cored out and grafted back on. I still have not looked at that side because it is still covered by gauze (too much skin taken off to get clear margins) and hyper-sensitive to touch.
0 -
Must tell this story. This past Friday I was standing at the elementary school playground, watching my kids play when.....bam!! I was knocked to the ground by something hard and round which had hit me at high velocity where but in the breast of course! Some of the bigger kids had been playing catch with an object (we're still unsure of it's makeup but we think it's painted ceramic or wood), rocketing it into the air to each other and of all the people in all the places it hits me on one of my newly reconstructed breasts. A full on 10 on the pain scale and panic that I'd ruptured something. Honestly, is the universe trying to tell me something? So, new swelling and bruising and back to the hard meds for the weekend. Luckily, the TE is still intact and no other real problems but it has really shaken me. Have been laughing about the odds of this with husband and friends but inside I feel about as fragile as I've felt in this strange process. Writing here helps so thanks for reading.
Kelly
0 -
OMG Kelly, what are the chances? Hope you continue to heal and don't suffer any setbacks because of this. Take care!!!
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+
0 -
OMG Kelly...not right now, but one day you'll look back on this and laugh!! I think you better go run and play the lottery. The universe is trying to tell you something...that you're one tough cookie and you're going to make it through this whole thing with, um, flying colors!
Feel better!!! (p.s. I'm originally from Maryland...I know how those playgrounds can be!)0 -
Hi all!
I had a nipple sparing mastectomy with immediate implant placement on the 18th of this month. I still have a drain and noticed that I have a little bit of rippling/dimpling on the upper part of my breast. Could this be from the drain? It feels a little hard and bumpy when I touch it so I'm thinking it could be the drain. Has anyone else has this happen to them? Perhaps it's just some swelling since I had my surgery only 3 days ago?
Thanks!
0 -
I just responded your question in the other thread too....
The outline of the drains were VERY noticeable under my skin from day one. They felt hard and bumpy. It feels amazingly better once you get those horrible snakes out of your body!
0 -
Ugh! I hear you sista! Can't wait to get the drain out and look forward to putting all this breast cancer treatment and surgery behind me!
Thanks!
0 -
thanks tina and 42! 42- loved your advice and did just that. if i win, expect a royalty coming your way!
0 -
Kelly- Dang girl! Maybe you should stay in bed and have people bring you food! It's way too dangerous out there! LOL! Glad you're o.k.
shredbetty- Welcome! I totally forgot about the whole drain under the skin thing! It is a weird feeling and they really should warn you about it. The tubing of the drain should wrap entirely around the breast. Like everyone says you'll feel so much better when it's out. So glad your NSM went well. Sorry you have to join us here but glad you posted. (((gentle hugs)))
0 -
Shredbetty, I had the same problem with my drains over my TE's. I wondered if it was the top of the TE's, until the doctor pulled the drains out. I could actually feel it snaking out of the area that I was worried about. After the drains were removed, so was the tubing I felt.
0 -
Thanks gals! I'm pretty sure it's just the drain and can't wait to get it out. I'm actuallly seeing my PS today because I've got a tiny little blister on my skin that looks a little infected. I'm hoping it's OK!
0 -
shredbetty- Another thing that sometimes happens is the sutures, that are supposed to dissolve, work their way to the surface instead. It can cause a sore red spot so it might be that. None of my sutures seemed to dissolve and my PS eventually had to pull them out one by one with tweezers. Hoping everything is o.k.
0 -
OK, am I getting excited over nothing? My NSBMX was on Feb. 16.
My left breast (the cancer side) is not nearly as lovely as the right. I had sentinel lymph node and blue dye so the discoloration isn't pretty. Also the nipple looks sad
right now. However, other than some brusing and the incision under the breast the right side looks really good. Here's the weird part....I think I actually have some sensation in the nipple. Could this be possible less than 1 week after surgery? Loss of sensation was one of the harder things for me to come to grips with through this whole process so far. I won't get my hopes up.....well, maybe just a little
.Hope everyone is doing well this week. It's a chilly, but beautiful day in Northern California.
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+
0 -
TinaT: My cancer side always looked worse to me, and it's probably due to the fact that they have to really get as much tissue as possible from that side so it's not going to look as pretty. If you have TE's, then give it time to A) Heal and
Expand. You may very well see the left one comes along finally after givng it some extra tlc and time. Sensation... I had sensation in my non-cancer right nipple from day 1 out of surgery, so I believe you completely and no, you're not imagining it. As I expanded, I could swear some of the sensation went away but now I think it was just at the beginning of each expansion because it's been a few weeks since my last fill and ... yep... sensation is still there! My exchange is Monday so I'm nervous that I may lose it, but my PS seems to believe if it's there now, it'll remain because he's going in the same way as last surgery. 0 -
Thanks Kate! I saw my PS today and he said it was the drain under my skin making the lumpy look. He also said I'm still swollen, which probably also plays a role in why my skin doesn't look so smooth.
How long did it take for you guys to not be in so much pain? It seems like the side where i had my tissue expander replaced is in more pain than my nipple sparing side. Both sides feel extremely uncomfortable though and it seems like I have to take my pain meds every 5-6 hours otherwise I'm in a great deal of pain! I hate taking meds too. Bleh!
0 -
cc4npg: Thanks for the encouraging story. Good luck with your exchange!!!
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+
0 -
shredbetty: From what you've said, you're only like 4 days post op right? So I think you're quite normal to still be having some discomfort. Everyone is different in healing and with how they handle pain. I was fortunate in that I was able to stop most of my pain meds by 48 hours, but I was an unusual case. Many women have to continue pain meds for about a week and some longer. Just watch for signs of infection and otherwise just take it easy, drink plenty, rest, but don't just lay around either. TE's are uncomfortable.. period. Mine felt worse until they were expanded to a degree, then felt a lot better, until they were expanded too much and then they were not comfortable again. You're in the process of healing... it's early.. you've been thru major trauma. Your PS would have noticed if anything looked out of ther ordinary today, so just keep watching and make sure you report anything out of the ordinary to him.0
-
Shredbetty ~ I couldn't believe how painful it was for me either. I was hoping I was going to be one of the lucky ones that felt pretty good after a few days and was really hesitant to refill my pain prescrip after a full week. I was giving myself a hard time about it and thought I was being a wimp. My PS's nurse sweetly gave me a lecture about "not trying to be the hero" and staying on top of the pain ~ everybody is different. Yes some are off pain meds within a couple days, some need it for 4 weeks! All are okay.
I ended up needed the percocet for 2 weeks. In the end I was alternating between the percocet and advil. Getting out the first set of drains helped IMMENSELY and when I finally got the second set out (a little over 2 weeks) it was heaven!!!!0 -
shredbetty- Hang in there. I'm exactly 4 weeks out and I'm only just getting off the heavy pain meds. Give yourself time. My good friend had the same surgery two years ago and she was off all pain meds within a week so I was very surprised to still need them as long as I did. I'm still taking something heavy before bed (vicodin or valium) and frankly, if I didn't have to be 'on' for the kids, I'd prefer to be drugged up watching reruns of Project Runway!
0 -
shredbetty- I think everyone gets so worried that they'll some how get "hooked" on the pain meds. I know I was. My mom said, "Are you in pain?" I said, "Yes." She said, "You're not hooked." She said the ones that are hooked are the ones that keep taking it long after the pain has subsided. After that I stopped feeling guilty. I was one of those that had to take it for about 3-4 weeks but towards the end just during the night. You are the only one who knows what your body needs. It's not a competition to see who is strongest. Take it if you need it. You body has been through a major trauma.
0 -
Thanks you guys! I hate taking the pain meds because they constipate me so much. I have to take colace just to keep my bowel movements regular. I'm going to try taking tylenol today and see if that helps with the pain...if not, I'll go back to the hydrocodone. Today is my 5th day post-op and it probably doesn't help that I have a hard time sitting still and want to do stuff around the house. I vacuumed this morning and am now regretting it. My DH has been wonderful in cooking me all my meals and my dad will be visiting from out of town to help out for a couple weeks. When I had my first surgery I watched all 5 seasons of Prison Break...I'll have to find another series to watch while I'm recovering.
I wish I would've started chatting on this forum when I was first diagnosed last March. You guys rock!!
0 -
It's so good to read your exchanges and see how everyone is coping. I just had the last fill to my tissue expander--I am carrying 920 CCs right now--it looks huge, until I compare it to my saggy baggy left b**b, and realize that I will have to have a reduction to have a matched set. My plastic surgeon is going to lift and reduce the left side. But, no one ever told me how painful the tissue expander would be. I have to take hydrocodone and flexaril for about 3 to 4 days after each fill, until I can finally switch back to aleve. I fell and injured my right shoulder about 6 weeks ago, so, I am pretty worthless on my right side. I will be having my permanent implant placed end of March, and the lift and reduction at the same time. I know I will be glad I went through all this after it is done, but it is certainly no picnic, and my hats are off to all of you on this journey with me! Any helpful suggestions for gaining range of motion back would be appreciated--Thanks!
0 -
paulatkc: Since you injured your shoulder could you get a referral to a physical therapist? Seems that would be the safest alternative.
I've had adhesive capsulitis of both shoulders (before breast cancer) so I was concerned about the possibility of recurrence after BMX. About 6 weeks before my surgery I got a set of lightweight kettlebells (3# and 5#). They really worked well for strengthening and stretching out my shoulders and upper back and "opening up" the chest. Again, I would check with your MD or a physical therapist first. Can't wait to get the OK to get back to using them.
Best wishes for your upcoming surgeries!
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+
0 -
Question: Next week I am having double nipple sparing mastectomies with immediate reconstruction with LD flaps and implants. AFTER THEY REMOVE ALL OF THE BREAST TISSUE WILL I STILL HAVE TO CONTINUE ON FEMARA? (that is if they only find LCIS tissue and no turmors) I hate how Femara makes me feel 20 years older than my 58. Weight gain is too easy, I'm still up 3 kg, aching knees so in the morning I have to grab furniture to keep from falling over and I sure don't want sex! Yikes. All my BS, PS and GP says is I will have to wait and after all of this go see the oncologist. I just wondered what you all have had to do? Thank you
0 -
shredbetty- Just remember to hydrate! I kept a bottle of Vitamin water next to me constantly and drank some every time I thought of it. Walking will also help with the constipation.
Paula- I agree with Tina that a physical therapist, preferable someone trained to work with MX patients, is your best bet. You have to be careful about how you exercise your pectoral muscles now. The main thing is just to keep stretching. This is something they advise us to do our whole lives since that pec muscle wants to keep pulling into its original position. If you don't stretch it gently you can end up with pain. Another thing I read is that MX patients tend to start "hunching" as it to protect our chests. This can also cause a lot of shoulder pain. So be very aware of your posture at all times, too.
justagirl- There seems to be a lot of disagreement amongst doctors on the need for Femara, Armidex and Tamoxifen. Some say it isn't necessary if you've had a BMX and some say you still do. It's very confusing for the patient. The way my BS described it to me is that by having a BMX I had lowered my recurrence rate to 1%. She said she would prescribe Tamoxifen if I wanted it but she didn't think it was necessary. I elected not to take it but I know others who have.
0 -
Kate - thank you. I know my BS and PS say having the BMX lowers my chances of getting BC back down to less than 1%. What I keep thinking is my cancer was described in the pathology as aggressive (grows super fast) and invasive (had already burst out and was ready to spread)....and that was with a clear mammogram and U/S Nov 22 and I found the tumor the first of March...so effectively three months. That still scares me and right now, as much as I hate Femara, I hate BC more and would even take it for 5 years if there was a chance it would help prevent a reoccurance. I think...... Again, thank you!
0 -
Recently a friend who had NSM (bilateral) in NY showed me her incisions. They were in the crease below the breast. The result was almost beautiful. I now think I want this approach.
My GS had told me the incision would be a line from nipple towards armpit, across the middle of the breast. So I am going to have to negotiate this. Are there any downsides that people have encountered to this incision placement?
Also, my PS said he hates the "lollipop" incisions that run from nipple down the center of the breast to the crease. Not sure why.
0 -
Just had my NSBMX 1 week ago at CPMC in San Francisco. I had tissue expanders placed during the same surgery. My incisions are below the breast. I went into my consultation appointment with the breast surgeon fully expecting that the she would use a lateral incisions (perhaps due to some CPMC literature I had seen?) so I was excited to hear that she planned the inframammary incision. Breast size? Location and type of cancer(s)? Type of reconstructive surgery planned? I'm sure each surgeon has reasons and feels strongly about their particular approach. It's mind-boggling.
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+
0 -
Hi TinaT, thanks for your insight.
Hope your recovery is easy!
I am scheduled for BMX for bilateral invasive DCIS. Am a D right now.
I plan to have Dr. Khouri do lipoinjection for reconstruction. He says he can deal with any type of incision, but I know I am stuck with it forever, and really would like to know the "ups and downs" of each type.
It was really just random luck that I was shown the inframammary incisions in time.
0 -
flygirl- From everything I've read doing the incision across the center of the breast is the "old" way of doing things. My BS told me that by doing the incision below the fold of the breast and saving the nipples the MX surgery time can double. But this is something we have to live with for the rest of our life! I have heard, though, that for women who are large breasted it can be too challenging to get all the breast tissue with the incision below. You're lucky in that your surgeon will do a NSM on you since you are a D cup. The majority of surgeons won't because it's difficult to maintain the blood supply to the nipples. So count yourself lucky you found one that does! I would still press them on the incision location, though. If it's possible to do it I would insist. It is a lot less disfiguring. You can barely tell I had a MX now.
0
