Nipple Sparing Mastectomy with immediate reconstruction
Comments
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Ladies,
I need your advise! My NS/BMX was done last Friday. I am still having trouble with pain control but feel better today. Everything went well or so they have said.
My nipples look good and are showing no signs of trouble yet. My concern is my right breast. It is so much flatter than the left. The left is beginning to take shape but the right is not and looks very wierd! It is not red, hot, nor showing any signs of infection so I don't think that is the problem.
I know it takes "time" for our new implants to drop and finally take form but this doesn't seem right. Am I just expecting way too much way too soon? Thoughts? Ideas?
Thanks for your help!
Sandy
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Sandy: It does take time. Have you had your post op appt yet? Express these concerns to the PS and ask his advice as to the cause of the problem. You no doubt still have swelling. If it doesn't seem right to you though, then give them a call today and see if they can advise over the phone or hopefully get you in to see. Check out the picture forum and see if you can find anyone else who had similar issues... sometimes it helps to hear what another person's problem was so you might be able to mention it to the PS. But hopefully it's just really early and everything has yet to settle.
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I saw the BS and the PS Physician Assistant today. The BS and PA each said much the same thing. Things look good and I am still swollen and things will get better. Neither seemed worried! Well, I love the BS and think he honestly believes everything will be just fine in a matter of time but he cannot, of course, promise this to be the case. The PA also said she thinks it is swelling and the fact that since I am right handed, the pec muscle is much stronger on the right side and it is taking a bit longer to permit the implant to settle in place. The BS also mentioned being right handed and I had never given this a thought but it is something to ponder!
They both say they are very pleased for I am one week post op and doing so well... I haven;t yet looked at the photo gellery for I haven't had the courage and don't really know where it is nor how to access it... I should look and perhsps I will feel better.
Another part of the problem according to both of them is that the implant was larger than usual. It could not be smaller than I had previously been for I would have then lost skin. So, accommodting for the size is also taking more time.
Somehow this makes some sort of sense but not all that much...
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There are a number of ladies here who can help direct you to the picture forum. It is seperate from bc.org. I think MBJ is one who can help you so try pm'ing her. You'll have to be granted access to it... because of the nature of our pictures, they are quite cautious. If you need additional help, please pm me and I'll send you a list of the women to contact. The pictures really helped me, and it helps the women who post them if someone can respond with ideas, support or encouragement for normal looking things.
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Tina-it really sounds like your nipple is going to be alright. I know how you feel about bumps in the road, I had a few, but trust me everything will work and be just fine. Hang in there, you've made it this far, it's all going to work out.
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Kate Yes, I had it done at the Mayo Clinic here in Phoenix. Dr Rebecca is a most talented plastic surgeon. She is incredible! I would highly recommend her to anyone.
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I saw the PS and his PA today. Very happy there's no evidence of infection (whew!), but my heart sank when I heard "necrosis". PS debrided the nipple and a large patch of adjacent skin. Fortunately, it didn't go through all the skin layers
, but I did lose part of the nipple 
. So, won't have my first outpatient fill until this thing finally heals up. The procedure today should definitely speed things along.0 -
Tina-Happy to hear there's no infection. That's important news. I'm sorry there was a little issue with the nipple. It sounds a lot like what happened to me. Mine was looking strange and I had to go back into surgery to replace one of TE because the incisions weren't closing. At the time of surgery he removed the tip of the nipple. It really looks ok though. Still better than not having anything there. Hang in there. It's all going to be ok and your going to look great when you'll done.
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sweetie2040: Thanks, it was disappointing but I know I'm in great hands. The PS and his PA have both been wonderful and I know that we all have the same goal in mind. It's all good!0
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I you all don't mind sharing......do you have any sensation in the nipples or not? If so, was it there all along or did it take a while before some feeling came back? Thanks!
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TinaT- I had my BMX 3/10 and finished recon 6/10. I do not have any sensation in the nipples but have some return of sensation on the breast skin.
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Tina - I just had exchange this week, it's been 3 1/2 months since BMX and I have some sensation in areas of my breast skin, and in one nipple I have 'sensation'...it's not like it used to be, but I am aware when I touch it and it feels kinda weird & hard to explain, definitley nothing like before either...there's no sense of "enjoyment" when it's touched, if you get my drift!
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Tina,
I had a NS/BMX March 18 so I am 9 days post-op and both nipples are slightly reactive to temperature most of the time. The left one is more reactive to temperature than the right... I had one-step with Alloderm with immediate implants. I am just beginning to have a very, very slight reaction to touch on both nipples. I have more reaction to touch on my right nipple which is strange for this breast seems to be not taking shape as quickly as the left... I have some sensation to touch in most of the breast skin as well but it is very different than it was prior to surgery.
My docs told me to be prepared for NO real feeling at all in either breast so I am happy to have some feeling in both. It may improve for this is very early in the game.
Hugs
Sandy
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Thanks, the side that came through like a champ does seem to react to temperature, but no feeling at all. Strangely, I thought there was some immediately after surgery (phantom?). The other side is the one that didn't totally survive and was partly removed during the debridement a few days ago. PS and his PA have been wonderful and keep saying not to worry, things can always be "tweaked" later, but don't know if that means beefing up that one or taking some away from the other (or both). Hope I don't have to decide between sensation and symmetry (fire-dancer, I do get your drift!).
Well, I'm jumping way ahead. I need to see how things look after healing is complete. Patience is NOT my middle name
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Tinat. My Ps said some feeling could back up to two years after but not to expect it. I do have some feeling but nothing like before, kind of like a feeling of pressure.
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Skin and nipple on cancer side not really healing since the debridement of necrotic tissue last week. Sent some pictures in today and have to go back tomorrow for either another debridement or for resection and closure of wounds and remove/replace TE with another with less fluid to reduce pressure on the skin. Bummer......
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Tina-I'm sorry your still having issues. It's going to be alright. I had the same thing happen. You know I told you I lost part of the nipple. I also had the issue several weeks after my MX where my wounds kept opening up. He tried covering them but on one side he saw theTE exposed through a hole in my skin so he said I needed to go back to surgery and have the TE removed and replaced to prevent infection. That is what he did and closed the wounds on that side too and took the tip of the nipple at that time. It was a little setback but everything turned out alright. It actually gave me a lot more time to heal before I had my fills. When I got to the fills I had no pain or discomfort with them because I was healed so well. I only needed a few fills. Hang in there, I'm routing for you and it's all going to work out. These things just happen sometimes, but you have a good Dr who is on top of it and that's important. I know it's disappointing but you'll get through it. I'll be thinking of you and I wish you the best.
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Sweetie: Thanks, it really does help to know someone has been down a similar path and made it through to the other side! I ended up not having to go to the OR yesterday, PS felt comfortable tending to it in the office once he saw me. They partially deflated the TE to ease the pressure on the skin, debrided again, resected the margins of the largest wound that isn't healing, and stitched it closed. No evidence of infection and no tissue expander, muscle, or SeriScaffold visible. If things aren't looking better by next week I think it will mean a larger resection in the OR. Thanks so much for the good thoughts and the encouragement!!!
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Tina- So sorry for all you're going through. This road is long enough as it is so can understand how hard it must be for you right now. Really hope they get everything under control so you can start healing. Once you start the fills they really do go fast and soon you'll done and life can get back to (your new) normal. Hang in there. We're all here for you- whatever you need. (((hugs)))
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Tina-thinking of you. How are you doing?
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Thanks, all, for the encouragement and good wishes! Things have finally taken a good turn with healing in the past few days, hopefully it's not just wishful thinking on my part. Still pretty discolored where the blue dye was, but the wounds are looking much better. Back to PS office next week to get the official word and some stitches removed. Plan is to wait a while longer once it's completely healed before re-expanding the TE on that side. Eventually it will catch up with the "good" side and I'll finally be back at square one. I think I'm getting there!
Thanks again for your concern. Hope you're all having a lovely weekend!!!
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Tina- Am so glad to hear that things are turning around. It's so hard when things don't follow the timeline they're supposed to but you'll get there! Before you know it it'll be time for your exchange. Just continue to take care of yourself.
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Tina- YAY!! Glad to hear your doing well. I had one side under expanded too. I remember putting a little pad from my bra on that side to balance it out. I'm telling you though the longer you wait for the fills the better because your body is just that much more healed up. The fills will be a breeze and soon your'll be on you way! Keep us posted.
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Yes, dressing to disguise a lobsided chest is definitely easier when the weather is cooler - layers and all. Before my surgery I thought my timeline might have me done by June, before the really hot summer months. But, things are already way off course
so not going to frustrate myself with predictions. I'll just take it as it comes!Thanks again for the good thoughts. Have a good week everyone!
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Well, the stitched area is still not totally closed so steri-stripped back together. Also PA was concerned that she might be feeling a seroma above the TE so she tried to tap it; fortunately, nothing came out. She did, however, remove another 100cc from the TE to ease the pressure on the skin. Now I have 350cc on the good side and 100cc left on the problem side. More antibiotics and back to the office on Friday. This is starting to wear me down.......
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Tina- So sorry! I'm sure this must be wearing on you emotionally and physically. Maybe while the problem side is healing she could remove some cc's from the good side so you're not so lopsided. Might make you feel better even though it feels like a step back. Either way hope the healing kicks in soon so you can get on your way. (((hugs)))
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Kate33: Thanks for the pep talk. Na, the good side looks so pretty I don't want to mess with it. Plus, I need it to show the other side what it's supposed to look like!
I'm getting a sore throat and feeling chills and really tired so I guess that partly explains my feeling kind of blah today. Haven't been sleeping well either. Tomorrow is another day!
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Tina- You have such a great attitude! Sorry you're not feeling good. Can they give you something to help you sleep? Good sleep can really help the healing. Hope tomorrow is a BETTER day!
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Still dealing with an open wound 8 weeks after NSBXM. PS removed stitches and steri-strips today and it popped right open. Now we're going to try packing it for a week to see if that will encourage it to finish healing. I hope, I hope, I hope!
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Tina,
I am so very sorry you are having trouble with wound healing. I wish there was something I could suggest you do to make things go more smoothly and to help the wound heal more quickly. I have one side which has also done just great but the other acts like it is not related to the other one. My problem is not with wound healing but with shaping. But I think this could be an easier thing to deal with than with a wound which is taking its own sweet time healing.
Hope you feel better very soon and am praying the wound heals very quickly!
Hugs
Sandy
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