Nipple Sparing Mastectomy with immediate reconstruction
Comments
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Kate33 - did you get any instructions for how to care for the harvest sites? I had fat grafting done almost a month ago on a much smaller scale and the spot where the fat was taken from is still very evident in that it's much firmer than the area around it. I had an OB/GYN appt a week ago and that doc said she didn't think it was infected but agreed it was swollen. Anyway, I'm just trying to determine what's "normal".
I'm so glad that your revision went so well!
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vmudrow- Yes, the warm skin was the first thing I noticed! It seems like such a simple thing but it goes a long way towards feeling "normal".
tory- Thanks! The only thing I was told was to wear compression garments (like Spanx) over the areas where the fat was grafted 24/7 for 2-3 weeks. My stomach, where most of the fat was taken does feel very hard to the touch, and I was wondering how long that would last. I guess time will tell.
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takeadeepbreath - I just check out your pictures - I think you look wonderful!!
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Many of you all are talking about the breasts with the implants feeling 'cold to the touch' - is this common? I assume your PS placed the implants under the pec muscle... I am a little scared of a 'cold breast' - think it would feel like a dead person's (sorry - i know that is morbid).
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vhshea - the implants are under the pec muscle, but the muscle doesn't cover it completely. And it doesn't feel really cold, just cool - just kind of odd. I don't really notice it all the time - just sometimes.
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vmudrow - hm. ok - so i can see how the fat grafting would definitely help with that - i suspect that the larger the difference between the orginal cup and the new cup size, the more likely that the pec muscle would not cover as much. thanks. that helps.
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Hi Ladies-I'm getting behind on this thread. I agree with the comments posted about being "lucky" to find a Dr who does NSM. I lucked into it myself because of my researching and asking until I found someone. I was lucky in that the two Dr's who are excellent in my area just started doing NSM and I was the 6th one. Since that time they have done many more and even had a patient of theirs call me to talk to me about my experience as she was about to go through it. She's doing quite well post BMX NSM by the way.
Speech-I have seen your pics and I think your PS did an excellent job. I would said you have one of the most natural looking reconstructions I have seen, in the way that it doesn't even look like you had one, but have two great looking breasts! I laughed about how your PS said your pre surgery breasts were perky. Mine were small too and I used to refer to them as "athletic" it sounded better and than shruken,sagging, post having children, middle aged breasts!
vhshea-I have the cold implants as well. I don't notice it so much, but my husand always comments on hold cold they feel. It is kind of weird but not terrible. My PS said all implants feel cold and we don't have any fat covering them so we will notice it more.
Kate-I could really use lipo right now! I'm starting to think I'd do the FG for the lipo alone. It may push me over the edge to do it. It's getting tough to lose 10 pounds after 40.
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Hi ladies! I am new to this site, but am SOO happy to have found it!
I am scheduling my surgery in the next few weeks and would really like to find the pictures you all are talking about. I will of course share mine when I'm done to help others as well. I am doing this prophylactically, I'm a little unsure about a decision I was dead set on a few months ago. I'm afraid of a bad outcome I guess. Now the cold boobs thing makes me a little nervous too. Any of you have cold feet beforehand, but glad you did it? 0 -
I have a friend who was DXd about four weeks before me.. she just told me about the nurse navigators that are available in the various hospitals (we have Methodist and Baylor programs here in Dallas) -- they are free of charge and will help BC patients through the process - I just called and left a message - it'd be nice to have a professional help guide us through this stuff! Just passing on the info!
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Scoot,
I believe it is quite natural to be nervous before having a PBMX for I certainly was and had a lot of questions I needed to have answered. I am 9 weeks post-op now and am so happy I made the decision I made for I no longer have to worry about BC.
If you have done your research, feel comfortable with your BS and PS and they are experienced with the type surgery you are having, everything should be just fine. I wouldn't worry about the "cold implants thing" very much. I really don't notice this too much and my husband doesn't notice it all that much either.
You can send me a PM to ask any questions you need to have answered.
Hugs,
Sandy
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i love this thread! you all are the best!
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Hey Scooteroo....there are a couple of gatekeepers to the picture site (MBJ, TimTam or Whippetmom...) ---it is not run by BC.org. You need to post here a bit just so they can sort of establish who you to maintain privacy etc. then email them requesting access/password.
I had prophy NSM in December with TEs which got exchanged for silicone implants a month ago. I am thrilled I did it and have never second guessed my decision at any point. The stress of constant testing/biopsies/watching was way too much for me. I had no complications at all. I was out of work for 3 weeks and no real pain to speak of. The drains were the worst part for me but I had those in for less than a week. My PS does fills of the TEs in tiny increments (30cc at a time each week), so while that was uncomfortable toward the end, it never required more than an Advil. Sleeping is a drag as the TES are hard as rocks. Things are settling in pretty well (I went from small A cup to a B and they probably look better now than before NSM). Right after the exchange I worried as I thought they looked sort of shapeless/small, but the gals here jumped in immediately to reassure me and a few days later everything started taking shape nicely. My nipples have no sensation, but I knew that going in and was totally ok with it . I occasionally-not often at all- get the cool boob thing but not really noticeable--to me, its sort of like when your hands are a bit colder than the rest of you. Anyway--please feel free to PM me if you have any questions I can help with--I am so very grateful that NSM was an option for me (and grateful for all the women on this site...that, you will find out for yourself!).
IIene
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Scooteroo13: Welcome! I had nipple-sparing surgery, but I'm still going through the expansion phase of my reconstruction and don't have my implants yet.
Just so you know....NSM can also be done with various types of flap surgery (DIEP, for example). In those cases your own tissue would be used to build the breasts so the "cold" thing wouldn't be an issue.
I've had healing problems since my NSM in February, but even if I could turn back the hands of time I would still choose the same surgical course.
You need to be a member of the discussion boards for a while before getting access to the picture forum, which is a totally separate site. Then you have to go through a little screening process by one of the moderators there. Contact Lilah, MBJ, or whippetmom for more info...
All my best!
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vhshea: My hospital/health system has a wonderful breast cancer navigation program. Yes, well worth checking into. They have lots of local resources, can answer questions, and act as a patient advocate should you need one. I haven't used their services much, but the few times I've had a question and didn't quite know where to direct it, the navigator "steered" me in the right direction. It's a great resource!!!
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I have been following this thread being that i was not sure what my outcome would be. Just a recap I had a lumpectomy 9/10 followed by rads. Starting having pain the first day of rads and it continued on all the way through. No one seem to take me seriously about the pain and kept telling me this was normal. Well I finally could not take it any longer and went back to see my BS to find out I have permant nerve damage cause from surgery and rads finished it off. So I have been on meds for the pain that are helping but still having problems so will see a pain Dr. this Friday. In the mean time my BS wants be to have a MX now so that she can try to sever my nerves to relieve my pain. I am fine with all this and have decided that I will follow through with it. I was thinking of having both done while I was at it but after speaking to my BS on Friday she really only wants me to have the one done, but the good news is she thought I was a good candidate for NSSM which I am really happy about. So I was really scared about the symetry thing with only doing one. Speech thank you for posting your story as that gives me more confidence that only doing a uni might just be OK. I am 48, will be 49 next month and very small breasted. I do not even fill my A cup bra. So I figure if I am going to have this done I will go bigger and I was wondering how some resulted from this. I don't want huge but I would like to look like I have boobs for a change. I also work out alot so I don't have alot of fat areas so I am not sure that any flap will work for me. I see the PS in June and will just take it one step at a time and see what he recomments. I also like the healing time of implants over flaps. I have gotten on the picture forum but have not quite figured out how to master my way around there. Will give it another try.
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takeadeepbreath - maybe you can tell me... i keep hearing about the drop and fluff - any idea what that is??? thanks...
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Ilene,
I saw your photos and you look just amazing! Such beautiful work and such a magnificant outcome! Wow!
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I'm glad to see this thread is taking off again as it means more and more women are becoming aware of this option for MX.
takeadeepbreath- Just saw your photos and you look wonderful! I think the size and shape are just perfect for your proportions and your PS did an amazing job. You look very natural!
sweetie- I've been struggling with not being able to lose the pounds as easy this past year, too. I have to admit the lipo aspect of the fat grafting was very appealing. The hardest part to lose is the stomach area for me so that is where I told the PS to take from first. It is a tough recovery, though, something I wasn't prepared for at all.
scooteroo13- The biggest factor in the success of your NSM will be the level of experience of both your BS and your PS. I would definitely try to be as prepared as possible beforehand, though. There are some great threads on here with tips on what buy, pack etc before your surgery. A little preparation will go a long way towards making things easier physically for you after you come home. And everyone on here is happy to help with any questions you have, too. Good luck.
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scooteroo - Mine was done for prophylactic reasons also (ALH) - don't let the cold boobs scare you - it is just kind of funny is all - I have been so happy with my results - and the whole process.
Sherry - I also was barlely an A cup before and decided to go bigger - have been very happy - I wasn't a canidate for flap - so I had tissue expanders. On the picture forum I think most of us have used the names we have here - so you can just look for those names - under the "under construction women" - most put nipple/sparing in their title. '
Good luck everyone!!
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Sandy-
From what I understand, with silicone implants (not the gummies) the "drop" part involves your muscle softening/easing up on the the implant so it doesn't sit so high on your chest. The "fluff" seems to refer to the implant filling out the lower portion of your boob so there is that natural slope. Folks seem to indicate it is a couple of monthe process. My PS did not use that expression, but when I showed him an indent at month one in one side, he said "let's see what it looks like in July after the muscle adjusts and has loosened up a bit". Guess "Fluff and Drop" is not a medical term! (Sounds like that thing they tell kids in a fire---stop-drop-roll...!)
Kate-THANKS! I posted a note to you on my pic thread--you were actually the first person I followed on these boards--you literally found me "lost" on the wrong thread and course corrected me back in Sept. --3 months before my NSM. Your pictures really helped give me a dose of courage re the outcome. Really glad things seem to be going well for you now after your setback. These boards have been a saving grace -I'm thankful to all the ladies here who helped inform so many about this procedure. My BS has done hundreds of NSMs, he is a big advocate (for appropriate cases) and supported me from the get-go--I felt complete confidence heading into this journey with him. I didn't even realize how many are unaware of the option.
Ilene
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Ilene- Your post just made my day! Thank you!
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dear all, hoping to join in on your board too since am hopefully having a NSM in August and want to get as informed as poss....have found some other boards about diep etc, but i think this one is just for NSM?? also, still being relatively new to bc and this site i cant seem to work out how you access photos?? i would really appreciate seeing some real photos and not just looking at ones that are posted by PS sites to get some idea of the process and what to expect from this kind of reconstruction...thank you, Rosemary
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Kate - so glad to hear all went well!!! It must be a relief to be over the hurdle of another surgery, wishing you all the best!
Ilene, I have a divot on the top of my implant (I'm 9 weeks out from exchange). I have a appt at the 3 month mark with my PS to evaluate my progress (AKA "drop & fluff!"). I have purposely not called to schedule getting in sooner to adress the issue because all I have heard to wait it out and see how everything settles. Actually it's not the biggest deal ever, having the divot...my DH swears it's just my critical eye, but if it can be corrected, I 'may' think about it. I am in no rush to do anything with the summer coming, if my PS decides FG could remedy it, I'd think about it. I am thrilled that my minor rippling has gotten even less, I think or assume (?) that as the implants settled and filled out they softend up? Who knows, but it's at a point where I could live with it.
It is kinda wierd about the chill of the implant! I wonder if the implant makes me colder sometimes...Is it possible for the implant to give you a chill? sometimes when it was colder out I felt like I was chilled "to the bone" and I guess that might have been because there was no fat to insulate me anymore...hmm, But in reality the coldness doesn't really bother me to the touch, considering I'm numb I only notice it when I am touching them, so in daily life it's not that big of a deal to me, I guess...
Louis - welcome to the NSM thread! It's a great place for info on this surgery, I echo the ladies here when I say that NSM changed the way I felt about the BMX. It is a remarkable surgery that more women need to know about. Good luck and we are here for you!
It's really great to see the action on this thread again! Wishing you all a great day!
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louis13: Send a PM to one of the picture forum moderators if you're interested in seeing not just "before and after" shots, but some of the steps in between. This is a site totally independent of this BCO site. There are a number of gatekeepers there, the ones I can think of are MBJ, Lilah, and Whippetmom.
I've had some healing problems, but will still have a good end result and would do it all again in a heartbeat. It just feels like it's taking forever to get there
. There are quite a few nipple sparing photo journals on the forum.What kind of reconstruction are you planning...or have you gotten that far yet?
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firedancer,
Wow, you are so right about the chill from the implants! Now we are into winter here in Australia, I have noticed how much colder I am than the rest of my family. In fact, I noticed this right from getting my implants in March. The other night we were sitting around watching tv with the oil heater on and everyone else was cosy and I just felt cold so went upstairs to get another sweater. In my bathroom I put my hands on my breasts and was shocked how 'cool to the touch' they felt. I stripped down and put a very warm tank top on and then my shirt and sweater and it was better. Maybe in summer cool tits will be nice.
I am also finding it weird to have no feeling on the breast area. I am afraid to do a 'Mrs Doubtfire' and catch them on fire or burst one of them. But, all in all, it's better than worrying about breast cancer happening again.
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Gosh - justagirl - tonight the forums have been JUST what i needed - a good set of belly laughs - your Mrs Doubtfire comment made me laugh out loud!
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vhsea,
We all need each other and this website.
I choose to laugh now rather than be upset by something I can't effect or change.
I chose to have my DM as I had a lumpectomy 3/2010 for a nasty invasive and agressive tumor, followed by the not-so-lovely chemo and then got fried by radiation. Being self-conscious of one boob having so much cut out of it and reducing it's size, I thought I just would have the other 'healthy' breast reduced to match it size-wise....and the pathology from that tissue showed me to have lots of stage one bc tissue. That was enough for me. I didn't want my boobs to kill me.
I went into hospital to have a nipple-sparing double mastectomy but just before surgery the plastic surgeon and the breast surgeon talked to me and advised since both my nipples had been reattached a few times their was a high risk of the nipples not having adequate blood flow, therefore infection and removal of the implants. So I decided right then, off go the nipples too.
It wasn't what I planned but it's ok. My only goal is to never have bc again....so I guess I don't belong on this forum as my nipples got the ax but I like it here.
I'll keep you posted if I catch on fire!
vshea - I just read some of what you wrote today. Do not be afraid of your masectomy surgery as leaving the cancer in or the potential of what it could do is worse. Do not be afraid of pain. Discuss pain control with your dr BEFORE the surgery and ask/demand it after. I washed my hair two days after my DM with reconstruction. You can do it. You are healthy now and the reason you do this is to stay healthy/have a healthy future for yourself and your family!!!!
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thank you all for the welcome and yes tina, i ended up working out how you access photo site via moderator and am waiting on validation now..am looking forward to seeing some real pictures, how women generously share their experiences is our best resource have come to believe....re my surgery plans? am currently having neoadjuvant chemo, surgery will be in august. am having at least uni mx with immediate diep reconstruction..hoping to get away with nipple sparing too...i keep equivocating about doing the other breast at same time, and prob am going to keep doing that for a bit longer..have already had lumpectomy in other breast( non cancer side) to remove all the ALH...microscopic as it turned out...so, tech clear on that side atm..but mostly am being swayed by the time/economic aspect, but not fear ie. i just dont want to lose another year and have to go thru all this again. gotta say that this whole breast cancer ride is very busy lol. feel like i am just getting a handle on chemo( have been active in chemo forums) and suddenly realised now need to shift gears and think about my surgery that is coming up soon...much to learn as you move thru each turnstile.. btw, i was talking to friend last night who had implants long ago( had them removed cos of problems) , and she told me how she lost all sensation with implants( no breast cancer or breast cancer surgery, just did it for augmentation) ...is this what always happens with implants?? rosemary
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louis- Pretty much everyone loses all sensation with MX but it really seems to vary as far as how much of it comes back within time. I had heard that a lot of women lose all sensation in the nipples with augmentation. (Can't understand why anyone would do that voluntarily!) I had quite a bit of sensation return to the skin on the top and in the middle of the breasts. I've only heard of one person having any sensation return to the nipples. The doctor that I just had my revision with claims with his method of fat grafting that I could have a lot of my sensation return. There is another member on here, leeinfl, who has done 3 rounds of fat grafting with this doctor and she has had this happen. Unfortunately, everyone is different and you never really know how much you'll get back until it happens.
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Louis - I have regained sensation in my nipples, one more than the other, but it is NOTHING like the sensation before. I am aware of them when they are touched, but it is a wierd feeling and not pleasant. It's hard to explain, but I have a decent amount of sensation in various spots, definitley the cleavage area, across the top, and gaining some feeling along the outer sides. Intimacy-wise, there is defintley no reaction anywhere for me on the boob-area...it doesn't feel like it used to, but I guess I'm glad I've gained "something" back...
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