TE TROUBLE
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Well I had to have the expander removed. Not surprised, just disappointed. Now I will be looking into Lat Dorsi flap. Not at all what I wanted to do, but it is what it is.
Thinking positive, I'm not even sure what "cording" is? I'm guessing that probably means I don't have it and should be grateful. I hope you get relief from it soon.
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Ruth7733 .. posted from breast cancer.org... you would know if you had it... I had it after my MX... went to PT and it was totally gone... finished PT a week before my exchange... now its back...
Axillary web syndrome (AWS), also known as cording, sometimes develops as a side effect of sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Both procedures involve removing just a few (SLNB) or many (ALND) of the axillary, or underarm, lymph nodes. Most people with breast cancer need to have at least one of these surgeries. Scar tissue from surgery to the chest area to remove the cancer itself also can contribute to cording.
If you develop axillary web syndrome, you'll often be able to see and/or feel a web of thick, ropelike structures under the skin of your inner arm. Lymphedema therapists often call these "cords." (In some cases, you may not see or feel the cords, but sensations of pain and tightness will tell you they are there.) You may first notice them when you're doing something that involves raising your arm to shoulder level or above your head. If it happens, cording typically occurs anywhere from several days to several weeks after your surgery, although there have been individual cases where it appears many months later.
With cording, it's possible to have one large cord or several distinct, smaller cords running down the arm. These cords usually start near the site of any scarring in the underarm region and extend down the inner arm to the inside of the elbow. Sometimes they can continue all the way down to the palm of your hand. In some people, cording can extend down the chest wall instead of, or in addition to, the inner arm.
The cords tend to be painful and tight, making it difficult for you to lift your arm any higher than your shoulder or extend the elbow fully. This pain and limited range of motion can have a major impact on your day-to-day life. Cording can be especially problematic if it happens before or during radiation therapy, since this therapy typically requires lifting your arm above your head.
Researchers are still studying what exactly makes cording happen. Some experts believe that the surgery to the underarm and chest area traumatizes the connective tissue that encases nearby bundles of blood vessels, lymph vessels, and nerves. This trauma leads to inflammation, scarring, and eventually hardening of the tissue. This hardening can spread down the fibers of the connective tissue, which causes the cords to form. More research is needed before we'll know for sure what the cords are made of.
We're not yet certain how many people go on to develop cording after breast cancer surgery. Very few studies have been done, and most have involved small numbers of patients. One study found that 20% of women went on to develop cording after sentinel lymph node biopsy. Studies of cording after the more extensive axillary lymph node dissection have ranged widely, finding that anywhere from 6-72% of women develop it after ALND. Still, many experts believe that cording is more likely to be a problem after ALND than SLNB, since ALND is a more extensive surgery (and more surgery tends to be more traumatic for the body).ure I am going to explain this correctly... so I am pasting from web...
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Special K
I am doing okay- some days better than others. I have a question with the implants in, mammograms are done yearly.? What the screening proces
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psalms - no, you have no breast tissue to mammogram. Usually an annual physical exam by your BS and/or PS, and some have MRI at periodic intervals to check the integrity of the implants. If you have a local recurrence it is usually pretty obvious since it would be between the implant and your skin with no breast tissue to obscure it.
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Hey SpecialK..how are you doing? Can an MRI check to see if an implant has moved? Can that happen? Still wondering about mine.. have another apt with PS Thursday.
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I am doing OK - I am now a month out from my last surgery. The wound seems to be staying closed this time but I can't have another TE placed until at least six months, so the end of this road is still pretty far off. That is ok though, I am just happy that I don't have to do two bandage changes every day! I can be happy about the little things! I would imagine an MRI could see a shift of the implant, what does your PS say about your feeling of it being too far to the outside? You might have a hard time getting insurance to pay for an MRI unless your PS is pretty sure there is a problem.
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I told him what I thought last time..and he agreed that it did seem more swollen that the MX side..but was pretty sure that it was swelling from the surgery.. Its just a gut feeling I have..that it isn't right... I am having a hard time now getting the insurance to pay for the reconstruction... they have pended both the hospital bill and the plastic surgeons bill and requested my medical records to review. I guess they will pay in time...probably want to make sure that I had a reason for the reconstruction. But you would think that with all the other claims that I have and that they have paid..they would know.. Insurance!!! Glad to hear you are doing well!0 -
Special K thanks a million
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I'm glad every is moving on. I miss chatting with the beautiful ladies that in full re very. I'm doing well had the TE remove and got implant.
Lady's surgery is over!!! My hubby said the gummies description is 620cc I was wondering is that a lot? I see them small? He did fat graphing from my stomach and thighs I'm don't have fat from my thighs where did get it from. But I'm happy I want see them but I can't. My ladies what should I expect? They don't look big like the expanders. What is 620cc in our world? and I only see them small like a A ... I don't understand is the bra that's making it flat?
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Good to hear things are going well with your recent surgery, Special K! I was wondering what PS and plans were decided. We'll talk at the Tampa Bay BCO get-together next month.
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Hi Ladies...hoping for your thoughts. I had a BMX a couple months ago with immediate expander placement. I'm 5'11 and slender, and had been a 38DD before the surgery. I've been aiming for around a D cup and everything had been going great up until a couple weeks ago. I had my final fill...Mentor expanders, filled to 710 ccs, and I think my PS was aiming to put in 650 or 685 Mentor MemoryShape implants later this fall. I was happy with how I looked and had a final fill. A few days later I had a lot more pain than usual on one side after expansion, and next thing you know I had to have serous fluid drained off one side, and then a few days after that ended up in surgery to check things out, remove some old and a few new blood clots, and reinsert a J/P drain. (This side was always an overachiever...I had had the last of 4 drains in on that side for just over 7 weeks.) PS removed 100 ccs of saline from the expander on that side and had said he was concerned about the skin thinning a bit in one area. Sounds like now I may not make it to a D without doing a lat flap, which I don't want to do. I know this is silly when so many people have far far worse problems and so far I'm very fortunate in my prognosis, etc. Maybe it's just the last straw when I've felt so out of control, and thought I at least had a bit of control at this point, because I was supposedly done with fills and surgery was scheduled for the exchange. For now he did leave the other side's expander at the larger volume and I still have to see him for postop eval. At the last fill he had put in 60 ccs, and everything was going ok before that. Do you think there's a chance he might consider adding 50 back in, and splitting the difference since he took out 100? I think he said in one small area the skin was 1/4-inch thick...but I was in recovery room, so memory may not serve me right! My main concern is that I want a certain amount of projection...I want to notice my bust more than my abdomen when I look down and I wanted to get as close to the old me as I could...was NOT counting on 2 cup sizes smaller...and I know with implants I'll lose some of the projection provided by the expanders. Any advice, even if it's just that I need to get over it? Sorry...today was a bad day for me. :-(
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Czechmate. Just Hugs. Tell your P'S what you want and ask him or her to get as close as they can. Then see what happens. They really want it to work too. The hard part for us is there really is no way to get big boobs because we have only chest muscle and skin to hold them up. There are stress points along the edges that cannot take the weight. A natural breast is held up by every single cell and they can't duplicate that yet.
PatriciaHurtado, CCS don't rely translate to cup sizes. Because all our breasts are different. The cavity the implants fill differ from one another too. But if it helps I'm a big lady plus size 3x. My implants were 750 filled to 850 saline rounds. He was going to use 850 but they were too wide at he base when he got in there. Anyway I fill a C cup. I wear a BAli bra in 46C. Hope that elps.
Specialk, glad you're still plugging away at this.
As for me, seeing my P'S because of what I hope is scar tissue on my left side. Yeah my temperamental cancer side hopefully just scar tissue. Also that side is hanging a bit lower now. So we'll see. I'm pretty sure with the trouble I've had I'm not going ing to try anything to fix it.
Much love to all.
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Czech - there is no way your skin is 1/4" thick, average skin thickness is about 2mm - and this is one of the issues with heavy larger implants - as moon stated. There are limits to how large an implant can be placed - both from the standpoint of the product, with standard implants having a max capacity of 800cc for silicone, and 800cc for saline that can be overfilled, and whether the patient's individual physical situation can support the selected size. I believe there are some newer products that have a larger fill volume, but not sure if they are widely available and the pocket must be made larger to accommodate, and there are also custom saline implants that are not likely to be covered by insurance. Almost without fail, your implants will look smaller than expanders. I have had implants that have varied by 50cc and 100cc, since 50cc computes to about 3 tablespoons distributed over the entire implant volume, so it won't really be noticeable.
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Hi, I just found this thread. My troubles with TE's has been mostly from the cough I have had since chemo started back in May. My MO said my cough could not be from chemo, however after going to an ENT and a gastrointerologist, it seems that it is. I have had several tests, including a endoscopy. Inflamation to my esophagus. I am on medicine, hoping it works. With the coughing, my chest expands and the TE's have pushed hard on my ribs. I had a chest X-RAY and inflamation on the ribs. I have my exchange next Friday. I am still coughing some and am hoping it does not affect healing.
Question: My PS uses glue under my Breast and not stiches. And, he does not wrap or bandage at all. That worries me too. He did not use any with BMX either. Anyone ever heard of no wrap at all?
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I have had 14 surgeries and have never been wrapped for any of them. I have only had gauze and paper tape applied to incisions. I was glued for ALND surgery and have had glue over interior stitches for a few of the toehr surgeries.
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Thanks, Special! Just concerned that implants could fall. ?? Ohhhhh, wanting these hard things out, but not looking forward to surgery. How do you do this?
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This should be a much easier surgery for you and often docs use the wrap up higher to hold the implants down, not really keep them from falling. The pocket is behind the pectoral muscle, and the allograft slings hold the implant up from underneath. Try not to worry.
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I'll try! Thank you!
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Hi ladies,
I'm not sure if this is a problem or not...
I currently have Mentor TEs 350cc overexpanded to 500cc. I have developed multiple small bumps on the surface of my TEs in a number of places. Some are not much larger than the end of a ballpoint pen, others are slightly elongated in shape. They're definitely on the tissue expanders, not on my skin as I can slide it over them.
Has anyone else experienced this?
I am being careful as the skin over these little bumps is easily irritated. I'm concerned that these may be weak areas in the TEs. I still have 6 weeks until exchange and do not wish to spring a leak!
I only had one or two which my PS noticed at my final fill. She wasn't sure what they were.
Any advice would be most welcome.
Hugs to you all,
Suzette 😄
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suzette, could they actually be scar tissue on the layer of skin beneath the top layer? I have a scar that is not under the incision but a little off. It's the 2 nd layer of skin. The top skin slides over it. Then i have little bumps that feel like bubbles. I feel them for fun some days. LOL they re thin places in my skin the PS says. So not my implant but my skin. But if they don't hurt that's good. Watch to see if they change. Ask the PS again if they are still there.
Much love
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Hi moonflower,
Hmm, I had thought that I only had one thin layer of skin over my TE but scar tissue in another layer would make sense if there's more than one.
Thanks for your input 😊
Best hugs,
Suze xo
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hi ladies,
I posted this its own several days ago, but didn't get any replies. Hoping someone can weigh in on this board.
I had skin saving bmx w te 5/14; infection and removal of right te 6/14. Exchange on left 10/14. Surgery on left (flat) to "clean out" because it kept swelling 1/15. Did NOT have te replaced. Took a break from surgeries to enjoy my summer.
My left migrated a LOT into my arm pit and somewhat down. And was very ripply. Could notice points of the implant through my bra and shirt.
Considered and thought very hard about throwing the towel in and going flat. Told my plastic surgeon that I only wanted one more surgery. Whether that was two boobs or none,I wanted to be done.
10/20/15 placed implant on right. Exchange for smaller implant on left. Fat grafting. I had a LOT of skin removed from both sides. I had very very large breasts before and wore a 46G.
I'm in a surprising (to me anyway:) amount of pain. Reminds me more of my bmx surgery than any of the ones afterward. I'm ten days post op and was able to stop taking pain meds. I'm taking Ativan and Tylenol.
I'm seeking advice on keeping my implants in place and some thoughts on when my pain might start to subside.
Also my ps said I could drive as soon as I'm off the percosets, but I don't feel I'm ready. Any advice on this front?
Thanks :-)
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Lynn - You have had a bit of a more unusual combination with an implant swap (maybe with pocket work to adjust the migration?), FG, and essentially a direct to implant. It always hurts to put things in, a lot less to take them out. I am not surprised you still have pain and don't think it is necessarily unusual - it has been less than two weeks, right? Hopefully someone will happen by who has had a more similar combo, but I think time will help. Hope the discomfort dissipates soon, what does your PS say?
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thanks SpecialK,
Think I'm just feeling a little depressed and just ready to be pain free and finished with this! I just figured I'd bounce back as quickly as I had from the last few surgeries. I see the NP at my PS Wednesday to get this godforsaken drain out
and check me out. I'm still sleeping in my recliner (two weeks tomorrow) and I'm going to be afraid to transition back to my bed because I will be afraid I'm going to roll over and push my implant back under my armpit. I'm doing Ativan and Tylenol 3 times a day, any fewer times and I am very sore. I guess I just need to be a little more patient! Thanks again for the response
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Hello all.
I had a double mx with expanders placed on November 9th due to a genetic mutation. The first week of December I woke up with my left side extremely swollen and had 280 cc's removed, a drain placed and started getting daily IV antibiotics. I continued to feel worse and on 9 December had the left TE taken out. The PS checked all of the fluids but nothing grew. He referred me to infectious disease and they discovered I had a mycrobaterium but that it would take 4 to 5 weeks to grow the specific type. Results just came in and I have Mycrobacterium Sengalese. I have to take Ethambutol, Azithromyacin, and Rifampin for 3 months and then another 3 months of blood tests before I can have the TE placed again. Infectious disease keeps calling back East for consults on how to proceed, and the PS is just as puzzled. Has anyone else experienced this?
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Greenbeantrees-
We are so sorry to hear of the troubles you've had! Do they have any idea how or where you could have contracted the bacteria? Hopefully, your doctors are able to get some answers soon, and that the treatment works. And hopefully the delay doesn't affect your reconstruction any more than it already has! Good luck!
The Mods
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Greenbeantrees ...
Happy New Year and welcome. This is an amazing site and everyone is so helpful.. i tested BRCA2 positive in 8/15. Had ovaries out and hysterectomy surgery in Sept. Had bilateral prophylactiv mastectomy 5 weeks ago. I am so sorry to hear about your complication of infection. At least by going through the prophylactic surgeries you have prevented cancer before it could develop. That is the reason for the surgeries. Good for you to make that difficult decision! Reconstruction is an additional step that is just going to take longer than hoped. it is fortunate that the bacteria was identified and appropriate effective treatment can begin! You will be in my prayers. Please post again!
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GBT, so sorry you have to go through that. Sucks. I've had two TES removed due to bacterial infection and the I'D doc was driven nuts. Didn't have the exact one you ad but it really doesn't really matter it still sucks. Rest assured you will get there it just takes longer than you would like. Hugs.
Much love.
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greenbean - I would check with your PS about whether any allograft material used in your surgery was bovine derived - the bacterium you mention can be associated with cattle. I would guess that your docs are asking their colleagues for help because this is a rare situation.
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Specialk..have not seen you on here lately, hoping you are doing well. How is eVery thing after your surgery?
I had my final reconstruction, skin graft from my leg for the nipple. 4 weeks ago. It seems to have flattened out a little. Is that normal? I go for a follow up Tuesday.
Just hoping nothing more needs to be done New insurance sucks 3000 deductible then 50/50 coinsurance Out of pocket 6900 Big difference from 3000 deductible and then 100% covered! Guess it could be worse!
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