Nipple reconstruction
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I had my nipple recon done 10/5. My ps was going to take tissue from thigh, but at preop appt he took some measurements of my existing areola and determined it was large enough to take half and make my new areola. He used scar tissue to make nipple. I'm still all bandaged up so don't know what either side looks like yet. I'm a little nervous. I also had some fat grafting done, and my stomach, doner site, was so sore I needed help sitting up the first couple of days. This surgery was almost as hard as the mastectomy and ancillary node dissection surgeries. I have my fingers crossed this is the last one!
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I just had areola and nipple reconstruction 8 days ago. I couldn't be more delighted with the result. I could not decide if I wanted tattoos or recon so I ordered temporary tattoos on the internet and was able to try them out and in different colors as well. From a distance they looked pretty good but it helped me to make up my mind that I wanted bumps back. I was going to have just nipples reconstructed but my pc moved away and my new one won't do just the nipple. He said that he thinks they flatten so much, why bother? He does nipple AND areola recon and thinks that it has a much better result. He took the areola graft from the area of my c-section scar so that I wouldn't have additional scars. I also wound up with a mini-tummy tuck! BONUS!! It's about time there was something a little bit good about all of this. He took the bandages off 2 days ago and OMG!! for the first time it actually looks like a real breast. The areola graft covers up some of the mastectomy scars and it minimizes the distortion from flexing pectoral muscles over implants. I still have healing to go but this is the happiest I've been since I learned my lymph nodes were clear. He said the nipples will shrink about a third. He said that if I think they are too big later on he can shorten them with a local in his office. For me, this was definitely the way to go. I have to add that this was basically pain free. I never took any pain meds after the recovery room and believe me, I am not someone with a high pain tolerance. My stomach incision is barely noticible and completely pain free. The new nipples and areolas basically have no feeling anyway. The worst part of the whole thing for me was (as usual) anesthesia.
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lakelady thanks for sharing. I am getting fat grafting from my stomach too and I worry how sore I will be. I took 2 weeks from work you think that is enough?0
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Lakelady, thanks for sharing. I opted for tattoos only in Jan. You make me a bit jealous.
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Carrol2 - I think two weeks off from work will be fine. I did the same with my last surgery (nipple and fat grafting with lipo from stomach, sides, back).
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Has anyone had the nipple recon where they use the skin and sort of create the nipple from that? When I first had mine done in August it stuck out ok. Now it's flattened out quite a bit. I'm wondering if I should be asking about a redo? Has anyone had it done again and gotten better results? I have my tattoo scheduled for end of November so I need to decide if I should ask PS about it or if it is what it is.
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Carrol2..My PS said one week off should be ok.. Have old my work I am taking a week (plus two weekends) Surgery in on a friday..Had my port out Thursday, took longer than antisipated as I have had it for a year and a half, so it had made itself quite comfortable in there, Took a lot of pushing and pulling to get it out, Quite sore and stiff both yesterdday and today.. But PORT IS OUT.... I have been "deported" lol
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Congratulations on getting your port out! I have a friend that is celebrating that milestone too. She is really happy.
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Jwilco, my PS created a nipple from my lumpectomy scar. It still looks just about like it did after reconstruction surgery on August 10th. If it shrinks though I doubt I will bother with doing another one. I'm getting my aerola tattoo on Monday.
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Carol2 - I didn't have fat grafting, I had a skin graft to make the aureola. I had the areola and nipple surgery on Thursday and went to work on Monday but I sit at a desk for the most part. I did have fat grafting last year about this time. They lipoed out some fat and then injected it into an area that was sort of low. I totally had no pain from either the donor site or where they injected it. I also had a revision at the same time so I had those damn drains again but was back to work in a week or so. I think if I only had fat grafting I would have been back in a day or two. It might depend on anesthesia.
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CMartin - Please don't be jealous. I waited a whole year because I was sick of surgery. I think everyone I talk with has a different experience and we all have so many choices to make, somtimes quickly. My motto is "It all sucks, you just have to figure out what sucks the least". The decisions we have made about our cancer were right for us at the time.
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I am getting my nipples early next month. My PS explained that he will be making a couple of slits in breast and pull up some skin to fashion a nipple. This will take place under local anaesthesia and apparently I won't need any recovery time at all. Has anyone had it done this way? It seems that a lot of you are getting nipples made from skin retrieved from other sites on your body?
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Thanks for the responses. I am very excited about this now.
Joanquilts my PS is making my nipple from the skin on my breast. He called it a skate flap I think. It's like they cut out a star shape and then they twist the skin into a nipple.
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Lakelady...thanks!
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Lakelady, thanks so much for your input. I have been in the deciding stage for a while as my exchange was in January. My PS also wants to use some skin from my c-section scar & states I would get a mini tummy tuck....glad to hear your not in too much discomfort. How long do you have to be out of work?? Is the tummy tuck noticeable?? Worthy of another procedure??? Please keep us posted, I so look forward to finishing this process.
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Hi Joan Quilts - I could be wrong but there seems to be several different ways to do the nipple and aureola. In my case, he made some slits in the skin and twists and sews them into a nipple. Some doctors then do sort of a purse string stitch around the area where the slits were lifted into a nipple and pull the purse string stitches together to close around the nipple and then the aureola is tatooed later. In my case, instead of doing the purse string closure, he grafted skin from another area to cover where the skin was lifted to craft the nipple and sews the skin graft down around the nipple. I will probably get that tatooed later. He thinks that this results in less shrinkage of the nipple. I couldn't figure out what he was talking about but I found the entire surgical procedure on u-tube and watched it. I know that sounds weird to a lot of people.
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Lakelady: I really like when you said, "I think everyone I talk with has a different experience and we all have so many choices to make, sometimes quickly.....The decisions we have made about our cancer were right for us at the time." For me this rings so true. Given our myriad of feelings and the sometimes imperfect information we have at any given moment, we each make the best possible decision we can for us at the time! It helps if we can adapt to new situations and find that happiness within us that is not based on outcomes but based on simply being. Want what we have, be who we are, do what we can! (to paraphrase Forrest Church)
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My PS did the "skate flap". When he drew it out ahead of time on paper, it looked a little like skate board.
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My PS told me he is pulling and twisting skin from my scarline to make my nipple
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Ossa, I think that is what my PS did. She also said she put a plug under the skin to keep the nipple from going flat.
Get my areola tattoo tomorrow! Woohoo!!
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Good luck tomorro yorkiemom. Please keep us posted.. When did you have your nipple recon? My PS aid I could have my tattoo done in about three months
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Ossa, I had it done on August 10th. My recon was a little different. Don't know the technical term, but the PS moved my lumpectomy side tissue around to resemble more of a cone and built the nipple. She cut down and lifted the non-bc side. I had more difficulty with the good side, as more was done there. But all is well now. Both sides have nicely healed.
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Tenaj - I had my surgery on Thursday and went back to work on Monday but I have a desk job. Yes I was tired. I think it might depend on the person. My children are grown so when I come home, my husband will kindly get dinner and I can veg. out. The tummy tuck was noticible on me. I am 62, had 2 c-sections and have had weight go up an down. I had that flab of skin that sort of puffs over the c-section scar that many women have; sort of a "pouchie". That is mostly gone YIPPIE. I still could stand to lose some weight but I feel much better about my appearance. The healing process with a skin graft is a little more (I think). Right now I am doing great with healing. He sewed on a "bolster" which is a bandage that supports the new nipple, aureola complex. It stays in place for a week and then it is removed by the doctor. You CANNOT get it wet at all for a week. I have a hand held shower attachment so I showered with that from the waist down. The rest of my body I washed daily as a sponge bath. I washed my hair by leaning over the sink. The incision at the c-section scar could get wet and had steri-strips. It definately took longer to get ready for work in the morning. I suppose you could do all of that the night before. After the bolster came off I have this dressing change daily for a week that involves stacking up gauze and cutting a hole out of the middle. It's easier to see than explain. I'm still doing that. After the second week is up I can't remember what I do next. I'll have to call the doc . Hope this helps. I will add that getting the temporary tattoos helped me tremendously,, and they were fun to wear. My doctor also mentioned that there are silicone nipples that can be held in place for up to 3 months with "surgical glue". Lots of things out there to think about and try.
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Lakelady, thanks so much for your reply. I'm very encouraged as you seem to be doing so well. I'm 52 but sound very similar to your situation about 2 c -section & weight changes. I have thought about temporary tatoo's for the interim, where can I buy them? I've been busy this summer starting a new job, I'm a visiting nurse, so I have put any additional procedures on hold. Its been nice to not have all those appointments!!!! I'm encouraged to make an appointment with my PS now and get the finished product. Keep us posted on your progress :-) thanks
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tenaj -
I got a variety pack of nipples at rubonnipples.com Doesn't it sound funny? It's like saying I got a can of peas at Krogers!
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Lakelady- I just placed my order!!! Thanks for the help & encouragement :-) I'm going to call my PS this week. Have a great evening!
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Today is day 5 after nipple recon still have a small strip bandage over the middle of nipple but as much as I can see they look so real. I have never felt so back to normal as I have since the begining of this journey, I look in the mirror and see nipples not scares. I thought and thought about just doing the tats but I want to be as much back to normal as I can for me! and all aspects of my life! I was woried about them being on all the time but you know I allways wore a bra before bc. The donor sights for the fat grafting are still way sore, a tight ace wrap has helped.
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bcs2011, so glad you are happy with your recon. I've been scheduled to do mine the week after Thanksgiving but having some second thoughts. I think I will go ahead and do it; considered the 3-d but just think I'll be happier in the long run. Keep us posted.
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bcs2011 - Congrats. I'm about a week ahead of you with my recon. I feel the same way as you about the nipples. I just love having them. I keep looking in the mirror, amazed.
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Hello Everyone, I am 3 weeks post revision exchange with alloderm. What a mess my revision has been but I'm happy to report that after 3 weeks, I'm hopeful my implants will stay in place and nipple reconstruction will be next. I see my PS in 4 more weeks and then we'll set the appointment for the nipples. I'm told she can do it at her office. BUT, she said its a one shot deal. either they work or they don't (meaning they may or maynot flatten out). I have a lot to learn about nipples so I appreciate all the info and input.
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