Nipple reconstruction
Comments
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Does anyone know if the cook cylinder is available in Canada? I do have an appointment with Vinnie for the end of March but my nipple fat grafting that I had done last week has failed and I just can't wrap my head around not having nipples. I'm looking for options before going the 3d route. This is my third nipple failure and it's important enough to me that I will keep trying as long as there are options out there that can be tried. I did have a CV flap but the nipples were destroyed during a horrible tattoo incident. Since then I've had two fat graftings and after removing the bandage today, I can see that this was just another waste of time and money and emotions.
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jamie that is an erogenous zone your feeling go with it! I am very excited to realize this.
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Mantra - I'm not sure if the Cook cylinder is available in Canada but it's worth asking your dr about. My PS said he does them because with fat grafting, the fat sometimes gets reabsorbed into your body and therefore you flatten out. So I'd def check into it!
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Just wanted to let you know that my meeting with my PS went very well. (6 months post BMX -- the first meeting I've had with him since July 2). It was so reassuring to hear that he had basically the same assessment as I was expecting about needing a mini breast skin reduction on both sides along the inframammary fold and anchor vertical scar. He will take off the small "dog ears" at the edges and so the incision will be a little longer than the original. He is going to move the right implant about 5mm lower and widen the pocket a bit towards the underarm to get a better match between the two sides and reduce the upper pole problem. He will work on the symmetry since my left breast is softer and looser and the right breast is firmer and higher with NAC pointing more to the right. For my left breast with my real nipple and areola, he will make a crescent cut towards the upper pole to move it slightly upwards.To re-create the reconstructed nipple that I lost on the right side, he cannot use the skin from the mound because of it already being grafted skin. But he will use some of the excised breast skin to create a nipple. Hope it works this time (although I wonder why should it when it already failed once already during BMX -- I had reconstruction with the implants on the same day? Maybe because this time I will have less parts of my body to heal and can focus healing powers on the nipple?)Although I asked about it, my PS has a "policy" against using any of the pig collagen and alloderm type products of Cook support for achieving nipple projection, but perhaps that is just his conservative nature and none of his patients ask for it.My revision surgery is scheduled for Dec.4th and I will have to have a general anesthesia, and stay just for one night. Then if nipple takes, tatoos 3 months out.Do any of you happen to know of any definitive studies from Journal of Oncology Plastic Surgery or similar that show nipple failure / success rates depending on sources of tissue and method used?What would those with successful nipple reconstructions recommend for how to increase my chances of the nipple surviving and staying projected?Thank you for your advice. Fearlessfoot0
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fearless I have no idea really what to tell you. It sounds like your PS is really willing to work with you and do whatever it takes. I had my nipples done from the skin at the incision site of my bmx using a CV flap method 2 weeks ago. He gave me these little silicone like thimbles to put over them and protect them. I think they make a big difference. Plus keeping it all very clean but being very gentle when cleaning them. I now have feeling in my new left nipple. Not like I used to but kind of feels tingly and gives me goose bumps. My other side i have nothing but that one is closer to the incision than the other one. When I am not sure of all the decisions I get 2nd opinions from other doctors. Sometimes it's just reassurance that this is the best way to go.
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fearless I am a failed nipple sparing mastectomy. My PS took skin from my hips and created an areola graft and nipple at the same surgery. He put a foam dressing over it which he staples it covered a large area as he anchored it with 15 staples. This stayed on for a week I think. Then after that I bought nursing pads that mom's use. I cut a hole in gauze pads or non stick gauze pads and layered them up to the height of the nipple top then covered with the nursing pad. Mine shrunk as they all do but it is ok. He did not use any collagen in it. I have to have a revision tomorrow on the right to make it a bit smaller to match the one on the left. Good luck
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Thank you, Carrol2 and hopefulhealing for sharing your experiences. I've decide that I am going to get a second opinion from a PS for a different perspective. This is from one I almost went with for the BMX.
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fearless always a great idea to be examined and get as many opinions as you can from the experts. Most of them will do these consultations for free as well.
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Went to NOLA yesterday for Vinnie. He is a class act and I would recommend him to anyone. I'll post pics when the healing is done.
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ohhh Cindy can't wait to see. Mine nipples are still healing 2 1/2 weeks since surgery and I have 3 more weeks in the protective cones.
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Hi ladies - I'm still in the expansion stage, but will be having my exchange surgery sometime in January. My PS does the nipple reconstruction at the time of exchange using the local flap technique (skin from the breast site). Just wondering if this is common practice? I'm based in DC and still trying to figure out if I want the nipple reconstruction or just go the Vinny route.
Cindy, how long did it take you to get an appt. with Vinny?
Any advice or experience on how you came to your decision would be appreciated!
Grier
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I had my exchange and nip done at the same time. I am happy with the results. He used breast skin to create an areola and nipple. Just had my tat done not quite two weeks ago. Unless I choose to do some revisons, which is not likely, I'm DONE!!
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My Ps uses skin from the inner thigh. I didn't want more cuts. Nipple recon doesn't appear to be seamless in a lot of cases. I also didn't want to be concerned with having to cover up nipples. Tattoos are exactly that...just the illusion but I wouldn't change my decisions....maybe only going slightly smaller with implants.
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Grier my PS used the skin on the breast to make my nipple using what he called the CV method. Seems like that describes the shape of the incision. It was on october 30th and healing nicely. I have about an inch long incision on either side of the nipple seems like most of which will be covered but the tatoo when i get it. I think this is a very common popular way to do it.
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I had the same procedure as Carrol on Oct.26..Healing well..think I will need another fat grating session though,,
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My PS also used local skin to do my nipples over a year ago. Still looking good
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Thank you ladies...very helpful to hear your experiences. I still have some time to weigh options, but I will probably do the nipple recon and then tattoos with Vinny.
I read about having to wear protective cones for awhile (I'm picturing the kind they use around dogs heads to stop them from licking!) - two questions: a) how long do you have to wear them and b) were you able to disguise them fairly well in clothes or was it chronic headlights for awhile?
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Thank you ladies...very helpful to hear your experiences. I still have some time to weigh options, but I will probably do the nipple recon and then tattoos with Vinny.
I read about having to wear protective cones for awhile (I'm picturing the kind they use around dogs heads to stop them from licking!) - two questions: a) how long do you have to wear them and b) were you able to disguise them fairly well in clothes or was it chronic headlights for awhile?
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I just built up gause on both sides. No cones were offered to me. I was able to hide it but couldn't wear anything tight or thin T-shirt like. Thanks goodness it was November December. Don't remember how long though but I don't think it was more than 2 months, probably less.
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I had my nipple reconstruction done in the summer and it was pretty easy to cover up with heavy tshirts and especially shirts with pockets. I remember my friend stopping by once when I wasn't that concerned about being prim. She looked actually shocked to see my headlights shinning through my tshirt! And the cones are not at all like the cones of shame used on dogs. Think more of nipple protectors and shields from breastfeeding. Lots of people have posted their various ones on this site. Mine were donut shaped gauze smashed down with plastic for the first two weeks. Then just the gauze donuts for another 4 weeks. I have seen plastic ones that have a hole cut out for the nipple. Just depends on your PS. FYI...I wish that I had consulted NOLA before getting my nipple reconstruction in July. I had nipple reconstruction that also included fashioning an areola from flap skin. Vinnie does not like to tattoo this kind of nipple. I went in last week and he said I would not be happy with the result because flap skin doesn't take the ink as well. He prefers just the nipple done and he does the areola with ink. I am now deciding wheather to start the process all over and have NOLA redo the nipples and then have Vinnie do his majic. So wish I could turn clock back and not have to repeat Phase II. You just might to check before you proceed.
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Thank you both. Glad to hear it's not the "cone of shame" LOL!! grt42btexan, SO GLAD you mentioned the areola and tattoos. I will definitely talk to my PS about not doing it and just focusing on the nipple. It's so nice to be focused on nipples and areolas and not cancer. : )
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the cones are kind of like a big thimble on a flat square made of silicone with little air holes on top. yes it has been very hard to disguise the cones in clothes. They show in everything I wear. I have to wear a quilted vest or a scarf over them to cover them. In a tshirt they look like little mini madonna cones lol.
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My PS did my tattoos and I'm pretty happy with them. Needs a touch up because one lightened up but still looking pretty good
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Hi Ladies,
I am scheduled for te exchange in a few weeks and my PS said that he could probably do nipples at that time. He uses alloderm, rolling a cone shape. It sounds like a homemade version of the Cook's Cylinder I have read about here. When I google it, I can only find the cylinder as part of a Clinical Trial. Is it something I should do a little more research on? None of the study sites are within a reasonable distance of me. But I have been through about 7 recon surgeries, and am finally feeling twinges of excitement at how I might/hope look so I dont want to louse it up with a possily failed nip job. Any advice?
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Ask your PS more questions and see if he could sketch out what he's doing. Ask if there is anything your can read up on about it. Most importantly ask what are the risks and failure risks.
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I forgot to mention my PS said he would use hyaluronic acid to achieve projection, which I guess is an filler injection and may need repeats, to the nipple made from excised breast skin (I have some excess skin under the fold after my double reconstruction with silicon implants). Has any heard of this?
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Hi Fearlessfoot - yes, I've heard of using fillers (like Juvaderm) to give the nipple projection. My nurse navigator actually had a BMX and this is how she got projection. She said she has to go back periodically to have it touched up (about once a year) and she hasn't bothered to do it in awhile.
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OK for those on the forum I posted my new nipple pics.
Keep in mind they were only taken a week out so they still look a bit frankensteinish.
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OK for those on the pic forum I posted my new nipple pics.
Keep in mind they were only taken a week out so they still look a bit frankensteinish.
thread called New Nipples Oct. 30th
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Just checked it out and left you a comment there - you look fab! : )
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