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Is anyone going flat or living flat?

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  • lisey
    lisey Member Posts: 300
    edited May 2017
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    I LOVE the knit! i crochet. It's such a dying art. Bareclaws you look great.

  • mustlovepoodles
    mustlovepoodles Member Posts: 1,248
    edited May 2017
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    bareclaws, i am concave with hideous folds of skin and scar tissue. Not at all what i expected. I'm unhappy with the look, but now that I've made the decision for DIEP I'm glad the extra skin is there. I just can't stand to look at it. Every time I bend forward or lift something it accentuates the concavity.

  • bareclaws
    bareclaws Member Posts: 246
    edited May 2017
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    mustlovepoodles, I'm sorry about the concave issue! But glad you have a solution to pursue.

  • ksusan
    ksusan Member Posts: 461
    edited May 2017
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    Even though muscle is preserved, "flat" can mean a concave divot along the incision line.

  • ravzari
    ravzari Member Posts: 32
    edited May 2017
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    bareclaws some women can have a concave appearance if all the fatty non-breast tissue is removed as well.

    I have a couple minor concave areas where the fat was mixed with the breast tissue and they had to remove the fat along with the breast tissue to make sure they got as much of the breast tissue as possible. I don't think they're noticeable visually (I just took a peek; tank top day, so the concave areas are uncovered), but if I run my hand over the area there's definitely a dent there. On my chest, it's higher up, where the upper pole of the breast would be.

  • ksusan
    ksusan Member Posts: 461
    edited May 2017
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    I can post a photo if that would be useful.

  • bareclaws
    bareclaws Member Posts: 246
    edited May 2017
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    I stand corrected about the concave issue! My observation was based on discussion with my BS and also my own experience. But of course, as these forums illustrate every minute, we're all different. Having said that, I do think MamaOz should pin her Drs down about exactly what they mean by the term "concave".

  • Momine
    Momine Member Posts: 2,845
    edited May 2017
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    I had BMX and the plan was to have delayed recon. Once I had been through 10 months of cancer treatment, the idea of more surgery was not appealing. Also, I fall in the group least likely to have a good outcome, because of extensive radiation. I can't do autologous recon, because I have no extra tissue.

    Some reconstructions look beautiful. The ones that do are usually ones done on women with early stage cancers, like 0 and 1, where it is feasible to save the skin and nipples.

    If the recon would even "take" on me, I would have breasts with long ugly scars running across them and no nipples.

    I get what you mean about the heart. This did sort of bother me slightly in the beginning.

    I am not concave, but because my musculature is freakily light (so say the docs), my ribs are very noticeable. There is just skin covering them, with a few millimeters of muscle underneath. That does bother me at times, but 4 years of weightlifting hasn't done much to change it.

    I wear tiny fakes, just bra liners, not proper prosthetics. I like fitted clothes, and I can't get them to hang right without a bit of a bump. Also, I prefer not to have a my breast cancer patient status be the first thing people know about me. That said, I do often walk my dog in the morning without bothering with the fakes. I have run into people and half the time, they don't even seem to notice.

  • Erica
    Erica Member Posts: 237
    edited May 2017
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    MamaOz, I see that even your doctors have now warned you about the high implant failure rate after radiation. Many doctors advise against implants if radiation is necessary, so I don't understand why your docs are pushing so hard for it. Well, actually, I do understand why -- many docs (male and female) just can't believe we can feel happy and whole without reconstruction. I hope you'll decide with your gut to do what feels best to you.

    Momine, I'm like you. I'm thin and my ribs are noticeable, even though I'm not concave. It helped that the wonderful social worker at my hospital (who herself had a mastectomy without recon and is also very slim) warned me that this would likely be the case. And my breast surgeon told me it was good -- because it meant that she'd removed every possible bit of breast tissue! I like to look at it that way -- prominent ribs are a small price to pay for minimizing the possibility of a recurrence.

  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    Erica, thank you for your insight.. i spoke with my onc surgeon yesterday to let him know i was unsure

    He told me it was up to me and whatever I chose he would do , but hoped i would at least give the expanders a try, , if I hated them then we take them out..

    The PS connected me with a patient of hers that had had expanders in for 1 1/2 years! She was badly burned in radiation and after still not healing right , she now need tissue grafting to help the blood flow to breast before inserting implants.. so thats helped me ..

    Geez, I thought chemo was bad.. This decision is daunting, but my first instinct is just be done , i know the purpose of chemo first to shrink my tumor was also hope for conserving breast , however , Im a luminal B,With lymph nodes involved so doing both is the way to go

    and I am leaning toward flat

    Did you have radiation?



  • Momine
    Momine Member Posts: 2,845
    edited May 2017
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    MamaOz, that is common advice, to "just" give the expanders a try. As your friend's case shows, once radiation comes into the picture, complications, as well as outright failure, are common. "Just" taking them out is another surgery, another recovery, more scarring and yadda-yadda.

    The fact remains that recon can be done at any time after the initial surgery. If you decide that you are not comfortable being flat, you can do your research in peace, interview plastic surgeons, and take your time deciding on the right recon surgery for your particular situation once you have recovered from the actual cancer treatment. It will also give your body time to recover from the rads, and allow a PS to assess how bad the permanent rad damage is, something that will affect the choices for recon and their chances of success. In other words, it seems to me that a more reasonable piece of advice would be to "just" give flatness a try and go from there.

    Finally, my surgeon, who is also my follow-up doc, is delighted that I have remained flat. He says it makes it so much easier to check for recurrence and keep a careful eye on me.

    Erica, I hadn't really thought about it before surgery, and I didn't know anyone in my situation. I had seen maybe 2-3 pictures, if that. It is not that big a deal, but at first it rattled me. It didn't help that I was ridiculously skinny, by the time surgery rolled around. I also remember freaking out slightly because there seemed to be a large bump on my chest. My onc laughed at me, nicely, and explained that I just have a crooked rib there :D

  • pabbie
    pabbie Member Posts: 70
    edited May 2017
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    Hi, an update from me (Pabbie) who started this thread:

    In my journey of deciding whether I should go flat on my left "good boob" or have a breast reduction/lift of my D to a B., I had another cancer recurrence. I was meeting with my PS 2 weeks ago to discuss a breast reduction/lift and I showed her a "blood type-blister" at the end of my right breast mastectomy scar under my arm. My PS immediately punch biopsied it, and it came back cancer. The pathology suggests it's the same breast cancer I had 2 times before. I had an ultrasound on Friday that showed no lymph nodes and the tumor is not attached to the muscle which is good news. Tuesday I have a bone scan. And if all is well, I'll have outpatient surgery next week to remove the 1.1 centimeter under my arm. If I don't need chemo, I think my surgeon would consider taking off my left "good" breast to be totally flat. (my surgeon admitted my right breast mastectomy in 2014 is more concave to get rid of the cancer., she would try to make the left side not as flat but as even as possible.) OR I can wait until I heal from the surgery and start the process on a breast lift/reduction. I still don't know what I want to do. I think being cancer-free trumps it all for now. Take care to all.

  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    Momine!,

    Thank you for response.. and I agree an expander try either succesful or not is another surgery , possible complications.. and as i said I have little extra fat tissue

    Its just annoying all 4 of my drs act like im crazy for hesitating on expanders ...

    On another note .. anyone have advice besides biotin for helping hair grow back

  • Momine
    Momine Member Posts: 2,845
    edited May 2017
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    Mamaoz, bottom line is that it is your body and your decision what surgery to have or not to have. So, they can act like you are crazy all they want. Ignore!

    As for hair, it is soooo frustrating waiting for it to come back, but I am not aware of anything that is genuinely effective in speeding the process. Patience is the most effective remedy, I am afraid ;) I did, however, for the first time in my life make frequent use of a skilled and expensive hairdresser through the growing out stage. It meant I got to try various short dos and even when I didn't have much hair, at least what little I had looked good.

  • lisey
    lisey Member Posts: 300
    edited May 2017
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    Momine is right. You can always get recon later. Let your body heal without the hard plastic bowls inside your muscles. You are not crazy, you are just thinking outside the box.

  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    lisey, outside the box !! its wonderful to still have humor!

    As one friend who recently had expanders and just got home from DIEP surgery, insisted i feel her expanders when she had them , they indeed felt like boxes!!


    She is doing ok and hopgully her grafting takes

    But she said if she knew how the recoup would be she may have rethought it.. but the foobs look ok

    However she needed no chemo or rads

    I so appreciate everyones help..

    and to all youmoms outthere?

    HAPPY MOTHERS DAY


  • Erica
    Erica Member Posts: 237
    edited May 2017
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    MamaOz,

    You asked earlier if I'd had radiation. Yes, I originally had a lumpectomy and radiation on my right breast. Then, three years later, a new primary cancer was discovered in my left breast. It was so extensive that a mastectomy was necessary. At that point, I decided to have both breasts removed and my medical team supported that decision.

    I was leaning toward not reconstructing, but I did explore my reconstruction options. The PS I consulted thought I would be a great candidate for an implant on my left side (which didn't need radiation), but not on the right because of the radiation. But even if I'd been a good candidate on both sides, I didn't feel comfortable putting foreign objects in my body. And I didn't want the long and invasive surgery for a flap reconstruction, whether DIEP or lat flap or GAP. So, my appointment with the plastic surgeon confirmed my inclination not to have reconstruction. My husband, by the way, was very glad I chose not to undergo reconstruction. He came to the PS consult with me and turned positively green as the doctor was describing the various options. :)

    Given that it's Mothers Day, it seems appropriate to add that my two sons (then in their early twenties) were also completely comfortable with my decision. They didn't care whatsoever about whether or not I had breasts -- they just wanted me alive! I mention this because some women do worry about whether their children will be upset if they are flat-chested. In my experience, kids take their cues from us. Since I was making the decision that felt right for me, it felt right to them, too.


  • lisey
    lisey Member Posts: 300
    edited May 2017
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    "In my experience, kids take their cues from us." Dead on right, and its not just kids, but friends and strangers as well. I feel whole and it shows when I'm talking to people. Tig Notaro in her comedy shows takes off her shirt and owns her flatness (LOVE HER)... she looks absolutely normal and wonderful and I'm sure a part of that is because of how comfortable she is in her own skin.

  • janett2014
    janett2014 Member Posts: 2,950
    edited May 2017
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    pabbie,

    So sorry to hear that you've had a recurrence!

  • pabbie
    pabbie Member Posts: 70
    edited May 2017
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    Thank you. XO

  • pabbie
    pabbie Member Posts: 70
    edited May 2017
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    Pabbie here. Beat like a rug from my Onc. Cried during my bone scan. Feels like I'm getting sick before surgery....


  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    hello ladies,

    Surgery in a few days Sat 20th, a bit nervous, a lot!

    Even though my cancer is limited to right breast I have decided on BMX, surgeons agree its a good choice

    I finished chemo several weeks ago..

    I have decided against recon .. and im sure I will be ok with that decision, my surgeons tedpect my decision although Zi know they were hoping I would try recon

    However , I may still need radiation and that I am leery of

    Anyone else had rads after Bmx? I know its a given with lumpectomy But not with bmx, hoping my margins and lymphs come back negative and I wont need rads

    Although my med onc told me radiation is determined by inititial diagnosis..

    Any input ... I am trying to calm my nerves! SAT!!


  • ksusan
    ksusan Member Posts: 461
    edited May 2017
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    Yes, I had radiation on the right (IDC) side after BMX. I had a positive sentinel node. Anything general I can tell you about my radiation experience?

  • georgiarai
    georgiarai Member Posts: 60
    edited May 2017
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    I had rads after neo-adjuvant chemo & BMX. I was lucky and didn't have any skin irritation; the only side effect was profound tiredness. I had some discomfort putting my arms overhead for treatments, but that improved over the weeks - it was a general stiffness from surgery but not bad enough that I felt I needed physical therapy.

    I worked every day then stopped in for rads on the way home. By that time of day, I was actually fine with laying on a table with a warm blanket, in the dark, listening to music for 15 minutes. ;)

    Good luck, MamaOz! And best wishes to you, pabbie. So sorry for all you're going through.

  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    ,ksusan,

    Thank you , As I mentioned Im having bmx surgery Sat

    With no reconstruction, im just wondering how radiation is with a flat chest .. does skin it tighten up more, turn to leather, discolor? Painful etc

    I know im getting ahead of myself but info from someone thats experienced it would be helpful

    I meet again with radiation doc tomorrow for her inpu

  • ksusan
    ksusan Member Posts: 461
    edited May 2017
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    I can't compare it within my own experience since I had BMX. It tightened a little but actually radiation flattened out the scar more. I have what looks like a not very dark tanned box, as if I'd fallen asleep by an open window on a sunny day. Radiation was, for me, a little painful from about the 25th session on, but not bad at all. My massage therapist and lymphedema prevention nurses (3) all characterize my skin on the radiation side as "supple," "vital," and "healthy."

    I should mention that I had no pain after BMX except where the compression binder hit the armpit on the IDC side. I got range of motion back pretty quickly once I was permitted to start stretching, and scar massage a year after finishing radiation has loosened it up even more.

  • Momine
    Momine Member Posts: 2,845
    edited May 2017
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    Yes, I had rads, fairly massive dose and large field. I did burn, but got some of those gel burn plasters, which healed it very quickly once I was done. I ain't gonna try to kid you that radiation is a party. It is not. However, it is a limited timeframe, and comes to an end. My scar on the radiated side is significantly more ugly than the other scar. There are little red spots along the scar line and the skin is visibly thin.

  • wildplaces
    wildplaces Member Posts: 544
    edited May 2017
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    Mamaoz,

    Sounds like you made your decision - and it sounds like it is a well thought out one.

    Wishing you well on Saturday!!

    There is work that suggest that surgery may promote angiogenesis and thus support an environment for tumour survival/growth so it makes sense to confine the surgery to only that which is absolutely necessary.


    https://www.ncbi.nlm.nih.gov/pubmed/21403615

    For some women having a breast reconstruction is absolutely necessary and that is fine - lots of further work into antiangiogenic factors in the perioperative period in the pipeline.

    But if in doubt to ME i makes sense to see how you feel before/if doing more.

  • MamaOz
    MamaOz Member Posts: 239
    edited May 2017
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    thank you girls for your input! The most important thing is survival !! I am foung my best to have positive thoughts!

    Its so wonderful to be able to reach out to others, and I am grateful

  • Momine
    Momine Member Posts: 2,845
    edited May 2017
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    "But if in doubt to ME it makes sense to see how you feel before/if doing more."

    I completely agree. If you are not sure about whether you want recon, or you are not sure which kind of recon you want, it makes total sense to me too to give it time. Certainly if you are facing major treatment, not having recon surgery on top of everything will lighten the treatment burden, at least a little.

    Another thing I wanted to bring up in this context is that how I see the whole boobage thing has evolved quite a bit since my surgery. At first, I tried to find foobs that more or less matched the departed pair. This was a bit weird, since I had for years been annoyed with the natural ones for being too big. If I had gone for recon in that period, I would very likely have ended up with bigger breasts than I really wanted. It took me a while to realize that I liked myself much better back when I was an A-cup (and barely), so now I wear tiny foobs, when I wear them. So even if you end up choosing recon, and adjustment period where you experiment a bit with how you want to look etc can be a good thing.