Exchange City

Here is how I feel about radiated skin.

It depends on the amount of damage the radiation has done and the amount of stretching you want the skin to do AFTERWARD.. Also if you have had a full mastectomy (which I did).
If there is damage internally, to the muscle, and the scar tissue, and the surgeon has to cut out everything but the skin,,,  the skin will not hold the implant by itself if it is a large (500 or more), implant.  The pressure of the implant pushing on the skin is too much. 

I think using an alloderm sling, would not have helped, the skin was too compromised and even though it looked fine,  It was not.

Now, if you are fully expanded first, then you have a better chance, especially with alloderm or another fake skin product.  In my case, although the skin LOOKED  fine, it started getting blisters and weeping.  There was no way I was going to worry about it even if it did heal in the end and turn out fine..

It could fail months down the road..

I really did not want a LatDorsi flap.  I didn't want any other part of my body cut to make my breasts.  In hindsight, I should have told the doc, if he has to cut out that much 'stuff' from the pocket, to go ahead and do the LD flap...So I'll get it done on Friday, two and a half weeks later.  I would have preferred one step...

Unfortunately, it is not a lesson I'll use the future...but perhaps those of you with radiated skin, who had a full mastectomy, who are not expanded fully ahead of time, can at least give the doc the 'out' during surgery, if he feels it is necessary....that is how I feel about it.  It is not the end of the world if you have to go back, but if you can avoid it, why not?

JUDY

I never had problems with my exchange or implants until I had surgery post radiation (nipple recon). The infection that developed has been impossible to get rid of. I ended up having two surgeries to replace the implant and will probably lose it permanently. I think if you have exchange surgery with an implant and develop an infection, you can't have the lat flap right away. You have to remove the implant, cure the infection and wait for it to heal. So you could be in for more than just one extra surgery if it doesn't work out. I may be missing something, so maybe someone else wants to add to this. Also, I admit with the problems I've had with recon, I'm totally risk averse. 

Lilah, I was even nuttier than you.  I even asked the PS for an earlier date for the exchange, but when he agreedand his assistant called me with the new date I started freaking out.  I was very nervous during the weeks leading up to the exchange, so I think your reaction is pretty normal.  Like Julie, I'm very happy for you - you are one week closer to being healed.

Kristen, so glad you are feeling better!

Judy, best wishes on Friday...

I was really nervous about the exchange even though I hated the TEs and pressed to schedule the procedure.Before the exchange, I felt like anything was possible but once I had a date, I realized that whatever happened I would be living with the results for a long time. And then my PS made a comment about the implants being a lot like the TEs and I FREAKED! Thankfully many of my bc sisters talked me down from that ledge...  and now I have nice squishy foobs even if they are rippled, a little crunchy and assymetrical they are way better than the TEs.

oh and Kittycat:  I've lost weight since the hyst/ooph and am in way better shape than before

If I eat crap, or have drinks, I will put on weight, but that's middle age :0!!  I am on Arimidex also.

you'll be just fine.  I don't think it's a given at all, other than perhaps some ladies have given up on weight control. .  some gain, some don't, but in general, at 54, it's been a big non issue for me.

Take care xoxo

MYKIDSMOM: Good morning. I don't know if you saw my request to please add me to July, 2010 list for fat grafting and nips.

Thank you so much.

Have a great day.

Good morning again. Any Northern NJ people on this site walking in the Susan G. Komen Walk Race For the Cure 0n April 25 in Branchbrook Park, Bloomfield/Newark, NJ. I will be there and hope to meet some fellow Breastcancer.org gals.

Love to all.

Ronna:  I think it's better if you pm Mykidsmom about your exchange date.  I'm happy for you that you already have one!

Brenda 

Regarding the discussion on "late" infections, like after simple nipple procedures, esp on radiated skin:  I wanted to comment that I've seen a fair amount of info about how dental health & hygeine, and lack thereof, can be a factor in systemic diseases and infections in other parts of the body.  Even the act of brushing your teeth (even if your mouth is reasonably healthy) can apparently release enough oral bacteria into the bloodstream that, if your immune system doesn't clear it quickly, can take up residence elsewhere, e.g., cause an infection.  Not surprisingly, bacterial infections start most easily in existing wounds and poorly vascularized tissues, both of which reconstruction patients, esp ones w/irradiated skin, have in abundance.  So the theory would go that if you had actual infections in your mouth - periodontal disease, inflamed gums, absesses - those could raise your risk of infections elsewhere significantly.  Along these lines, I'm aware of 2 BC/reconstr pts whose chronic infections ceased after taking care of needed dental work.  Just anecdotes, but still.  Anyway, I put this out there for anyone interested to consider for yourself, in case it resonates with you. For interested folks, here are some references:

an interesting article from 2000 in a well-respected medical journal that summarizes known oral-systemic infection connections:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88948/

data on links between periodontal disease and heart disease (not proven causal, but proven statistically associated):  http://www.perio.org/consumer/mbc.heart.htm 

As a caution, I'll note that these ideas do not appear to be well accepted in medical practice despite some good data, so if you ask your docs about the connection of your dental issues to your BC reconstr infections be prepared to be dismissed or even laughed at.  It may be another area like nutrition that you may have to go after on your own if you think it applies to you.

CS

Hey, ladies!  Okay.....just opened my mail, which included my packet for the Komen Race next weekend.  When I saw my pink "survivor" shirt and bib, I just started crying........still going to do it, but I guess I'll definitely need some waterproof mascara.....

Judy - Hugs and prayers for you tomorrow, sweetie!!

Lilah - Thanks for the sweet words about my dh....he's a keeper.....at least most days!  And you are COMPLETELY normal to be freaking out about the date change - I'd be doing the same thing.  I was a mess before that surgery....maybe not quite so much as before the bmx, but a mess nevertheless....wish I owned stock in TUMS as many as I popped.  In fact, today when I realized that my next - AND HOPEFULLY THE LAST - surgery is in only 4 weeks, I started having those same "tummy pains".....yuck.....but I'm excited that we'll be "surgery sisters" that week! 

KristinP - Yippee for no more cough!!  

Welcome, ACole, from a fellow Texan! I can't add anything about the rads issue, but you've received advice from some real experts already.  I can, however, speak to the "foreign feeling" you're worried about with the implants.  I'm very active, too (pilates, teach aerobics) and was a sub-AA cup before bc - now a DD.  I will admit it did take a bit to get used to accommodating the implants when working out, and I truly did feel like I wasn't "myself" for a few months, but now they really feel "normal" to me.  A lot will depend on how your skin responds, too.  Good luck!

Judy: Sorry to hear that you're going to have to have another surgery. I guess it's what's best in the end for you - fewer issues down the road. I'm praying for you and that your PS does a fabulous job so you can finally put this step behind you. Sending white light and prayers your way on Friday...

Kittycat; I had a hysterectomy at age 40 - actually on my birthday, what a gift that was! I didn't gain any weight afterwards and I think your co-worker should have just said nothing rather than get you worried. Everybody is different and if you're watching what you eat and doing a bit of exercise everything should remain the same. Best of luck with your surgery,

Hoping for great results to all those having surgery tomorrow.

Terri

Good Evening EC Ladies!

May I join in and share with you, please? Today is 7 months since my right breast mastectomy and I celebrated by getting my EXCHANGE surgery!!  And I say YEEEEEE  HAAAAAAW (HillBilly STYLE, y'all!!!!)

You are a lovely group of ladies and I had quite a bit of catching up to do (as a lurker!) before posting.....Wishing you the best Judy and KittyCat and anyone else with upcoming surgeries and consultations, etc.

I had nipple-sparing, I've only peeked from the top of my surg-bra down, so far....but the feel of it (very light touch, yes!) is WONDERFUL!   Natrelle style 68 MP, Saline 600 ccs....may be doing lift on the opposite breast a couple months down the road after implant settles and will hopefully have a better opportunity for symmetrical outcome that way!

Ladies, thank you so much for your forthright teaching and guidance....given very freely and absorbed greedily by all of us newbies!!  My DH will be home soon & saying "Have you been on that computer the whole time we've been gone?" Ha!!  Then come bedtime he'll rub my back or my feet or my head and say "You know what this is, don't you....FOREPLAY!"  Gotta love these husbands!

JUDY... I am praying for you to have LITTLE TO NO PAIN.... and that this is it for you sweet friend. I am still mourning for you ( you are ok with this... and I am still pissed that you have to do this) There needs to be better education done for women and rads and implant.. so we too, can have the implants only IF we choose this. I KNOW alloderm has saved many implant only girls if done in the right order... BUT... our skin. that is the issue. grrrrrrrrrrrrrrr

Anyway Judy, my heart is with you tomorrow. Know this.

ANNIE... little stinker... how ya been? I am just fine lady. FYI... nips and rads skin... risky. Nips and rads girl who had flap surgery.. NO BIG DEAL. The issue lies only with ladies who had rads and implants ONLY. If you had a flap done... nips of any kind should do just fine. It is the rads skin that can give fits... not flap skin. Hoping you get to matching ones SOON... VAVAVOOM!

Colleen.. it always makes me sad to see so many new sisters here...:( Actually... this is 50% the reason I stay on BCO even though I am finished with my 2 yr long treatments.... for them)

Ladies.... Have a great weekend!

Yes.. Dental work.

I have been to the dentist twice since implants and both times my dentist gave me anti-biotics first. ACTUALLY, he does this for ALL his implant ladies... BC or Augmented.

bcincolorado:

You reminded me that I meant to thank the smart lady who advised antibiotics prior to exchange....thanks to you dear lady, I got that covered today!  I also have mitral valve prolapse and should have already thought of it but hadn't and your advice was so well-timed!  My dentist always calls in antibiotic pre-meds for me as well.  Don't remember who posted the advice but thank you, thank you!

bc----have you tried Biotene mouthwash? It's alcohol-free & taste helps with chemo-mouth issues so tolerating food is therefore easier.  I had noticed thick saliva, too...happy to say it has resolved now that I'm 3 months post-chemo.  Hope this helps....you have helped me on another thread and I do appreciate you so much!