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Topic: Hardened tissue after explant surgery/mastopexy

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Apr 14, 2020 03:22PM

sunshyne95 wrote:

Hi, I've been a member of this site for years but have never posted - I had IDC in Rt breast in 2008 with lumpectomy and radiation, reconstruction surgery (with recalled Allergan Naturelle textured surface implants) 2013. Began to have BII symptoms approx 4 years later, had explant surgery with mastopexy and u-flap procedure March 3rd 2020. My problem is that the tissue on the Rt side is very hard, doesn't move well and is healing much more slowly than the left (non-radiated) side. I totally understand that radiated tissue has decreased blood flow and is tighter therefore will heal more slowly and feel harder to the touch, I just need to know if the hardened tissue (that is also through the depth of the breast) is possibly fibrosis and what I can do to try to maybe loosten/soften it up a little! Unfortunately I am not able to see my plastic surgeon for my 6 week check up this week due to Covid restrictions, I have sent an email but have not heard anything back. I was hoping somebody on this site has experienced a similar problem and can maybe pass on any information that might be able to help! Thank you very much in advance! :)

Shirley


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Apr 23, 2020 09:57PM OnTarget wrote:

I didn't have radiation, but I had an infection and my right implant removed.

At my 2 week visit, the PA said that it is normal for everything to feel "wooden". That was a great word because it did feel super hard.

She said it would take 3 months to soften up.

I'm now 3.5 weeks out, and the skin is softening. I have raised hard bumps that I think are scar tissue in a circle shape and a crater in the middle.

My scar is hard and tightly adhered to my chest. There is no moving it.

I have a video call with my PS next week. Maybe you can do telemedicine with yours?

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Apr 24, 2020 12:46AM sunshyne95 wrote:

Hi On Target! Thank you for your reply, it's very helpful to know that the hard tissue is normal. I'm just over 7 weeks now and you are right - wooden is a great word for how the tissue feels! My PS told me at 3 weeks that I could start trying to gently massage, my 6 week appt was canceled due to the virus so that would be a good idea to try a video call or even phone call. Now I have a small hole that opened up on the left side under the nipple (right side was the lumpectomy/radiation) Looks like I'm maybe just not the greatest healer lol! I hope you have a good meeting with your surgeon next week and your skin continues to heal and soften!



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May 5, 2020 08:56PM OnTarget wrote:

Hi Sunshyne,

I hope you contacted your PS immediately for the hole that opened, that is an emergency I think!

I think that my skin is getting softer, although my PS said that the scar part will adhere to the chest wall and it won't unstick until they cut it off of there. My PS is of the "leave it alone" school, but he said I can massage if I want. You bet I'm massaging it!

I found out that they left my capsule in there, which is why it looks lumpy/bumpy.

Let me know how you are doing!

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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May 9, 2020 06:56PM sunshyne95 wrote:

Hi On Target!

I'm glad to hear your skin is getting a bit softer, but that's a bit alarming you found out your capsules got left in - I've done alot of research about implants and the problems silicone can cause (joined 3 Facebook groups including one for BIA-ALCL) According to all these women implants should be taken out 'enbloc capsulectomy' which definitely includes the capsules because BIA-ALCL (Breast Implant Induced Anaplastic Large Cell Lymphoma) can still occur around the capsule that is left in after explant. They also feel that the capsule may have remnants of the silicone (called 'silicone gel bleed' I believe) in it which can cause an inflammatory response and sometimes autoimmune disorders in some women. Possibly ask your surgeon about it? Some Drs don't believe it's problem but more often than not they are just not educated about it yet. Maybe do a bit of research yourself first so that you can talk it over with the Dr! Anyway, thank you for asking about my healing, I did contact my PS about the little hole and they said no problem, stop using emu oil for a few days and put some polysporin on, it's usually just a stitch your body is trying to 'spit out' lol! I don't like polysporin so I used some medihoney and it was fine in 3 days! Now I'm almost 10 weeks and the left side is great, right side still hard... I'm trying my best to massage, it's like a small India rubber ball tho. I'll keep trying, although I'm also getting myself used to the fact that I will be 2 different sizes/shapes - realistically doesn't matter, I'm lucky I have my heath and feel so much better after explant! :) Have a great weekend!

Shirley

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May 14, 2020 10:32PM OnTarget wrote:

Thanks Sunshyne!

I was concerned over my capsules staying in for biifilm primarily. I'm getting a replacement implant so im not too concerned with the other silicone issues.

Mismatched boobs are tough, but it is better than no boobs for sure!

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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May 22, 2020 06:13PM cake8icing wrote:

Hello there, this is especially for OnTarget::

I did not have reconstruction but what you posted about the tissue feeling “wooden” prompted me to reply.

Despite diligently doing my PT exercises as soon as I was discharged one day after my unilateral MX, I found myself with hard, hard, hard “wooden” tissue as soon as 3 weeks later. 3 weeks after that, 6 weeks post mastectomy without reconstruction, the tightness under my armpit and all down the side of my torso was crazy. The team at MSK In NYC had closed down their PT department, in an “abundance of caution to protect the chemo patients During Covid-19”. I get that you need to protect those patients, but the local Bergen County NJ facility has like 4 entrances, chemo has their own entrance, so why can’t you treat the non-chemo patients In PT? So I called Kessler rehab and found a breast cancer trained PT at one of their sites in Dumont, NJ, just 30 minutes from my home. I suggest you do a little Googling in your area and look for a PT facility that Treats mastectomy patients. My PT, in only 6 visits, has massaged my scar and surrounding areas such that my range of motion and ability to stretch in all directions is 300% better than it was two weeks ago. Hope this info helps!
Surgery 3/20/1963 Lymph node removal: Sentinel; Mastectomy: Left Dx 2/14/2020, DCIS, Left, 3cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+
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May 22, 2020 10:00PM OnTarget wrote:

cake8icing-

I'm glad you found relief!!

My PA had said that it would feel less wooden as time passed, and they were right. My flat breast is much softer now, almost 2 months out. The only thing that is still hard is the scar.

I'll still go to PT when they open back up, but I'm happy with my progress and my massage efforts. I too have a miracle worker PT, and I'm eager to get back to her!


Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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May 22, 2020 10:12PM sunshyne95 wrote:

Hi OnTarget and cake8icing!

Can I ask what kind of massage the PT does for you both? I'll be 12 weeks post-op next week and have yet to be able to see my PT (damn covid!) I was finally able to speak with her on Thursday and she mentioned a tx she's heard of being used for 'fibrotic tissue' (her words, makes sense I guess tho). The tx is to warm up castor oil, massage it around the whole area of hardened tissue, then put moist heat on it (she said use a towel and boiled water but don't make it so hot that it would burn skin). I can't remember how long she said to leave it on for or what to do after though - will have to check with her again on that! She said it seems to have decent results softening up the fibrotic tissue, I guess it won't hurt to try because certainly nothing has changed since I originally posted this question!


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