Feb 20, 2021 10:55AM - edited Feb 21, 2021 08:32AM by abigailj
edited to fix a few typos
Some details on my experiences in response to recent conversations regarding outcome, revision, etc.
- Although I did have an out-patient surgery at 2 or 2 1/2 weeks after my initial skin/nipple sparing BMX with immediate DIEP recon (my surgery was 23 June 2020), that was to remove the 'insurance' flap of belly skin they put underneath my reconstructed breasts in case my breast skin and nipples did not survive - that way they would still have enough of my skin to cover the transferred belly fat/ blood vessels/nerves. Thankfully everything survived.
- Well, more or less survived - as I mentioned in the past I did have some wound healing issues. One of these was an infection in one reconstructed breast and in conjunction with that there was some fat necrosis - approximately one big tablespoon's worth came out through the infection opening which was at bottom of breast (hope I am not grossing anyone out) - it didn't hurt or anything since that was maybe a month at most after the initial surgery, nerves hadn't started regenerating there yet, BUT it did leave a divot in addition to leaving that right breast a little smaller in general as a result. So, I will have fat grafting to smooth that out. I do not think I need it for anything else, I'm not going for perfection here and I'm otherwise very happy with how I look now. The recon breasts are a little smaller (D vs. DD before) the nipple on the right breast is a little lower, but that should perk up to the same height as the left once the missing fat is replaced.
- I also needed a second out-patient surgery about 6 weeks after the initial one due to wound healing issue with the bikini-line incision - you would not believe how awful and huge it looked at that time (I documented my recovery with pictures, I am willing to share my pix privately but mods don't want us to post pix on the threads so PM me if you want to see anything). It took a while for that incision to heal but now I just have the 'normal' type of post-DIEP scar now that I am 8 months post-surgery and as I mentioned I have been working with a wonderful PT and using massage myself too so it is not raised much at all anymore for most of the length.
- My PS did not want to talk about revision until I was fully healed, which I would say took me a good 4, even 5 months, and even after that, the appearance of my breasts has continued to improve as I have been using massage on them too - the scars underneath are soft, less visible, the feel/softness and weight of them overall, the way they shift around when I go without a bra, etc. all feels really natural and good. So for me, I really don't want anything aside from that fat graft (my insurance covers any and all such post-mastectomy recon procedures) at this point. Based on my experience, I would be cautious about any PS willing to do recon very quickly after the initial surgery - as I have detailed, things continued to change for the better for me for quite a while.
- Insurance in the US - the Women's Health and Cancer Rights Act mandates insurance cover post-mastectomy recon but do not know if fat grafting is always mandated to be covered even though it is implied by the 2nd bullet. There is probably more info on this site about that somewhere, but here's what I found on the American Cancer Society website:
Under the WHCRA, mastectomy benefits must cover:
- Reconstruction of the breast that was removed by mastectomy
- Surgery and reconstruction of the other breast to make the breasts look symmetrical or balanced after mastectomy
- Any external breast prostheses (breast forms that fit into your bra) that are needed before or during the reconstruction
- Any physical complications at all stages of mastectomy, including lymphedema (fluid build-up in the arm and chest on the side of the surgery)
Wishing everyone the best!