Topic: Any regrets, Nipple-Sparing or Skin-Sparing Reconstruction?

Forum: Breast Reconstruction — Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: May 27, 2022 06:49PM

Posted on: May 27, 2022 06:49PM

jacq37 wrote:

Anyone out there regret having nipple-sparing with reconstruction and wish they would have gone with skin-sparing and reconstruction instead? OR vice versa? Is the partial or no sensation worth keeping your nipple? I am wavering on whether keeping my nipple is necessary... Just want it to be right and look good.

Looking for any information.

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May 28, 2022 09:53AM - edited May 28, 2022 09:55AM by exbrnxgrl

jacq,

Whether you keep your nipple or not you are quite likely to loseall underlying sensation. Leaving skin andnipples may result in skin sensation but all other underlying tissue has been removed. I had a skin and nipple sparing bmx with one step recon over 10 years ago. I have skin sensation but that's it. Some women say they do have more than superficial skin sensation but very few. Best of luck to you

Dx IDC, Left, 4cm, Stage IV, Grade 1, ER+/PR+, HER2-
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May 28, 2022 10:17AM wondering44 wrote:

I had a nipple-sparing last year over existing saline implants. I was glad to have the existing implants to alleviate some of the differences in size before reconstruction. While I don't regret my decision to try to keep as much of my breast as possible, I have almost no feeling in that breast. I was hoping to have some sensation around the areola and get my breasts to look the same afterward.

I discussed reconstruction with my PS with the skin-sparing unilateral mastectomy with mastopexy and a bilateral skin-sparing mastectomy. To get the best aesthetic results, I have decided to do a bilateral skin-sparing mastectomy with tissue expanders and implants.

If you have the option to do either, it comes down to what surgery works best for you without factoring in the nipple sensation. Talk to your Breast Surgeon and Plastic Surgeon about the differences and surgeries required for either option. It may help you decide which route is best for you.

Surgery 8/18/2021 Lymph node removal (Right): Sentinel; Mastectomy (Right): Nipple Sparing Dx DCIS, Right, 1cm, Stage 0, Grade 2, ER+/PR+, HER2- Dx DCIS, Right, 6cm+, Stage 0, Grade 3, ER+/PR+, HER2- Dx IDC, Right, 2cm, Grade 2, ER+/PR+, HER2- Dx IDC, Right, 6cm+, Grade 3, ER+/PR+, HER2- Surgery 8/31/2022 Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing
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May 28, 2022 02:27PM k-gobby wrote:

Jacq37-

I am half done. I have Brca2 and small breast, which I told the Plastics Dr. I wanted to keep. No jump up in size being 61. In Feb, I had my tumor and left breast removed with a skin saving mastectomy. No nipple area left due to the cancer and Brca2. So, I still have an expander as I ended up with a blood clot , so my 2nd sugery May 31st was canceled. I have said on these boards that it looks good. My Plastc surgeon said he can create a nipple or I can get a tattoo. I was supposed to get radiation, due to chemo before surgery, but the Rad Dr said it would have little benefit. I did not need that expander after all. I will say, it has a slight sag like a real breast and looks the same size as my real one.

He said I can keep my rt nipple when the breast is removed. No cancer on that side. He said he can work to create feeling once the tissue is all removed. I am glad my sugery has been postponed to ponder that idea.

I must add that with The Brca2 diagnosis and if I had larger breasts, maybe a lumpectomy would have been in the cards for me. Yet, it wasn't that way. I am where I am, and grateful I still have choices. At 61 I thought, my left nipple served me well. She ended up being directed and studied. A Nobel end.

Chemotherapy 8/14/2021 Other Surgery 2/1/2022 Lymph node removal (Left): Sentinel; Mastectomy (Left): Skin Sparing; Reconstruction (Left): Tissue Expander Targeted Therapy 2/1/2022 Talzenna (talazoparib) Targeted Therapy 2/1/2022 Perjeta (pertuzumab)
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May 28, 2022 03:20PM bcincolorado wrote:

I have no regrets. I did this and for me it was a good option based on where my tumor was. I know for everyone that is not the case and they cannot do this but I did have a great surgeon.

Dx 8/2009, IDC, Left, 5cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 1/1/2010 Mastectomy (Left): Nipple Sparing; Reconstruction (Left): Tissue Expander Surgery 1/6/2010 Lumpectomy; Lumpectomy (Left); Lymph node removal; Lymph node removal (Left) Hormonal Therapy 1/14/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/29/2016 Femara (letrozole) Hormonal Therapy Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 28, 2022 11:03PM beebee22 wrote:

Cannot be both? Have to choose one? I had both skin and nipple sparing, 2 days post-op. My PS already advised that sensation is very individual, some gained it back, many don't. Imagine all nerves have been removed during mastectomy, so some lucky one have nerve regrowth over time. I can tell I don't feel anything now.

Surgery 5/27/2022 Lymph node removal (Left): Sentinel; Mastectomy (Left): Nipple Sparing, Skin Sparing; Reconstruction (Left): DIEP flap Dx DCIS, Left, 4cm, Stage 0, Grade 1, ER+/PR-, HER2-
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Jun 21, 2022 01:30PM runrcrb wrote:

JAcq37 - I had a unilateral nipple and skin sparing mastectomy in 2016. DIEP reconstruction in 2017 and a small lift on the natural breast in 2018. If I regret any surgery, it would be the lift as I have almost no sensation in either nipple; possibly would have retained it on the left without the lift. But at the time, I was recently widowed and was simply working on aesthetics for myself.

Dx 6/27/2016, IDC, Right, 1cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Dx 6/27/2016, ILC/IDC, Right, 2cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Surgery 9/21/2016 Lymph node removal; Lymph node removal (Right); Mastectomy; Mastectomy (Right); Reconstruction (Right): Tissue Expander Chemotherapy 10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/8/2017 Whole breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2017 Aromasin (exemestane) Surgery 12/12/2017 Reconstruction (Right): DIEP flap

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