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Topic: Flat or leave extra skin?

Forum: Living Without Reconstruction After a Mastectomy — Discuss prostheses, swimsuits, bras, and other options for women not having reconstruction or waiting for reconstruction.

Posted on: Nov 7, 2019 01:04PM

mybee333 wrote:

Hi all -

I’m explanting my implants in December which will leave me more or less flat on one side. I met with my PS yesterday - she is a specialist in explant - and I’m hoping for a smooth closure so I can comfortably wear a breast form and bra. She said if I’m too flat I’ll have a puffy dog ear under my arm. She said it’s unavoidable (?) She suggested that a little extra skin remaining would make me more comfortable, avoid the puffy dog ear and allow for a bra not to ride up on that side. I am concerned that any extra skin will rub against the breast form, be prone to chafing and just not be a pleasant outcome. (I think she thinks I may change my mind later about reconstruction but I will not; been there done that. And I don't want a flap.) I liked the surgeon otherwise.

Thoughts? Thank you!

Don't wait for the storm to pass, learn to dance in the rain. ~ UMX w/ silicone implant reconstruction. Multifocal -IDC, DCIS, Pagets. Dx 4/6/2011, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR-, HER2-
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Nov 7, 2019 02:21PM Aussie-Cat wrote:

Hi mybee, I'm sorry you need to get your implant removed. My breast surgeon left a fat ridge during my double mastectomy and it does help to keep a bra in place but it's not for the purpose of future reconstruction. I find it makes it harder to wear forms with a round back but it's fine for any forms that mold to the chest or already are concave on the back of them. I think it's true that being very smooth can be linked with a feeling of tightness and I didn't have any tightness. I think dog ears are related to previous size and also how the scars are done. I have never had any chafing from wearing a breast form. It's a good idea to be very clear with your surgeon if you're not interested in later reconstruction. Since you liked the surgeon otherwise, it sounds like you need more clarity about what she is planning to do and why and also the chance to express your wishes once you understand her more clearly. I hope she listens to you and it all goes well.

Diagnosed with nerve pain (post mastectomy pain syndrome) July 2018 Surgery 6/18/2018 Prophylactic mastectomy: Left, Right
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Nov 7, 2019 06:29PM mybee333 wrote:

Thank you for your reply! Lots of helpful tips there 😊 I’m wondering about calling or maybe emailing. She’s 3 hrs away from me and I won’t see her until my surgery day. But I could tell her then that I’ve thought about it, and I absolutely will not be doing any additional reconstruction. She sounded though like perhaps she didn’t know how to do a smooth closure without having dog ears. That’s a little bit concerning. Although I hesitate to say that I want an absolutely flat closure because as you mentioned I don’t want a lot of tightness and I also don’t want my bra to ride up. I’m finding picking a surgeon this time around to be difficult! I’ve also got an appointment next week at a shop that sells mastectomy bras and forms to talk to them a little bit about this whole issue as well as prepare for my life post-reconstruction.

Don't wait for the storm to pass, learn to dance in the rain. ~ UMX w/ silicone implant reconstruction. Multifocal -IDC, DCIS, Pagets. Dx 4/6/2011, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR-, HER2-
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Nov 8, 2019 06:18PM Aussie-Cat wrote:

mybee, you're very welcome. It's a good idea to email or ring your surgeon to clarify things. If she's not able to do a smooth closure without having dog ears, she may not be the best surgeon for you, if that's what you want. There must be a happy medium of a fairly smooth chest but without the scars being too tight. It certainly is hard to make all these decisions but doing research beforehand like you are is great! It's helpful that you've got an appointment at a mastectomy supply store - I did the same thing before my surgery and I found it informative. Not everyone likes to have silicone breast forms after surgery but at least they are lighter than they used to be. My favourite forms are filled with microbeads (that I filled myself) and I quite like my memory foam ones but I don't wear any of them most of the time. My silicone ones hurt my shoulders.

Diagnosed with nerve pain (post mastectomy pain syndrome) July 2018 Surgery 6/18/2018 Prophylactic mastectomy: Left, Right
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Nov 8, 2019 06:33PM mybee333 wrote:

Aussie-Cat- I have read numerous times that the silicone forms are too heavy. That’s too bad although nice that there are other options such as knitted knockers and micro beads. I agree this may not be the surgeon for me. I’ll have to call and cancel the surgery. You've expressed it well as far as a happy medium. I think of it as smooth as opposed to tautly flat. I’ve got a couple of other consults booked now to help me find the right PS. I’m in a couple of FB groups that I’ve found very helpful as far as that. It’s funny, through all this it’s always been other women, mostly online, who have been the most helpful, informative, and supportive.

Don't wait for the storm to pass, learn to dance in the rain. ~ UMX w/ silicone implant reconstruction. Multifocal -IDC, DCIS, Pagets. Dx 4/6/2011, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR-, HER2-
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Nov 9, 2019 07:07AM Aussie-Cat wrote:

mybee, I hope you find the right surgeon for you soon - please let us know how it all goes. I think a lot of professionals only know their bit of expertise and don't know what it feels like to be facing this surgery with so many decisions to make. It helps when you find people who have been there.

Diagnosed with nerve pain (post mastectomy pain syndrome) July 2018 Surgery 6/18/2018 Prophylactic mastectomy: Left, Right
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Nov 9, 2019 07:31AM mybee333 wrote:

hank you. I will check back and perhaps what I find may be helpful for others.

Don't wait for the storm to pass, learn to dance in the rain. ~ UMX w/ silicone implant reconstruction. Multifocal -IDC, DCIS, Pagets. Dx 4/6/2011, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR-, HER2-
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Nov 9, 2019 08:53PM Miriandra wrote:

Sounds like your surgeon is not up on the latest surgical techniques. I am fully flat on one side, no dog ears, no weird bulges or keloids. My scar tissue is still maturing, so I do stretches daily to keep the fibers from shortening up and maintain my range of motion.

I'd suggest a second opinion from a well-recommended doctor with experience helping women go fully flat. Good luck!

Dx 5/31/2019, DCIS/IDC, Left, 1cm, Stage IA, 0/1 nodes, ER+ Surgery 8/14/2019 Lymph node removal: Sentinel; Mastectomy: Left
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Nov 11, 2019 07:57PM - edited Nov 11, 2019 08:00PM by alto

I am half flat. I asked for a flat closure with no dog ears as I thought it would be easier for wearing a breast form. My surgeon said it would not be a problem. I was thin at the time from all the stress - maybe that helped thesurgeon. She successfully got me flat, no dog ear (looked like she cut/sewed a sideways Y under my arm). It did not feel tight after the first 3 weeks. I wear a slightly lighter weight form (not the basic model), no issues with the size C form feeling heavy or with my bra riding up. I did have to fully heal before a bra was comfortable. Until then, a camisole tucked in works well.

Diagnosed at 42. Had symptoms of Paget's for years prior to positive biopsy. No Tamox because low% ER. Dx 11/2/2018, Paget's, Right, Stage 0, Grade 3, ER-/PR-, HER2+ (IHC) Surgery 11/10/2018 Lumpectomy: Right Dx 11/29/2018, DCIS/Paget's, Right, 1cm, Stage 0, Grade 3, ER-/PR- Surgery 12/18/2018 Lumpectomy: Right; Lymph node removal: Sentinel Dx 12/21/2018, DCIS, Right, 2cm, Stage 0, Grade 3, 0/2 nodes, ER-/PR- Surgery 1/16/2019 Mastectomy: Right

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