nipple sparing mastectomy

Mom2Winston

I had DCIS on the right breast and chose to undergo bilateral MS. My PS said I was a perfect candidate for Nipple sparing skin sparing MS because I was young and had small breasts (small B cup). I had an MRI done prior to make sure the DCIS was far away enough from the nipple to spare it. Surgery was on 4.28 and so far so good. Skin color looks good, incision is not too visible and I'm sure will become invisible with time. Only thing is they do tend to face a little more "east and west" as one poster said. Not to where they look funny, but just not as forward facing as before. I'm still glad I had it done. I think the most important thing is to find a surgeon who has experience in this procedure. And you also have to be willing to not be able to upsize on your boobs. They will have to stay close to your original size so as to not compromise blood flow. Good luck with your decision.

Jackieo1976

I know this is years after your surgery, but I just recently had NS Bilateral mastectomy with direct implant reconstruction. Unfortunately 1 week later my final path showed cancer under the nipple and now I need a 2nd surgery. I'm just upset it wasn't found during surgery and I don't think she checked, which I expected it should. Hope you are doing we

NotVeryBrave

I just had nipple and skin sparing BMX. I'd had mammo, US, and MRI recently for post chemo results so there was no suspected cancer near the nipple. No testing was done during the surgery.

My final path report has separate specimens for the breast tissue and the sub areolar tissue. They seem to have been fairly aggressive with removing the tissue from under the nipple on the cancer side - it was pretty beat up but seems to be healing okay.

I'm not sure if there are current recommendations for distance from tumor to nipple ...

MTwoman

Jackie, I am so sorry that you're going to need a second surgery. While that is certainly disappointing and frustrating, it isn't that uncommon. Many times, women need a second surgery after lx to get good margins. She was attempting to provide you with your choice of surgery, ns mx. "Finding" the extent of bc during a surgery isn't typically possible. You can't see it with the naked eye, so surgeons do the best they can. Pathologists look at cells under the microscope. That's when they know if the cells are organized like regular cells, or mildly/moderately or extensively disorganized. Being upset at your surgeon because she didn't "check", doesn't make a lot of sense.

Going through another surgery most certainly sucks. I initially chose to have lx, I was young (38) and didn't want to lose my breast. After my surgery, just prior to rads, I got an mri that showed 2 more areas of concern (one of them very close to the nipple). I ended up with a series of other surgeries, as I got a hematoma with my lx, and they wanted to do the procedures one at a time, to limit complications. I had my mx with no te. Then I had a te placement. Then I had the swap surgery. Finally I had my plastics work (my ps built me an actual nipple, made from cartilage from behind my ear and skin from my upper thigh).

I get that we make decisions about out treatment plans; about what is going to happen, but frequently wrinkles occur that we just have to deal with. I am very sorry you are struggling right now! (I just don't think your surgeon is to blame). ((hugs))

Soxfan75

I had a prophylactic ns mx in February and while the nipple looks normal and has healed nicely, I have a small 1/4 inch hole on the side of my breast that was scraped too thin. The skin surrounding it is discolored and looks bruised. Has anyone else had this issue? My PS said that she may need to swap the TE for an implant sooner and while I don't want to have to go through more surgeries than necessary, I might do it. My other breast was a regular mx and will need to be radiated in August. I wonder how different my chest will look if I have an implant on one side and a TE on the other. Thoughts?

woodsyny

Hi Jackieo 1976. I had bilateral nipple sparing mastectomy with direct implants on 4/17 for DCIS. I just decided after 2 lumpectomies for ADH, and the second one did show DCIS hiding out, that I wanted to be done. The surgeon I used was Dr Ashikari whose father was the first to do NS mastectomy in the U.S. . I was told my nipple would be scraped during surgery to make sure there was no cancer in it. Well long story short, there was cancer in the right nipple and I lost it and will have nipple reconstruction at a later date. The left was fine. So sorry that you had to go through a second surgery. One was enough for me!

SLL101984

Hi ladies, looks like it’s been exactly a year since this thread was active so not sure if I’ll get a response....I just had a nipple sparing BMX 12 days ago. Things seem to be healing very well, little tiny scabs, and I’m keeping them lubed up. Just wondering what the magic time frame is? Like if you make it to 2 weeks, one month, etc, that your nipples should be in the clear? Or for if things aren’t going to heal you would know it within a few days? (My dr hasn’t really said so not sure if they really know Thanks for any responses and hope you all are doing well!

DebAL

Hey SLL, I had nipple sparing Feb 12 and things are going well. I used aquaphor nightly to the nipple area and covered with a gauze pad for several weeks. I still do it about twice a week now. Helps keep the area from cracking and possible infection. I tried to keep things warm in that area to keep the blood flow going. Don't know the actual time frame but I was getting one of my fills, maybe 5 weeks out, and the PA mentioned you should be "out of the woods" as far as losing the nipple. I would just call immediately if you notice anything that doesn't look right. Best of luck!

SLL101984

well my nipples look great!! Scabbing is gone and bright pink nipples are back! Now I have another question for you ladies....what were your favorite bras post surgery while you were expanding? I just want to have something for extra coverage when I go back to work. I’m a little self conscious about the odd shape they are right now and the constantly erect nipples will draw that much more attention! Thx!!

Anonymous

I had my surgery Sept. 5th of last year. I saw the surgeon for a follow-up Sept. 21st. At that appointment she told me I was out of the woods. She said my nipples were alive at that point and the danger of losing them had passed. At the time of surgery I was told no caffeine while they were healing. At this appointment that restriction was lifted and she told me I could have my pumpkin spice coffee on the way home!!