Nipple Sparing Mastectomy with immediate reconstruction

TinaT

vhshea:  Yep, I do know.....I don't think any of us wanted to know as much as we do  .   Best wishes!!!

Anonymous

I think we all look forward to the day when our world doesn't center around boobs!  LOL!

So I'm flying from Phoenix to Miami tomorrow for my revision surgery.  I am going to the Miami Breast Center.  Dr. Khouri is going to take out my implants, put in smaller ones and then do fat grafting over the top.  I've been having a lot of pain since my exchange in June and he thinks this will help a lot.  He said if I want to do 2 more rounds of fat grafting after that he can even get me to a point where I don't have implants at all.  I can't even think about that.  It's all I can do to get through this one!  It will be a 5 hour surgery and then I'll stay in a hotel until my post op appointment.  (My DH will be there with me.)  I get to fly home on Tuesday.  Am really hoping this resolves my pain issues! 

TinaT

Kate33:  Safe travels and good luck!!!

Sandy105

Kate,

I hope everything goes well and hope your recovery is very fast. I will be anxious to hear how this goes. Will be thinking about you and will be remembering you in my prayers!

Hugs,  Sandy

vmudrow

Kate - wishing you the best of luck and quick healing!!

Anonymous

Good luck & safe travels!

Anonymous

Thanks everyone.  It has been a hard day.  My DH (and I do mean dear) was DX today with Parkinson's.  He is a pilot so is grounded until further notice.  I was tempted to cancel the surgery but he said we should go ahead and he is fine.  (Typical guy.)  So we leave tomorrow morning but with a heavy heart.  

vmudrow

Kate - so sorry to hear about your husband....one thing after another...sometimes it seems like it will never end.....hang in there and take care of yourself.

Sandy105

Kate,

I'm so very sorry to hear of your DH's diagnosis. This must be quite a shock and I am just so very sorry you have more on your plate. Probably going ahead with your surgery is a good idea for it will give both of you something else to think about rather than just this new dx.

You are both in my thoughts and prayers! Hang in there Girl for this too is treatable!

Hugs,  Sandy

Anonymous

Kate - so sorry to hear of your DH's diagnosis...I can only imagine how difficult things must seem right now, take care of yourself and thinking of you!

Anonymous

Kate



Cyber hugs. I am so sorry to read of your husbands DX. Please know that the community is supporting you. Best wishes as you continue your surgery journey

TinaT

Kate33:  When it rains, it pours .  Why can't life let us deal with one situation at a time?  But, sounds like you need to focus on YOU for the time being.  I hope all went well and we can't wait to hear all about it!

TinaT

I initially joined the picture forum with the intention of posting some of my own photos as encouragement for others considering NSM as well as to help me make decisions during my TE and implant process.  However, things have not gone so well for me so far (3 months of wound healing).  I don't want to discourage any woman from seeking NSM so I hesitate to post my pictures there.  Yesterday, I finally got some saline injected back into my drained TE and am starting to actually get excited again about my reconstruction. 

What do you all think - wait until all's done and post some before and after photos (skip all the yucky stuff in between) or show the good, the bad, and the ugly??? 

Sandy105

Tina,

I think it is a great idea to post some of the "middle" photos as well for we all get to that point and really wonder if things are ever going to get better. The before and after are great for it gives everyone certainty that there is an end to this and knowledge that "it will look great when this is finished!" 

Hugs,  Sandy

Amara

Hi,

Can one have mastectomy and reconstruction (not with implants) at the same time if you still have to undergo radiation? Thanks!

sweetie2040

Kate-so sorry to hear about your husband's DX. Take one day and one breath at a time. It will all be ok. Take care of yourself right now and rest.

Tina-I know your having some issues and it's a personal choice whether or not you want to post the pics now, but I do think it can help others. There are a lot of women on here who have had issues with one thing or another. There was one women who had to have her implant removed and she bravely put that pic up. I put up pics showing all my ripples even though I don't like them.  I think it helps other women because if they go through something even if it is different they can see in the end they do make it through and get a good result. There are many women who have had revisions for all sorts of reasons and ultimately came out looking beautiful. I think too it may encourage you to see all the support you will recieve from all the wonderful ladies here.

TinaT

I posted my pictures on the picture forum under Nipple-Sparing Bilat. MX with TE - Necrosis.  Or you can search by my ID (same as here), TinaT.

Elyn-Jacobs

Hi, I am coming in late to this discussion....I had a bilat NSM in Feb 2007, my doctors were Alex Swistel and Mia Talmor at Weil Cornell Breast Center.  They were amazing and I would recommend them to anyone.  I requested a NSM and they said it was likely I was a candidate, but made sure I understood that if things did not look good during surgery, the nipples would have to come off. 

Saturday I attended a Q & A on new developments in breast cancer.  I raised this topic as sadly, many women are not aware of this option.  Dr Eleni Tousimis, also of CWBC was there and spoke on this topic.  She said they do perform NSM when the patient is a candidate, and that the five year data shows that for women who are candidates, the risk for recurrence is no greater for NSM than skin sparing mastectomies with nipple reconstruction.  Obviously there are no long-term results yet as the procedure is young, but my hope is that more women will be offered this option.  I will also add that my only scars are those under the bra-line; honestly there is no excuse this day and age to mutilate women needlessly...I hope more women demand this method.  hugs to all, elyn

TinaT

Elyn-Jacobs:  Thanks for sharing.  It's so good to hear that you're still happy and doing well 4 years out.  My road has been a bit rocky (my surgery was 3 months ago), but I am hopeful for a great final outcome.  I had to travel 125 miles for my surgery, but it has been worth it.  Once I am out of the woods I intend to offer myself as a local referral for anyone considering NSM.  My wonderful local BS is the one who brought the whole topic up and she practically insisted on sending me to San Francisco because it's not yet being offered locally.  She is willing, but the plastic surgery end of things is not yet in place here.

vmudrow

Elyn-Jacobs - I didn't even know they did NSM, until my surgeon (in Utah) suggested it.  That is wonderful you found someone in 2007 that was doing it.  I think I was just luck - as I had never heard of it. 

Just_V

I met with my PS today and have decided upon a uni-mastectomy with implant reconstruction.  My BS says i am a good candidate for NSS but, of course, until they get in there and see, we cannot be sure.  I am so excited to have the decision made!  Now just waiting for the surgery date once my BS and PS compare appt books... finally feel like I am on my way to getting the C out of my SOB (stupid old boob).

TinaT

vhshea:

SOB - C = BNB (Beautiful New Boob)

Just_V

Perfect TinaT - that must become my new signature!!!!

speech529

I haven't been on this thread in a while but noticed a question about symmetry for women having unilateral mx & reconstruction.  I PM'd vhshea about it but thought I'd write to the thread, too.

I had a NSM on my right breast last June.  My left was augmented to match.  Alloderm was placed to support the implant.  My breasts were barely an A to start and very lopsided (left was probably a AA and the right A).  Although my implants were not that large, I am a 34D now.  My PS was trying to get me to a large B or small C.  I am symmetrical and I am very pleased with the cosmetic outcome.

I had no idea this surgery was available and it was the first option presented to me by the BS and the PS.  Noone ever mentioned any other option.  I was really in a whirlwind cloud back in April-May of 2010, so I am really lucky that this was the first surgical option. 

I think because my breasts were so small and the skin was intact the outcome was better for me.  I was 51 when I had the surgery.  My doctor thought my breasts were fairly "perky" for my age.  Looking back at my "before" pictures compared to now...there is no way my boobs were perky!  Just twovery deflated teeny, tiny balloons!

I hope this is helpful.

TinaT

speech529:  It's kind of maddening how many of us "lucked out" by having the good fortune to end up with surgeons who either offer nipple-sparing surgery or are conscientious enough to send us off to someone who does.  Just as many (or more) have found out about the option after it's too late.  I realize that breast cancer patients have to educate themselves, but those first few weeks are such an overwhelming whirlwind that we are likely to do whatever the "experts" recommend. 

I had a breast biopsy in 2009 for calcifications/ADH.  The breast surgeon is a wonderful, well-respected doctor in my city.  After my first experience with her I would have done whatever she suggested when my ILC and DCIS were diagnosed.  I will forever be grateful to her for "sending me away" because NSM isn't available here. 

Just_V

I will be having teh NSM with immediate reconstruction (TE) on my right breast and then implants in both breasts at the exchange a few months later - my question is - since I am a very small A in both sides, how lopsided will I be during the TE period with the TE making my right side much bigger and my l left still being a little bitty A?  Do we just buy a bra for the larger size and stuff the other (reminds me of high school!)

Anonymous

I just realized I never gave you all an update on my revision.  I had my surgery last Friday in Miami.  The PS took out my 375 implants, replaced them with 225 and then did lots of fat grafting over the top.  I am pretty swollen still but everything looks so much better.  I was kind of paranoid about doing a revision for fear of something happening to the nipples but all is fine there.   There is a more natural slope to the breasts and the cleavage area isn't so boney.  My rippling issues have completely disappeared.  Since I have a smaller implant now the pec muscles don't contort as much when I move and flex.  But the most amazing thing is the skin is now warm to the touch where before I could feel the cold implant under the skin.  This surgery was by far the toughest one I've gone through, even my MX, because of the areas he grafted the fat from were very painful.  I'm pretty much bruised from breast to knee since he grafted from my stomach, hips and thighs.  It's been a tough recovery but every day I see improvement.  

TinaT

Kate33:  That trip home must have been tough!  I'll bet you were so glad to see your own bed when you got back!  Happy healing...

Just_V

Kate33 - here's to a speedy and successful recovery from this last surgery - please please keep us informed on how the fat grafting works out -

vmudrow

Kate - So glad everything went well.  Really your implants aren't cold to the touch anymore?  I think that is one of strangest things - my foobs feel cold all the time - you would think your body would warm them up.  So I take it fat grafting hurts - but I'd like to have some off my hips and thighs!!  Keep healing - glad it's behind you.

hugs, Valerie