Areola & Nipple Tattoos - Boston

lucyleester

Hi All -

I will be ready for areola & nipple tattoos next month.  My PS medical assistant does them and I am not comfortable having her do this procedure as she is quite young.  I have received a few recommondation on who to go to (one is in RI) the other is in Avon, MA.  Can you tell me who did your tattoo's and if you are pleased with the results?

Thanks in advance,

Lucyleester

jteach

Hi Lucyleester!

I'd love to know who your PS is.  I will be having DIEP done in Boston and assumed the PS did the tattoos as well.  Do you at least love your breasts?  I hope so!!! 

Thanks.

lucyleester

Hi Jteach -

Dr. Jonathan Winograd at MGH did my DIEP surgery in October 2009.  I had him do my nipples in February 2010.  I am very happy with my results!!  No one would ever suspect I had bilateral masectomy!  And having a flat stomach is a nice treat! 

Dr. Winograd's medical assistant does the tattoo's but I am not sure I want her to do this as she seems very young and I have heard that having a tattoo artist/micropigmitation specialist (cosmetic tattoo person) do this work would be better.  Who is doing your DIEP?  I really need to find someone that is happy with the results of their tattoos in the Boston area as I don't want to travel.

Best of luck to you and if you have any questions on your surgery let me know! 

nwood450

Hi Girls,

Lucyleester:  I was just surfing around looking for some advice regarding stage 2 DIEP and found you... I had Dr. Winograd in Boston do my surgery on 3-6-09.  I am just starting to think about stage 2.  I need nipple and tattoo and symmetry on the other breast.  Probably lift and maybe even reduction. 

I am so nervous about this.  I loved Dr. Winograd.  Just curious how you found this second part of the journey.  Recovery, etc. 

Thanks,

Nancy

Just went back and re-read your post.  You haven't done the Stage 2 yet.  I think I was so happy to see someone else who had Dr. Winograd that I didn't fully comprehend your post.  In any event, I love the work he did.  But have experienced some lymphedema and am worried about stage 2.  How do you feel?  Any LE issues?

lucyleester

Hi Nancy -

 I decided on PBM due to BRAC 2+ and the fact my sister died of BC.  I am so happy I went this route as my pathology showed LCIS in my right breast so I feel I was doomed to get BC.  So I didn't not have breast tissue that was radiated or have to have chemo - so stage 2 was a breeze for me!  I went into MGH for day surgery and I was in the OR for about 1 1/2 hours.  My nipples were done with local anesthetic and I truly felt no pain.  Dr. Winograd revised a previous scar I had that was high up on my breast and that was a little sore that evening but by the next morning I was fine.  My nipples look great so far and can't wait to have the tattoos.  I am a little nervous having his medical assistant do them as she looks so very young and not sure about her talent!!  It's nice to know that you liked Dr. Winograd as much as me - so many others have gone to Tobias and Lee (I interviewed Tobias but decided on Winograd).  Let me know if you have any questions - happy to help.

nwood450

Lucy,

Thanks for the info.  I do love Dr. Winograd.  I was so scared the day of surgery and he sat by the stretcher, held my hand and told me that after the surgery I would be a breast cancer survivor.  Just a bit worried about the lymphedema that I've had in the past, however, I want to move forward so badly ... to feel like "me" again.  With the summer coming, when I put on T-shirts, my right breast is quite a bit lower than the "perky" reconstructed breast.  I know it's vain, but I want to feel "cute" again.  A couple of people have told me, "you've been through so much ... don't put yourself through more surgery.  You look fine."  But it's not them... it's me.  I don't know.  I'm very conflicted.

lucyleester

Hi Nancy -

I truly understand as I didn't think I was going to do stage 2.  I felt who is going to see my boobs only me and my hubby why go thru the surgery.  I asked Dr. Winograd if most women decide on stage 2 and he said yes and thought I would be very happy.  He was right!  I am glad I did!  It makes me feel "whole" again.  Given what you went thru so far this surgery (I think) will be much less invasive and it really will make you feel so much better about your body (It did for me).  I also purchased great bras at Lady Grace (which my insurance paid a little towards the purchase price) that make my boobs look great in clothes - you truly would not know I had a BMX.  You make think about purchasing inserts for your right side to help "uplift" your breast prior to surgery to get you thru the summer months as it may help with the symmetry. 

nwood450

Lucy,

Thanks so much for your insight. I will think about this over the weekend and probably make a phone call on Monday.

Enjoy this beautiful spring weekend that's in the forecast!

mrsb45

Hi Ladies,

Hope you don't mind if I join in . I also had Dr Winograd for my Diep on left and alloderm implant on right 6/26/09. Found him very nice but last time in office visit didn't feel all the concern and compassion as before surgery. Get "fullness in breast and abdomen" and was wondering if I have truncal lymphedema.. Gets very uncomfortable @ times and he really didn't have any advice etc. Due to go back soon as I finished chemo 1-28/2010.I am also undecided about tatoo's. I have decided against nipples because my breast surgeon said they really don't come out that great. I was really interested in finding someone that does the 3D tatoo's. I also asked Dr Winograd who did the tatoo's in his office and was surprised when he said his medical assistant....Not sure what to do...

lucyleester

Hi mrsb45 -

I am sorry I can't help you with your question about truncal lymphedema as I only had one node removed on my left side.  As far as Dr. Winograd I agree with you that he seems very rushed at appointments lately and I feel like I have to ask all questions as he is not forth coming with general things. I disagree with your breast surgeon saying the nipples don't come out that great as I am thrilled with mine.  Who was your surgeon??  I had Dr. Gadd for my bmx.  I am not comfortable with his assistant doing the tattoo's - you must have met her and she seems very young and when I spoke with her I didn't feel she was that confident doing them.  Let me know if you have any questions!

Binney4

Ms. B, hello,

It is possible that you have truncal lymphedema, but doctors often are slow to diagnose it -- they don't treat it, so they're not always very familiar with it. The medical professionals who evaluate and treat lymphedema are well-trained lymphedema therapists. Here's a page about how to find one near you:

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

You need a referral from any member of your healthcare team. I got mine from my PCP, but an onc or rads onc or surgeon can refer you as well. If it's truncal lymphedema, the gentle therapy for it will bring you quick relief. And prompt treatment will help prevent cellulitis, which spreads rapidly and can be difficult to treat. Here's information about truncal lymphedema, and some suggestions for bras, camis and other compression-type garments to help control it once the swelling is reduced by therapy:

http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

Be well!
Binney

mrsb45

Binney,

Thanks so much for all the information. My breast surgeon did give me a Px for Physical therapy consult but just started back to work full time a month ago and don't know where I'll find the time to go... It has been getting better with time and then for no reason I'll have a day where Chest and abd. feel full and distended. Hard to describe..

Lucy, I also had Dr. Gadd... I think the world of her. She was my 1st contact when all this Cancer started in 2008. She is sooo kind and compassionate. Just saw her for follow up last week. She always listens to all my concerns and never makes you feel like your overreacting.. Told me to call her anytime and she will check anything I have concerns about..If anyone has any names they have found who does the 3D tattoo's would love that info. Thanks....

lucyleester

Hi MrsB45 -

Did you contact Dr. Gadd's office for advice on nipple tattoo's?  If so I would love to get the name of the person she recommended to you - if not I will give her a call.

Thanks, Lucyleester

renee-tattoos

There is a traditional tattoo artist

www.julimoon.com 

Let me know if anyone goes to her.

She is well respected in the tattoo industry.

PM me if any questions.

Renee 

germangal

For those of you that had Dr WInograd do a DIEP Flap reconstruction - are you truly happy with the outcome? What was the overall experience like? How long were you in recovery stage? Possible issues? If you had any, were you able to get back in to see him as soon as you felt it necessary?  I see the notes re his busy state as of late - but I will be honest, I had the same issue with Dr Gadd but I wouldn't trade her for anything, not after I've seen some of the scars left by other breast surgeons!

I had a double MRM 3 years ago (IBC, Stage 3) and am now getting to the point where I am thinking I might be around long enough to benefit from reconstruction. And I like the sounds of the DIEP, but I don't know anyone personally who had one. Dr Winograd was the plastic surgeon Dr Gadd had me talk with before my MRM, to see if reconstruction was viable. He was sure he could do something was the answer then.

Would you do it again?

lucyleester

Hi KWhite -

I had Dr. Gadd and Dr. Winograd do my PBM w/ DIEP in October 2009 and Dr. Winograd do my nipple recon in February 2010.  I am happy with my results and would do it again.  The first 2 weeks were rough but by the holidays I was feeling better.  As of now I am fully recovered and do pretty much everything I did before the surgery.  I would be happy to speak to you at any time - just send me a private message and I will pass along my phone number.

Lucyleester

lucyleester

Renee -

I made a appointment with Julimoon for my tattoos but am not going until September.  She didn't have an opening until the middle of June and I didn't want to wait out the 2 weeks of no swimming after the tattoo was done so decided to wait until September.  The studio sent me pics of 3D nipple tattoo's she had done - amazing!!!  I can't wait to go see her.  Thank you for the recommendation!!!

Lucyleester 

renee-tattoos

Lucyleester

Good luck..I am sure you will be happy..

Let us know...

AnnaBell

Hi Ladies,

I hope you don't mind my chiming in.  I am scheduled for an immediate DIEP w/ Dr Winograd but am having 2nd thoughts about the whole process mostly due to the fact that I will need radiation.  Not sure if I should delay the recon until after chemo & rads.  Would love to hear your thoughts about Dr Winograd & my dilemma. 

Thanks,

Anna

lucyleester

Hi AnnaBell -

Sorry I can't help you with your question about having an immediate DIEP with radiation - but I will say I had Dr. Winograd as my PS and am very happy with my results.  What does your breast surgeon say about having the immediate recon prior to radiation?  I had Dr. Gadd as my bs and she was wonderful and very helpful on my decision about my PBM.

Lucyleester

glanter

Have you spoken to your plastic surgeon about the fact that you know you are having radiation?   I'm with a reconstruction practice in the Carolina's and we will usually ask the patient to wait until 6 months after her last radiation treatment to proceed with reconstruction. 

AnnaBell

Hi Gail & Lucy,

Yes, my PS & BS (Dr Gadd) know I will need radiation.  They said since I will need chemo after the reconstruction I will have some time before the radiation to heal.  I believe this hospitol is in the minority in their approach.  Scares me!  They said they rarely have problems due to the rads on the reconstructed breast.  My PS prefers to do immediate reconstruction due to fresh fless and fresh blood vessels.   My BS seems however a little concerned that immediate reconstruction will delay my chemo a bit but she said if it were her she would have the immediate reconstruction. 

I met w/ another PS from another hospital in Boston & he highly recommended delaying reconstruction until after rads. 

Gail...Please advise what effect  radiation can have on the immediate reconstruction.

I'm so afraid of making the wrong decision.  But I'm also so afraid of living without a breast for a year.

Thanks,

Anna

glanter

Hi Anna,

What a hard decision, and two different PS opinions to boot.  There are many scientific articles on this subject that can easily be accessed just by Googling "effect of radiation on breast reconstruction".  Even if the full articles are not available, the abstracts are there and the conclusions worth reading.   If you can find one with before and after photos which demonstrated the effect of radiation on autologous reconstruction be it DIEP or TRAM it would be worth looking at to get the idea of what the risk is.  How about talking to the radiation oncologist and getting their take on the situation?    Best wishes - Gail

NativeMainer

As far as the timing of chemotherapy and/or radiation after surgery, there is no research to indicate that there is any time limit or ideal time frame.to start treatment.  Docs depend a lot on protocols, but that part of the protocol isn't supported by reserach--that's just when the chemo happened to be done when the reserach was being done to see if the drugs worked.  Ask your docs to show you the research that backs up the time frame they recommend. 

GippaMills145

my work , I'm a tattoo artist in boston