Pleural effusion after mastectomy-scared

Whovian05

The plastic surgeon said the left breast didn't look infected. He said it is the result of the skin not being able to stretch. He noted the skin is very thin in the area that is breaking down. Basically, it is a failed reconstruction due to the lack of elasticity in the radiated area of my breast. He is going to do surgery next week to have the expander removed. He wants to do a lat flap on my left side to create a new breast. I was surprised at this, because I thought you needed to wait several months before attempting a different type of reconstruction. Maybe this is because it is not infected? I will be meeting with him again on Thursday when my husband gets back from his business trip to discuss the details further. I knew this could be a possibility, but I'm still really down about it.

Tomboy

whovian! you dont have cancer again! you dont have an infection which could be life  threatening! i am sorry that you might have to do a different operation, but no matter what, there WILL be an end to all this. wishing you the best while you wait for your husband, and know that we are pulling for ya. is it just bandaged really well? wow, i didnt know that skin could break down so easily, so far from radiation.. am so sorry, dear.

carpe_diem

Whovian, 

The lat flap may have other advantages.  I went with the implant because it was the easier operation, but I may need more surgery if physical therapy doesn't take care of the contracture, which is more common with implants, especially after radiation.

Jaimieh

Whovian I am thrilled to here that your pleural effusion doesn't so malignancy. I had something similar happen with my expanders and had a free flap done. The best decision that I did and wish I had started with that.  Just know there are some options for reconstruction. 

Annie62

Carpe - that is good info and that from someone who has had pleural effusions.

Who- just wanted to say this.  Good news on the biopsy being negative for cancer. I know you are concerned that it might actually be cancer and all I can say is to keep on top of this. You are your best advocate. That being said, I had severe pleural (and pericaridal effusions) in Sept 2012. After draining several liters and spending 10 days in the hospital, I worried about never feeling right again. (BTW- I already knew I had mets). Since that time I've been to Ireland for a week, taken my daughter sledding and ice skating, hosted a Christmas dinner for 10 and lots of other things. It took me a good 2 months to feel like myself again. So don't think you'll never feel better.

Two other notes -1.After draining there were small amounts of fluid in my lungs. It took a few months but they did disappear. They did not cause symptoms while I had them. (No pain, shortness of breath, or coughing.) 2. I had cellulitis after a benign biopsy in 2006.  It was the worst pain I have ever experienced as a result of my cancer and I've had lumpectomy/axillary dissection, re-excision, the aforementional biopsy, a double mastectomy, thorancentesis. I had to fight my breast surgeon to take me seriously. Thankfully her partner did. Guess who changed surgeons? Draining it helped a lot. So if it is cellutis or an infection, you'll feel better when it is gone, but you have my sympathies while dealing with it. 

Hang in there. I hope my experience gives you some hope that you will feel physically better in the future, no matter what. 

Whovian05

I just got back from an appointment with the plastic surgeon. He told me I need to have the left tissue expander come out because the skin is so thin, and not handling the stretching due to the radiation I had a decade ago. He pretty much told me because of the radiation and existing lymphedema, I am not a good candidate for the lat flap procedure. The only alternative I have is the tram flap. I am not too keen on a tramp flap. I feel like recon or no recon, I am screwed. I will look hideous either way. I also be even more of an invalid for weeks, worse than I have been. My husband was with me at the appointment. I feel so beyond hope right now. I am going to post in the reconstructive surgery forum, as I think my posts will be more appropriate there. Thank you all for the support you've shown me, as I don't have a breast cancer support group in my area at all.

I'm just so tired of the crap sandwich and being forced to take more bites out of it.

ritza

Hi, my radiation was on the right in 2011 for dcis, after partial masectomy.  After 5 surgeries including 2nd diagnosis followed by dbl masectomy with diep reconstruction (16 hrs) August 2012. I developed plueral effusions on December 15th 2013 which had so many side effects i thought I was dying, trouble breathing,  pain and swelling of joints, kept changing so I wrote them all down.  Went to Pulmonolagist and Thorasic Surgeon, thoracentis was done and was pain free for 10 days.  Then Chest pain landed me in hospital with pericardial effusion with additional  bilateral plueral effusion.  All blood work negative for autoimmune disease and cardio fluid resolved with antiinflamatory meds. Dr. refused to do another thoracentesis..said not enough fluid ..but I had pain again.  Finally I had a ct done ordered by pulmonologist at my request.  Results were devasting Plueral thickening with loculations due to chronic plueral effusions.  Meaning permanent damage, thorasic surgeon did shedule Vat surgery (2nd opinionby me), unfortunately damage and scar tissue to bad to even reach the lungs. Plueral scaring  turned out negative for cancer. No explanation of cause,it has almost been a year and I still have trouble with deep breaths.  Any advice.