mastectomy with reconstruction...dying skin?

Coblndie

I had my surgery 12 days ago and am still laying flat on my back in bed. The cancer side is very dark purple. The healing has been slow. I'm really getting worried about my skin dying. I'm hoping to get my drains out on Wed, the 2 week mark. Does anyone have any advice or has anyone experienced this?

farmerlucy

Oh my stars - that sounds terrible. My only advice is to PM SpecialK. Unfortunately she has faced many failed surgeries and may be able to help. I hope everything is ok.

SpecialK

farmerlucy - lol! 

coblndie - necrosis can happen up to 20% of the time in a skin and/or nip sparing mastectomy surgery.  I know it is scary to see but there are some things you can do that may help.  I would increase your protein intake to 100g a day, if possible.  Also, walk if you can to take in as much oxygen as you can.  If not, do some deep breathing hourly.  The reason you are experiencing this is because the skin is failing to form a new blood supply with the pectoral muscle - when they removed the breast tissue they removed all of the vascular network, so your skin must attach to the pectoral muscle to stay alive.  Protein and oxygen are potentially beneficial for this, as well as zinc, bromelaine (or eat a lot of pineapple), and Arnica Montana - all healing supplements - ask your PS about taking them first though.  There are some topical ointments that may also be prescribed - ask about those - I used Silvadene. I would not take any aspirin, or wear tight fitting bras that cut off circulation.  Good luck!

Coblndie

I was told Arnica would not help and my ps has me lying flat as much as possible. I will try to eat more protein. I haven't been eating much of anything and have actually lost 10 pounds in the last 12 days since my surgery. I feel so stressed out. Is it an easy procedure to fix the skin if it dies? How long do they usually give it?

SpecialK

I would recommend protein shakes to try to get in the necessary amount if you don't have much appetite - and maybe protein bars.  The surgical fix is skin excision to cut away the necrotic part, cut back to healthy bleeding skin and then stitch together.  If you have necrosis over the face of the breast that means scars in the location of the necrotic skin.  Do you have implants or expanders? I assume you did neoadjuvent chemo based on your dates - how long since you finished?  Chemo can inhibit healing, so it is possible that could be part of the problem - did they do a CBC right before your surgery to check your counts?  I have seen some PS go a pretty long time - weeks - before going back into surgery as long as there is no sign of infection.  I don't want to scare you, but in the interest of full disclosure I want you to be aware that depending on the extent of necrosis, you may need to have your recon removed if it looks like it is not going to heal.

Captroynsteph1

Hi CobIndie. Just wanted to share that I had necrosis after my mastectomy and had to have a skin graft. It is inconvenient but the results turned out fine. Try not to worry! Just a little bump in the road! Best of luck

muska

Hi Cobindie, I had very large bruising of the color you are describing, especially on the cancer side. It took a while to heal and at some point the entire nipple and aureola area was crusty and peeling and I was concerned whether the skin/tissue were dead but eventually, it all healed on its own and without any interventions. The aureola remained slightly discolored compared to the non-cancer side. Give it more time and it will heal.

I had drains for five weeks. You aren't even two weeks out yet, just give it more time and it will improve.