Reconstruction being redone. Starting completely over.

madejade

Hi everyone

I am a 40 year old woman with an extremely high chance of developing BC.  My sister died at 35 from Triple Negative Breast Cancer.  Also had an aunt with this cancer and my paternal GM had ovarian cancer. I was BRCA negative. After 6 lumpectomies and due to the extreme density (and stress of these procedures) we opted to move forward with prophylactic Nipple sparing recon with insertion of TE.  I did extremely well.  TE were placed behind the muscle.  The fills hurt very badly as my surgeon was doing 120cc per side every week.  I worked for him so we were trying to get this done and me back to normal asap.  Had the swap out two months later and I looked beautiful and my stress level was greatly reduced as my risk was assessed at 40%.  After the swelling subsided the reconstruction began to fall apart.  He didn't like to us ADM and revised the recon 6 months later (Feb 2017) but again the implants came out of the pocket and I ended up resigning there due to personal reasons.  I couldn't get a doctor around here to fix me.  They all said I needed to go out of state due to the severity.

So I finally got an appt with a surgeon who comes highly recommended but I was not prepared for her assessment.   She agreed my implants were out of the pocket (650 Ultrahigh profile mentor), I was suffering from symmastia, and in general basically said whoever worked on me did a very bad job.  She says I need the implants out, nipples and skin removed.  She said my body needs time to heal.  She  is going to wrap the pocket/muscle in thick ADM, may place no prosthesis or may place a tissue expander ABOVE the muscle if I'm lucky.  Given my background working for a recon doctor I know this isn't the norm.  In fact, I can't think of a single case my previous surgeon did this way.  

Has anyone had their recon redone?  Anyone had implants/expanders placed on top of muscle?  If so, how painful are the fills?  How do you feel about your overall outcome.  She says I am facing three surgeries total.  She will do aggressive fat grafting at the second surgery but in general I trust her a lot but am freaking out on the inside.  

My recon was so bad I made it pretty far along in the audition process for the show botched.  I got cut at the very end and I believe its because I'm in such bad shape.

First surgery is 3/1/18, second will be in June sometime.

Any help or advice is appreciated.

Thanks

VegGal

That sounds horrible! I went from under to over the muscle and it all went well. It's becoming much more common. I had no fills as it was just a switch.

The one thing that puzzles me is why she feels all your skin and nipples need to be removed? Do you know her reasoning behind that? How do YOU feel about that part?

You know, you've been through a lot. Have you considered seeking one more opinion for comparison? Whatever you do, you need to feel absolutely confident about it.

amtreb

I didn't have a recon redo but I do have over the muscle implants. This is the newer trend bc there is much less trauma since the pec muscle remains intact. He also placed the alloderm at that time.

At the time of my nipple sparing BMX my PS did not fill my TE at all. He wanted my tissue to heal before expanding. We began expanding once my drains were removed. He did act 100ccs per fill. Not painful at all, just odd feeling. I had my swap out sure for my implants early Jan. he put in 420ccs Naturelle high profile, highly cohesive gel implants. He also did some fat grafting. So far so good. I was a small/barely a B cup pre mastectomy and I was just fit for a bra and I am a 34D but they very nicely fit my frame.

My down time was minimal, Ive been back to yoga and working out for a couple of weeks now (slowing getting back to it to not take any chances, but no pain!)

hope that helps a little. So sorry to hear you've had such a rough time

madejade

hi

Thanks for replying. She is the 4th opinion and she is out of state and supposed to be the best. My left nipple has migrated nearly to my left armpit. She says it needs to be removed because it can't be placed correctly and free nipple graft doesn't seem to be an option and I think to make the future tattooing match, take them both. I do have a lot of skin and even breast tissue that was left behind so she is going to remove that all and I think it will offset the nipples. But, I am going to ask her the morning of surgery to try to save them. I don't think she will. If I could post a pic to show I would

madejade

thanks for your reply. What you had done closely sounds like what I’m getting done. But she said if I couldn’t commit to a month down time she wouldn’t even do it. I’m a runner and due to the pain, I haven’t been getting much in. As far as implant size, I don’t want to be smaller but she says I have no choice so I’m mourning so much now. No nipples, smaller breasts...... ugh. So depressing. My moms passed, my sisters passed, I’m in this basically alone. My husband and kids have had their lives interrupted so many times for this mess and they don’t complain, I just feel bad always upset. Will be glad when this is over

Moderators

Hi Madejade-

We're so sorry you're dealing with this! It all sounds awful, and we certainly understand that you're having a hard time dealing with it. It sounds like you trust your new surgeon, but like VegGal said, it couldn't hurt to get a second opinion, if that's at all possible. Just to clear up some of the concerns you have with the options presented to you, and make sure you have all the information to make the best decision for yourself.

Please keep us posted on how things go!

The Mods

Lalala1

Hi Amtreb,

Congratulations on your reconstruction. It's very heartening to hear such great results and recovery.

I am having my current implants removed from under the muscle due to animation deformity and replaced with over the muscle implants. However, I have not yet had my surgery as i couldn't decide between the rounds or anatomicals. My surgeon suggests anatomicals however many people here really like the results with the rounds.

Did you get the inspira CSX (the cohesive gel ones? or the CSR slightly softer responsive touch ones?

What do they look like at the edges / step off?

Where did you get the fat grafting? was it in the same surgery?

Would love to hear more about it. So happy for you that it went so well..