Dog Ears?

I had a skin sparing double mastectomy in July because I wasn't sure about reconstruction.  In the time since, I've been leaning heavily on not having it done.  I'm comfortable going flat chested, and I'm comfortable wearing prosthetics.  Typically I've only worn the prosthetics at work since I wear a uniform and work at the fire dept.  I can retire in four years and probably won't wear them after that, I just didn't want people to wonder "what" I was!!  Anyway, should I decide not to do reconstruction, does anyone know if insurance will pay for additional surgery to remove the flaps of extra tissue left under each arm?

DVSB-- I'm glad to see I'm not the only one with this I have the extra under my arms pits . I was not told about this before my bil-mast 6/2008. I had told my BS no reconstruction, never saw a PS. After when I saw my BS they said in a year I could have them removed. Said that this is pulled forward when we have breast and now just extra . I talked with my BS the end of July he said he could remove them --- the surgery would take about 2 hrs (that long due to have to re-position me ) that I would have staples and drains also another biopsy on tissue removed and incision would go further onto my back... Let me tell you it scared me and my DH . I just saw a PS said he could do it in his surgical office with just a local, would take about and hour , no staples or drains and no biopsy. Go figure NOW WHAT!!!! My BS is well known. So I'm at a stand still I don't want more surgery but I really hate these dog ears. I have an appointment with my Onc next month I'm going to talk with him....But I'm really confused about this .. I posted ? on surgery forum about Mast revision surgery. But diidn't get much info only people said I should talk with a PS. So at a stand still right now ...Janet

Janet,

As far as the cosmetic part, the PS sounds like the better bet, but like dee1961, I agree that you may has well get the tissue biopsied just to cover all your bases. Perhaps you could request the PS do it even though it's not his normal procedure.

The surgery your BS is describing sounds like overkill for what you need. 

Pam, if you haven't already, I really urge you to try physical therapy. You need someone who is familiar with breast cancer and mastectomy issues and who does myofascial release, a very gentle technique that can break up the scar tissue that's probably causing or at least contributing to your tightness. From what you said, it doesn't sound like nerve pain so much as just uncomfortable tightness, which could occur as scar tissue forms around your incisions all across your chest.

I think the tightness is initially there for many, if not most, of us shortly after surgery. For some, stretching alone can help it go away. I needed physical therapy. I agree with you about neurotin--although it's generally well-tolerated, why take a medication if you don't need to.

If you go to the Physical Therapy section on my non-profit website, BreastFree.org, the issue is discussed in greater detail. At the end of the section, there's a phone number and link to the American Physical Therapy Association's "Find a PT," should you want to find a physical therapist with oncology expertise. 

Barbara

I am also large breasted-40DD- and after my mastectomy I did not have dog ears.  Actually, this is the first I have heard about them.  My chest is flat and there is no extra tissue or tightening.  My surgeon only does breast surgery and I think that makes a difference when they have that much experience.  Just for your information, I went to the breast center at Mayo Clinic, Jacksonville.

My bmx was 2/29. It actually looks like I had breast reduction rather than a mastectomy. I actually have a bit of cleavage. I wore a C cup before surgery, and now I look like an A cup with no nipples. I'm mortified. I initially thought it was swelling or fluid, and would go away in a few days. Apparently I was wrong.



A week before surgery, I told my BS I was very confident about not wanting reconstruction. I followed up with an email, to specifically discuss dog ears. I told her I wanted to avoid them if at all possible, and to NOT leave excess tissue for the possibility of reconstruction at a later time. I also said I wanted the most flat, smoothest scar possible. Her response was that without reconstruction, she didn't know if dog ears could be avoided. I wish now that I would have taken that as a warning sign, and looked for another surgeon.



These are not small bumps. I really look like I have breasts, minus nipples. I definitely need surgery to clean this up, which is exactly what I wanted to avoid.



Not happy!

Just learned the name for the deformities under both arms - dog-ears!  Accurate I guess, and at times mildly funny, but most of the time NOT!  Since I live just a few miles away, I'm curious who did your surgery.  I have Kaiser--do you by chance?

I know how you feel my doctor never dicussed the possiblity of dog ears.............. but I went back and had it corrected, my doctor told the insurnace (Anthem Blue Cross) is was not cosmetic is was caused by my surgery and needed to be corrected......... you need to talk to your doctor and let him know how uncomfortable you are and have him deal with the insurance company...........

I wish you luck and keep fighting........ if you had breast cancer the insurance would have to cover re-construction ( implants ) so they should cover the dog-ears !

wanted to let you know that I had scar revision surgery 10-11-12. the same surgeon that did the mastectomy did the second surgery. he knew what I wanted and got it pretty close. I still have healing to do but so far I am satisfied. from the front I have a scar across my chest. there is some puckering in back but I can live with it. I can wear the prostesis most of the day without any trouble but I understand that I am not completely healed yet. God is good....all the time. Wish you all the best and a Merry Christmas.. by the way, my insurance paid... just so you know..

I think sometimes dog ears are unavoidable the first time around. I did reconstruct and I had small dog ears, like pointy tips, at the ends of my incisions. During revision these were smoothed out, but I still had a lot of side boob fat. I just had nipple recon and the side boob area was liposuction, leaving a much nicer appearance.

If you are "plump" like me, it does make the situation worse because where ever they end their surgery the area next to it is fat. My first PS was less compassionate about the side boob fat bulges and the love handles on my hips that were terribly obvious after the diep tummy tuck. Fortunetly for me, that surgeon moved and I had to see a new PS for the nipple recon. He was much more generous with the lipo fixing both the side boob and the love handles. If you are unhappy with your results, second opinions can't hurt.

I think for the best cosmetic effect it is not unreasonable to expect there may need to be more than one surgery, even if you are going flat. If the skin is drawn too tight the first time it can cause problems, as others have mentioned.

Luna, I just had surgery 3 days ago so I'm still in the recovery period. It has not been bad. I took pain pills day one, two and only the morning of day three. I'm black and blue, but it looks worse than it feels. I have a long incision with internal stitches and glue. The incisions could get wet, but the new nipples can't so no showers for a week. No lifting over 10 pounds for a couple weeks. I can't stretch to reach things that are up high.

I'm very pleased with the results. Before my new foob seemed to start under my arm with a wide roll of fat. Now there is definition and shape. It feels so different when I put my arm against my side now, it gets so much closer to my body, lol.

I know it was my fault I gained weight, but I'm eating better now and trying to lose weight but there are just some stubborn areas that won't go away with diet and exercise. I am grateful for my new PS.

Thanks Luna. My first PS didn't offer any lipo - he was satisfied with his initial results. With him I had the initial DIEP and two revisions. After all that my one foob was still bigger than the other and it had a funky shape. I told him I was unhappy with the love handles that were left at the end of the tummy tuck incision and he said he couldn't do anything about those. He moved, I got a new PS who I was just expecting nipples from. But he suggested fixing the funky shape and size difference and the lipo. The shape is so much better now. I can't see the nipples yet, there are cotton donuts sewn over top of them, no way to peek. Can't wait till the reveal on Thursday. After my experience, I truly believe in second opinions now.