Does scar revision increase LE risk?

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Sher
Sher Member Posts: 540
edited September 2014 in Lymphedema

I posted a question on the Surgery forum "Scar revision after bilateral - no reconstruction?", but no one responded, maybe because of my poor choice of topic name.  Seems odd to me that no one from this site has had revisions to their mastectomy scars and humps and bumps.  I've read several posts where scar revision was done along with or in addition to reconstruction,  but nothing on revision being done just to get a smooth, even chest.  Besides that, I would also like know if I'm putting myself at more risk for LE by having the revsion.  We're talking about a lot of excess tissue on either end of the incisions that would have to be removed, mostly from the prophylactic side.  I'm very uncomfortable with all this tissue excess, but might try to live with it if it would somehow greatly increase my risk of developing LE. 

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  • sushanna1
    sushanna1 Member Posts: 764
    edited January 2009

    I do not know what "scar revision" entails, but can say that having had five cuts in and around the same spot (excisional biopsy, lumpectomy, re-excision, benign excisional biopsy, benign excisional biopsy) between April 2001 and April 2008, plus an additional benign excisional biopsy and benign "punch needle" biopsy, I was fine until the 2008 biopsy.  My surgeon decided to "clean up some of the scar tissue" while he was in there.  I still have a small hematoma from a 2004 excisional biopsy in a different location and developed lymphedema in the area betwen the two scars.  Personally, I suspect that it was related to having an allergic reaction to yet another type of surgical adhesive.  The breast was quite hard and it was almost as if I had cords or knots connecting the scars. It has almost resolved thanks to a wonderful p.t. Unlike my hand lymphedema, I haven't figured out the best way to deal with it on my own.  Just when I think it is gone for good, it returns. 

    Not sure if this is helpful or not.  The trouble is that no one can accurately, predict who will develop lymphedema.  While you are presumably increasing your risk of lymphedema, it does not mean that you will develop it.    Good luck making your decision.   

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  • Binney4
    Binney4 Member Posts: 8,609
    edited January 2009

    Hi, Sher!

    I'd have to agree with sushanna that there's no predicting your lymphedema risk. Surgery is trauma, and trauma creates or adds to the risk, but doesn't guarantee it. No easy answers, sadly! Undecided

    I know they've discussed the question of revisions of mastectomy scars on the "Breast Prostheses and Reconstruction Alternatives" forum, which is just above this one on the index of forums. Might be a good place to find the gals with experience.

    Sushanna, are you using chip bags (or Swell Spots) in your bra to control the swelling? They can help break up the hardness and keep the swelling down. Just a thought. Solaris-Tribute makes them in a dizzying variety of shapes and sizes: www.solaris-tribute.com

    Sher, wishing you comfort with whatever decision you make!
    Binney

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  • sushanna1
    sushanna1 Member Posts: 764
    edited January 2009

    Binney--I looked into purchasing a swell spot, but think that they may be too big for me.  I am really small busted and my problem breast is less than a AA.  What is a "chip bag?"  The PT suggested padding a sports bra and showed me how to use kinesiotape (LOL--It made me look like an exotic dancer.)  However, I am leaving for a trip on Saturday and did not have time to order anything new and there are no local suppliers.  I am experimenting with pads and my lumpectomy prosthesis under a breast binder, sports bra and camisole with a regular bra but sometimes think that uneven pressure makes the problem worse.  At this point the hardness is gone, but sometimes it is tender.  Thanks for the advice.  I didn't mean to high jack the thread.

    Sue  

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  • OneBadBoob
    OneBadBoob Member Posts: 1,386
    edited January 2009

    Hi Sue--

    Great to hear that the hardness is gone!  That sure is a huge step in the right direction!

    Here we talk about swell spots and chip bags:  http://www.stepup-speakout.org/foampadding_swellspots_lymphedema.htm

    The swell spots http://www.solaris-tribute.com/lymphedema/consumers/swellspots/productline.html come in many sizes and I have even sewn together two little "joju" spots for the cleavage area.

    Are you flying on your trip?  What will you be using for breast compression when you are travelling?

    The Bellise bra http://www.bellisse.com/comfort_bra/index.shtml  may be a good idea for you, because the pressure is quite even all the way around, and you can slip a swell spot into it.

    There is a whole assortment of chest/breast compression garments you can see at  http://www.stepup-speakout.org/Compression_camisoles_lymphedema.htm and http://www.stepup-speakout.org/compression_bras_lymphedema.htm

    Just be sure that the garment is returnable.  Those of us with chest/breast LE have such individual problems regarding just where the fluid accumulates, how high under our armpits we need compression, whether our torso also need compression or just the breast area and how high on our chest we need compression, that if you order a particular garment (and they do tend to be costly) and it is not a good, comfortable fit, you can return it.

    Several of the manufacturers will make the garments to custom fit for a small extra charge if you have particular problems or are an unusual size.

    Let us know how else we can help.

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  • sushanna1
    sushanna1 Member Posts: 764
    edited January 2009

    Thanks for all the tips.  I am flying and am still experimenting to see what works best.  At this point, the problem is improving.  I am down to a slight tenderness near the old (7.5 years) drain scar below my armpit.  I have been experimenting with a sports bra and a breast binder, with and without a pad and prosthesis.  However, too much compression seems to make it worse.  I looked at the swell spots and with the exception of the joju spots they are too big to be useful.  Plus I haven't been home long enough to order anything new before the trip. If it becomes a problem while I am gone, I think that I can manage it with kinesiotape (as shown by the P.T.)

    Wish me luck. 

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  • Sher
    Sher Member Posts: 540
    edited January 2009

    Thanks Sushanna and Binney!  It seems as though there are many decisions to be made with bc and often one right after another.  Never ending!  Anyway, I'm going to make an appointment with ps very soon to see what my options far.  I'm thinking maybe a little adjustment to the prophylactic side and leave the other (previous rads) side alone.  But I wonder if ps understands the concept of a "little" revision? 

    Today I got my first silicone contact breast forms, so will see how it goes trying to attach to my humps and bumps.  That may help me to make up my mind about scar revision.  But information in the booklet said "Please note that the skin requires a certain period to get used to the breast form.  When the breast form is removed, slight skin reddening can occur, caused by increased circulation."   Wonder if this increased circulation is a good or bad thing?  Is there any information regarding contact forms and LE?

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  • Binney4
    Binney4 Member Posts: 8,609
    edited January 2009

    No such luck, Sher! Go easy and let us know what you discover.

    I just started using the Silique Comfort-lite forms recently and love them. They have a silicone outer layer, but they're filled with "Beanie Baby" beads -- light as a feather and it conforms to all my lumps and bumps, and even to the occational LE flare. Very adjustable and the light weight gives me no grief with the LE. Great find, thanks to Barbara/"Erica"s website (www.breastfree.org).

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  • Sher
    Sher Member Posts: 540
    edited January 2009

    Hmmmm, wonder how the Silique Comfort Flex would compare to the Comfort Lite?  I guess they would be the same except for the back, right?

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  • smitasharma54
    smitasharma54 Member Posts: 1
    edited September 2014

    My surgeon did a revision and sent the scar for testing. It showed that I form hypertrophic scar tissue after deep cuts. The scar came back within a few months of the revision.It has now been almost 12 years since my revision and the scar has started to soften and fade. I would consult a plastic surgeon to determine the type of scar you have before even thinking of surgery.

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