the reduction+lumpectomy thread

Perhaps even in this too, I got off comparatively easy.  I had "pure" DCIS, so I didn't have a SNB or axillary dissection and never really lost full range of arm motion, though the first few days after surgery it was painful to move just about anything.  I bought a bunch of button down shirts but didn't need them.  As it turned out I could still raise my arms over my head, though maybe not for the first day or so.

I initially had a hard time moving myself around even in bed.  Just scooting myself up higher on the mattress, or trying to move to sit up, was difficult.  That also got better after a few days.

Not being able to lie on either side and being limited to sleeping/laying on my back was annoying and made for a restless sleep.  That got better after a few weeks.

I don't have a recliner or sofa, so I don't know if those would have been better.

The area where the drain tubes entered my body was REALLY painful, luckily I was able to have them out after a week, but I think one of them was removed too early.  I ended up taping the tubes down against my skin for an inch or two, so they wouldn't move around so much in the entry holes every time I changed position.  That helped a little bit.

No one told me to record the output from the drains each time they were emptied, so I didn't.  That was a regrettable oversight.  The breast that's been giving me problems, my formerly "healthy" breast, put out a LOT more fluid than the cancerous breast, and I wonder if some of those problems might have been avoided if I'd recorded the fluid amounts and we'd left the drain in a bit longer - even though it HURT LIKE HELL.

I have no family, so I moved into my best friend's house for a week and let her take care of me.  Thank God for her.  I couldn't have done it alone for the first few days.

I was mostly just asleep for several days. 

My surgery was Thursday, a friend stopped by to visit on Sunday - and even though all I did was sit on the couch, it was EXHAUSTING.

Ready made food is KEY.

Since you're having surgery on both breasts, you double the chance of complications.  My "healthy" breast is the one with the healing issues, the cancerous one is almost perfect.  On the other hand, the pathology on my "healthy" breast's tissue showed ADH, which made me decide to join the Tamoxifen club.  So you'll get more information which may be helpful in further decision making.

Agree with Cookie, move things to low shelves.  Stretching/lifting is painful - although again, for me, that phase didn't last very long.

Sports bras - my Dr. didn't want me in one, but the post surgical bras he gave me offered no support.  I think I was in more pain than necessary, though I'll never know if there was some medical reason he didn't want me compressed.  At Cookie's suggestion, I ended up getting some cheapo sports bras at K Mart for $7.99.  Much more comfy and didn't seem to change anything, healing-wise. 

Stool softener - I had a horrible time trying to poo in the first few days, before things went back to normal.  Not sure if it was the anesthesia, the painkillers, or both - but pooing was a real issue for a few days.  Lots of stool softener, start taking it the day or so before surgery.

Will try to think of more.  

Hi L-V!  Hope you enjoyed your travels!

Hello Ladies,

I have already had partial mastectomy and rads to right breast.  I finished rads on Feb. 4th 2010.  Before rads I was a very full D cup on both sides, now post rads on the right side I am a B cup.  So, to say the least I am a little lop sided.  LOL!  I am in the process of making an appt to go see a plastic surgeon to get "evened up".   What kind of questions should I ask?  I'm not sure what I want to do either.  I really have not thought I wanted to go back to being a D because I have had neck and shoulder issues, also the healthy left breast is quite saggy so I would like both of them lifted a little.  Have any of you had this done?  How painful was these procedures for you?  I am a nurse and really can't afford to be off more than about a week.  My job if mostly a desk job as I'm the director.  Lot's of questions I know but I'm thinking of making the call tomorrow for the appt.  I have been putting it off for several weeks now.  

Thanks

Renee

Mimi -

I also had a bilateral lift/reduction as the first surgery - one of the "reduction"s was basically a big lumpectomy and they reduced the other side to match at the same time.  It was all done before rads, which I will be starting soon.

I had my surgery on a Thursday and took the next week off, I was back at work (desk job) the following Monday; so I was out just over a week.

I'd ask how closely the PS thinks they'll be able to match the other side, have them explain the scars - which will probably be different than the rads side.  Or do you want to lift the rads side too?  Find out how they feel about doing that much work on radiated skin.

They all made it seem like doing a lift was a no-brainer, now I know better.  I've had some healing issues and will probably need revision surgery.  So, know going into it that it might be perfect but it also might not be.

I'd also talk to the rad onc and ask how long they think it will be until your rad breast really settles into its permanent shape.  It would be crappy to have a surgery to match it and then have it keep changing.....  I think my rad onc said it might take a year or two for my breast to really settle down, so if that's also the case for you maybe it's worth waiting.

Best wishes to you.

My PS made the side that will get rads a little bit bigger than the "healthy" side (about 10% bigger), to try and compensate for shrinking the rads would cause.  I told my rad onc about this plan before I did ANYTHING (I saw a LOT of Drs before I finally made a surgical decision). 

She (rad onc) said the PS was wrong and that you couldn't plan on 10% shrinkage, or shrinkage at all - that some people's breasts got bigger, some didn't change at all in size, some shrank more - that basically there was no way to predict with certainty and it all took a while to settle in. 

I got tired of fighting with Drs and let the PS go ahead with his plan anyway, I hope I don't regret it.

But that's why I'm suggesting you talk to your rad onc also - because the rad onc and the PS might not agree, and maybe the rad onc has more experience in being able to predict what size your rads breast will end up at this point than the PS does. 

I've been told that insurance has to pay - we'll see.  I'm in the middle of that now.  My insurance denied one of the procedures but the PSs office says it shouldn't be a problem to get the denial successfully appealed.  I certainly hope so.

Mine swoll at the first couple of weeks of rads, settled down and then the shrinkage started... Nobody told me to expect THAT. I was so pissed.

Now, it's a C with a dent and the other is DD. I'm in it with the ins. too... they want MY PICTURES!!!   I Want to know WHO wants my pictures? I think I should have the right to say who gets copies. And if they have to pay, why do they want my pics??

~Connie

I had bilateral lumpectomies, re-excisions, and radiation.  Needless to say the end result was two different sized breasts with one nipple two inches higher than the other!  The high side was held with scar tissue down to my chest wall. 

I waited until a year after radiation, per my BS's recommendation, and last December had a lift on the low side and a fill on the smaller high side.  The PS brought around the lat flap and filled the cavity left by the lumpectomy, removed the scar tissue allowing the nipple to move to a lower more natural position.

I couldn't be happier with the results as I now look pretty normal in clothes.  The secret of success is to have a PS with EXTENSIVE experience, on radiated breasts, with the procedures you need. 

Surgery on radiated tissue is much more complicated and has added complications.  See "Reconstructing the Radiated Breast" for more information

http://www.plasticsurgerypractice.com/issues/articles/2009-02_03.asp

I was scared taking on 5.5 hours of elective surgery, but almost cried after when I saw that I almost normal again!  I hadn't realized how much my deformed state bothered me.

Boo

Hi ladies,

Renee, The dent is where the scar from the lumpectomy and the PS said she would take all the scars and all the scar tissue out, mostly all the tissue that got the boost with rads and fix it. She seemed knowledgeable about the radiated breast and reducing it. I haven't read all of her credentials.

I missed the appt to go back to look at her book and ask more questions cause DD and grandD got so sick. They had shared the stomach virus less than two weeks ago, then baby got double ear infections and by Tues. last week they both got slammed with a nasty upper resp. must have been a virus it was a lot worse than just a cold. Probably from all the stress. See, the husband/daddy decided he preferred living with cocaine and alcohol abuse in his life rather than my DD and their baby girl, K. This came to the point of no return about 6 weeks ago now when she told him to leave and not come back unless he was clean and sober. He hasn't returned. They are young 20s, baby just turned one. I never in a million years thought that he would bring this pain and hardship on his wife and beautiful child. But, he did. Now, DD and K will be moving in with me and dh, we raised our three and haven't had anyone else living here in 7 years!! This is going to be a new adventure in parenting. I hope to get them moved in by Saturday. We need a twin bed.

Oh, sorry, I vented.    back to topic...

THANKS for the success stories. Maybe I'm over worrying this decision. I know theres a size difference and am going on 3 years out of treatment, so the shrinkage and the scars are done. Nows the time, except if I wait til early summer, DD will be out of school, I think and I wont have to wonder if I'll be able to drive to our girls cousins beach week in Myrtle Beach in May.  Would you try driving 4 hours after only 3 or 4 weeks after your reductions?  For a week at the beach? With your fun as anything cousins? Id rather put it off than not be able to go. We meet for a week each year. Been doing it for 9 years now.

Sure does make me feel better to know that ya'll have done this and that you are happy with the results. I'm going to read that article now.

~Connie

Lane, I'm with you on cutting or messing with the bc side. When was yours?  I'm going on 3 years out and have seen a PS about reducing the healthy side and I KNOW it will make a huge difference in how I look, dress and feel. I was so upset about being cut on for the lumpectomy I never thought I might decide to elect surgery. They are My girls, know what I mean?

Also, ten years or less ago, I might even have said that if I ever got a bc dx I'd say, Cut that puppy off. But in real time when it happened, I didn't want them cutting any piece of it. And I've had multiple other surgeries, so I wasn't scared of the process, but after... knowing that she cut my BREAST.  OMG. So, maybe I am a little scared of cutting either one, much less cutting both durning a long procedure and waking up with less boobage than I've EVER had. These girls have been mine since I was about 15. never wore an A cup. 'by 8th grade they were Ds, since giving birth 3 times they have been DDs for 30 years. Except now the left one is about a full C.

Should I really see more doctors? I mean, I like the one I picked out of the PPO and she was very aware of the rads. Said she could do two things that sound great. 1. remove all the scars and a lot of the damaged, radiated tissue, reduce the areolas and lift both sides. 2. They won't be so pendulous and the lift will take away the skin to skin contact underneath! --- that sounds like its too good to be true. To me. Is it?

What if? ... what if they don't come out even? What if they loose their sensitivity, that woud be the WORST.  What if I hate the scars, they will surround both areolas as well as the anchor scar underneath? What if the reduction and lift causes more scar tissue? What if she takes too much and I come out way smaller that I thought it would be? What if the bc side has complications in healing? I don't want any of those things to happen. I haven't made up my mind totally either. I just told dh that so he would drop it for a while.

~Connie

Thanks for starting this thread.  I will be having my lumpectomy/reduction on April 20th.  Thanks for all the knowledge shared!

lane4 - the plastic surgeon told me today that he will see me again in 8 weeks for a follow up.  He will not touch my breast that had radiation done to it till I'm 6 months out.  He plans to do a lift and a reduction to my healthy left breast then on my right (radiated) breast, he will do what he called a (I think) mastoplexy where he will straighten out my areola and lift my breast without getting into the actual breast tissue itself.  Therefore, my actual surgery will probably will take place somewhere around the end of July or the first of August (maybe)??? I am well satified with what he told me. I think I will be happy with the results.  I wish I could have the saline implants and do some augmentation, but since I can't I'll be happy just bein even. :=) !!!!

Renee

lane4 - LOL on the button up shirts not gaping anymore!  There are many doctors that do breast augmentation on radiated breasts but they are experts in their fields.  You have to look long and hard to find them and understand that there are risks involved, like capsular contracture and decreased healing or increased healing time, but those are the risks with any augmentation.  The risk is just increased with a radiated breast. As for the liposuction of a breast I'm not sure that I would go that route.  You would still end up with loose and sagging skin, if I'm not mistaken, and need the skin removed.  Is that right?

Renee

Connie my plastic surgeon actual told me that they can offer that service and estimate the differenc and do the reduction at the same time.  But that option was not even discussed with me by breast surgeon.  I'm not sure why?  Apparently there are a lot of breast surgeons that don't discuss it with their patients.  So... what happens is patients like us end up in the plastic surgeon's offices and we are complaining about the size diference in our breasts because of our radiation and lumpectomies, then we are stuck months or years later having to have a second or third surgery to "fix" it.  Unless you are one of the lucky ladies who doesn't mind and can live with the asymmetry of your breasts. 

Renee

I am a little nervous about having surgery on both my healthy breast and my DCIS breast.  I have met with both the general surgeon and the plastic surgeon and I have decided to have a reduction and a lift (mastopexy) at the same time.  My plastic surgeon told me that it's much easier to do with healthy tissue before radiation.  He explained that they will remove the diseased tissue first on my right breast, then he will remove the same amount on my left breast.  I guess you can lose some volume of your breast after radiation, and he explained that when the treatments are complete that if I have lost some volume, that he could do a little liposuction on the healthy side to make me more even.....I am tentatively scheduled for April 28 or May 3rd (whichever date the 2 docs can agree on).   I just want to get this over with!  My general surgeon is awesome, by the way, she does so much for breast cancer research....she called the surgery a segmental mastectomy....is that the same as a lumpectomy?????