Direct to Implant and AlloDerm Breast Reconstruction

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited February 2012

    So much GREAT information here!  Thank you everyone! 

     I'm taking a special note on "Soma" 

    Heading over to the alloderm link - thank you specialK :) 

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited February 2012

    I may have made a mistake but I went for a second plastics opinion yesterday and now I am considering NOT having the direct to implant with alloderm and also not keeping my nipple.  So many decisions its so difficult.  I wish I knew in my gut the best way to go about doing all this.  I feel like the PS are car salesman. 

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  • 1openheart
    1openheart Member Posts: 765
    edited February 2012

    GM...I don't think we can ever make a mistake by getting more information.  But, that said, it sure does make it hard to make a decision sometimes.  I was advised not to keep my nipple.  My DCIS was very close to the nipple.  My understanding is that all of the ducts terminate at the nipple and if there are cancer cells growing in the ducts, then it stands to reason that there could be some left in the nipple area.  Ladies, is my understanding of this correct?   Maybe if you do not have DCIS, it might be different?  I did a direct to implant with alloderm, skin sparing UMX.

    I chuckled at the image of my PS out in a parking lot full of breasts of all shapes and sizes trying to convince me that this nice little model over here would be a perfect fit for me.   

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  • BelaT
    BelaT Member Posts: 217
    edited February 2012

    I will be making this decision soon and I have no idea where to start and what are the optins, This is helpfull

    Thanks

    Bela 

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited February 2012

    okay..... I've made up my mind and I'm sticking with it. 

    My surgery date is March 5th.

    Because the cancer is my main focus I want to be at Sloan Kettering Hospital. None of the PS at Sloan use alloderm.  Also, my cancer doctor said I should NOT spare my nipples because the ADH on the left breast is very close to the nipple.

    1Openheart - your logic on this makes perfect sense.

    So I'm going to have the old fashioned BMX with TE :(

    The only happy, happy, joy, joy, moment in all this is being able to pick the size and color of my areola.  Today, I'm leaning towards "green" but that could change.

     I need to be at Sloan because my brain knows they are the cancer experts. So far, at the age of 52, with no family history of cancer of any kind I - a healthy, nonsmoking, regular exercisers, who  breast fed two children and had her children before she was 35 - has had 1 melanoma (on my back) 6+ basil cells on my face and body.  And now, ADH in my left breast and DCIS and a "highly suspicious mass" directly behind the DCIS on my right breast. From this point forward I also want to use the dr.'s at Sloan for my annual gyno exams.  Part of my reasoning to go to Sloan is also because they picked up the ADH in my left breast when the radiologist at my local hospital missed it.  So I don't have faith in the hospital anymore, or the doctor.  And the top breast doctor at this hospital said, "honestly, I don't see anything suspicious in your left breast but maybe the doctor at sloan used a magnifying glass" .....

    I hope this doesn't sound like I'm an advocate for MSK or against alloderm, I'm just writing out my fears and hopes so that I can remind myself of why I made this decision. I'm so scared.

    A doctor recently said to me, your decision should be based on the fact that you have cancer.  It should not be about cosmetics or convenience.  That rang true for me.  I wanted to get the operation over with so that I could go to burning man at the end of August (this would be my 10th year) and I wanted to save my nipples because my husband (not even sure if I'm keeping HIM) is a huge fan of them (and apparently other womens too).

    I knew from the beginning that lumpectomy was NOT an option for me.  If I could have done it without radiation that would have been different.

    I'm trying to find the thread that talked about the best pain meds. Does anyone know where that is? I'm so afraid of the pain.

    okay... thanks for listening! really appreciate the advice (here, no where else)

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  • 1openheart
    1openheart Member Posts: 765
    edited February 2012

    "honestlly, I don't see anything suspicious in your left breast but maybe the doctor at sloan used a magnifying glass"          SERIOUSLY?????   I don't blame you for not having confidence in the doctors at your local hospital.

    As far as pain meds.....ask if they will use a OnQ pump while you are in the hospital.  My surgeon gave me one.  My husband called it a "soaker hose" inside my chest.  It bathed the surgical area in numbing meds.  I had it for two days and then when I went home, they removed it.  Wish I could have kept it in longer.  It was great!  I can't take pain meds with codeine at all.  I get so very sick and dizzy.  About the only thing left for me is diloudid....an old school drug.  Pretty big guns, but it works. 

    I'm sorry that you are also dealing with issues in your married life while trying to fight this battle. That really stinks.  Hugs and positive, healing energy are coming your way.   

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited February 2012

    1openheart - I have that on TAPE!!! because I audiotape all my appointments.  I was so pissed off when she said that.  She had my film up, put her glasses on and said, "...I don't see anything...." THEN my husband put his glasses on and said, "yep, I don't see anything either"   At that point, I wanted to bang their heads together!!! (seriously). 

    as for the husband issues, I'm "pretending" we are okay because honestly... I need mr. nursing nipples.  I need him for insurance and for care.  My plan was to leave in April.  To go to New Orleans for a month so that I could be on my own and so that we could both think about whether or not we want to stay married.  He was initially going to go to Aspen with his asshole brother but he changed his mind on that.  

    It took him a very long time to even undertand/accept that I have cancer but he has been at every appointment and he finally gets it.  He also supports my decisions regarding surgery and reconstruction.  

    Really appreciate the HUGS and POSITIVE, healing energy!  This is what works best for me.  xoxo 

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  • MondaysChild
    MondaysChild Member Posts: 591
    edited February 2012

    GreenMonkey,

    I have had both: Straight to implant reconstruction with dermal matrix (like Alloderm, but a different brand) then had to have than undone and went the TE route.  I wish I had gone straight to TEs from the beginning.  I think it gets a better long-term result.

    Keeping your nipples should be driven by healthcare concerns first and it seems you have addressed that.

    So I agree with your decision.  It is exactly what I would do and I have the benefit of more than a year of knowledge. If I knew then what I know now.....and I do, I would do exactly what you are doing.

    (Edited to correct irritating typographical errors.)

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited February 2012

    Thank you Tampa.  that was great to read! 

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  • janiceg415
    janiceg415 Member Posts: 144
    edited March 2012

    GreenMonkey-

    It seems we have a close diagnosis with DCIS.  Although I don't know what ADH is in the other breast. 

    I had  my uniMX on Feb 23rd with TE and alloderm.  Did I miss something in your posts that mentions why you were against that?  I am doing well being out  just 10 days out, still have drains in which are uncomfortable and a little painful. 

     I am waiting for pathology reports following MX, it seems a bit odd that they are not back in yet.  I hope that they aren't waiting for me to come back in to tell me some bad news.  I know we shouldn't think the worse, but it seems everytime the BS thought one thing it turned out differently. 

    Hope & pray that your surgery goes well on Monday. 

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  • GreenMonkey
    GreenMonkey Member Posts: 666
    edited March 2012

    thank you Janice! the surgeon who was going to use the alloderm was using it with a one step, direct to implant - no TE. They also said I could keep my nipples.  then I went to another BS and PS who both said absolutely NOT because my ADH is too close to the nipple and I think it makes sense that noone with DCIS should keep their nipples (but this is just my brain talking to me, not speaking for anyone else).  In the end I made my decision based on the hospital (sloan-kettering).  I felt more comfortable there.  ADH is like pre DCIS (atypia ductal hyperplasam - I'm almost certain I spelled that wrong).

    So glad you are doing well!  as far as having to wait, my surgeon told me it would take much longer to get my results 10 days perhaps, because they have a team of dr.s that review it, not just one doctor.   I am sending you positive thoughts and let me know.  I'll be thinking about you as well.  

    xoxoMonkeyME 

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  • Lisa75
    Lisa75 Member Posts: 137
    edited March 2012

    I had this done, but they couldnt keep the nipple. The DCIS was between the chest wall to the nipple in the one duct. The stiches dissolve on their own, apparently laying down for long periods, and sitting up causes some temp pain. so much for sleeping flat. Im wondering how long before it appears normal again. It looks fine in a bra though.

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  • Carolanne03
    Carolanne03 Member Posts: 42
    edited December 2012

    Hello friends! I'm feeling as my 1 year "foobie"  anniversary approaches , I would like to check in w/ those others who are either facing the same procedure, or also at 1 year. What a year it was indeed!. Anyone else out there feeling discomfort still after 1 year? Not sure what is normal. I do excercise and work full time, etc, my pain feels like a sharp pulling sensation, mostly one sided. I had a bilateral mastectomy with immediate direct to implant w/ alloderm last Jan 2012. Mostly, I feel well, and of course super grateful for being cancer free now. Thoughts out there to those going through treatment and facing surgery.

    Carolanne

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  • Infreyred
    Infreyred Member Posts: 19
    edited August 2017

    i would be weary of textured implants (if that is what gummy bear is). A big NY Times article linked textured implants to a new form of cancer. Was published within the last few months. I think Sloan has discontinued them.

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