Choosing nonreconstruction on the BCO web site?

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Hi MT1,

I like what you said, "Ask your surgeon about the fat under your arm(s), we call these 'dog ears' and is defined as fat is left behind, sometimes incisions end abruptly leaving a tab or 'dog ear'. A good surgeon will not leave 'dog ears' or 'kisses' under your arms.

Remember, this is your body, you need to live with the results."

I truly wish I'd known about this before my surgery Feb. 28. She left me with these dog ears, or as I call them, A-sized boobs under my arms. I hate it. Plus there are fat pockets under the incisions I hate as well. Would prefer to be flat. Is this fixable? She said she could "fix it." Or will I need to go to a cosmetic surgeon?

Karen

Linda, I could be wrong, but I have heard that sometimes BSs leave them in case you want future reconstruction.  Other times I think it could be attributed to a lack of skill.  Or perhaps these two things are not necessarily mutually exclusive.

You know, sometimes I think it shouldn't be called 'reconstruction' at all.  That word implies so much.  'You are not put together, you are in a state of 'deconstruction,' your body is not finished, we are going to 'reconstruct' your breasts.  It doesn't seem quite right.  The word was probably chosen to make women feel better -- to make them feel reconstructed -- but as it turns out, it doesn't end up that way for so many of our sisters who choose 'reconstruction' -- either because they don't get the results they'd hoped for, or because the results -- however good they are -- don't mitigate what's happened to them as a result of this journey.

Starak, I don't think all "dog ears" come from such a misogynist place.

Imagine trying to sew together two pieces of fabric - one has a straight edge, the other a curve.  Or better yet, two unmatched curves.  That's what surgeons have to do when they "close" after part of the body has been removed.  Things like straight incisions to open up the belly are very different - the edges of the wound match up perfectly so can be re-approximated without any puckers.  That's not true of edges that are not from incisions simply opened and closed without change to those edges. 

So with breasts, there can be big mismatches in the edges that are difficult to eradicate.

I've just been diagnosed with Stage 1 cancer.  I am morbidly obese and wear a 48 DD bra.  I'm already pretty sure I don't want to have anything to do with radiation if it can be avoided.  I had a son pass away from bone cancer and chemo was used in an attempt to save his life.  Radiation followed to control the tumors in his spine prior to his death.  I remember well what that did to him.  I don't want to go through that if possible.  I do like symetry, however.  If there is nothing in the non-cancerous breast, can you opt to have them both taken off instead of reconstructing the one breast?  Also, I have severe arthritis in my back and the only exercise I can do is in a pool.  My non-operative arthritis makes it impossible to walk or ride a bike or pretty much any other exercise.  Swimming is all I have and will not give it up.  I'm curious how others fill the emptiness in their swimsuit after the removal.

Jksurrusco, I'm so sorry for what you've been through with your son. No mother should ever have to face what you have. Sending you BIG hugs. 

Yes, you can opt to have both breasts removed even if one is cancer-free, and your insurance would cover it. Many of us choose this for various reasons, symmetry being a common one! 

I've only been breast-free for a couple of months but buying a swimsuit was the very first thing on my list lol!! I was anxious I wouldn't find one so I went shopping right away. I ended up choosing a Speedo top because it went high enough to cover my scars and fit nice and snug against my flat chest. There are also mastectomy swimsuits that can hold a breast form if you decide to wear one. And a rash guard is another option for those of us who are flat.

Linda, I probably would not have had my second breast removed if it were a choice, I only took action when I realized i was going to get 3 lumpectomies and lose my nipple, so I saw no reason to keep it then.

There are indeed risks for surgery, LE being one of them. I wore sports bras (38 C with the one breast) smooshed it flat :-) with no foob and it worked pretty good.

bottom line is we do what we have to do. If you are not sure, then wait. No reason not to. I knew immediately after the guided MRI biopsy, 3 hours in the MRI machine I could never do this again...and you too will know when enough is enough. You wioll know the right time, if ever.

Linda, my surgeon left small dog ears in the middle, where the scars stop at the breast bone. He said they were for anchoring future recon, should I want it. He apologized for how they looked, and assured me he could fix them at a later date, if I wanted. They have smoothed out and are pretty much gone. I escaped the underarm fluff, and he said it was because I was slender. According to the surgeon, unless you are fairly skinny, it is very difficult to avoid. 

I still don't really understand why it should be so difficult to get rid of in surgery, but I suspect this would be yet another reason to have a good plastic surgeon involved during the operation. 

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How do you get to the pictures?  I have never been able to find them?

Also, I have heard of people having skin around the incision die after surgery, so leaving a little extra might be helpful in case more has to be removed later. I would probably have needed a skin graft from some other part of my body if that happened.

I had, and still have myofascial release massage done, and although my skin looks tight, I don't have that feeling at all. I do still have a bit of a "dog ear" but it has diminished a lot in the past few months. It certainly seemed to help with range of motion for me, as I didn't really have a lot of problem with motion, just the final part of a lift to get my arm straight up over my head. I only had one node removed.

The thing I was most surprised about and grateful for, was that my surgeon continued my incision a bit further over onto my left breast. He explained that I had some sun damage on my chest that had puckered a little, so he decided to extend the incision so as to flatten it out. I also really liked that the flat upper chest also meant I had a smoother neck, just a bit of an unexpected bonus.

Hi Erica,

I don't remember saying recon wasn't an "entitlement", per se, in Australia. It is absolutely available to everyone, both with our Public system, and with our Private system.

What I  probably meant to  say was, that, although I don't know an enormous amount of people who have had bc, of the ones I do know, most have not reconstructed, by choice. In fact my bc group of around 12 ladies, who regularly attend, ten of whom have had Mx, only 2 that I know of have reconstructed. The rest, go flat and fabulous, or wear prosthetics.  I don't know if those numbers are reflected all over Australia.

You're absolutely correct when you say that our surgeons may, do more Mx without immediate recon. I have no idea of the actual numbers though. This wasn't an area I knew anything about, before my Dx, other than my Mother's experience back in the 90's, she never considered recon either.

My surgeon came from South Africa, where he had set up breast clinics, and then did the same in London, before coming here to replace a well loved, but ancient surgeon, who was retiring from this large regional area. I was just incredibly fortunate to have him recommended to me. Otherwise, I would have gone back to Melbourne to one of the Cancer centres there, had I not found this surgeon and his great team. It was definitely serendipitous!

He didn't bat an eye when I told him I didn't want to reconstruct, but did say that the door isn't closed if I ever decide to change my mind. He did warn me, that I would have a "mound", not a breast.

A girlfriend of mine back in Melbourne, who did have recon, was mortified when she found out I wasn't interested. She tried to get me to go to her surgeon, who was Kylie Minogue's surgeon. Although I haven't seen my friend's results, I believe it is a magnificent job.

No problem at all Erica. You've brought up an interesting point, though. I wonder if that is the case here.

I do know that, in speaking with my group there is only one lady who isn't altogether happy with her surgery, but that is because of her "Dog Ear". She had a complete axillary clearance, and has had issues with that. 

I'll ask about it at the next meeting.