Nipple sparring questions

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Kb33
Kb33 Member Posts: 88
edited July 2014 in Breast Reconstruction
Nipple sparring questions
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  • Kb33
    Kb33 Member Posts: 88
    edited July 2014

    so... I was so very excited when my ps said he would do nipple sparing.   But of course, we all shook our head understanding that during surgery it may not happen if the biopsy comes back positive.   But I thought it was worth the try.

    My lovely sister then asked me if there was a difference between not planning to do it and being smooth in that area versus trying and not doing and having scaring from the removal.  I didn't know the answer to that.  Hoping you ladies might know if there is a down side to either choosing nipple sparing and it failing after the fact or choosing it prior to surgery and ps having to not do it due to a in surgery biopsy result.   Interested to hear experiences on any of the above.  Thnx

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  • Ally2345
    Ally2345 Member Posts: 320
    edited July 2014

    Kb33- My breast surgeon would not do nipple sparing so my incision is horizontal right across the middle of the breast. I am not smooth in that area because the incision is there if that answers the question about not saving and smoothness.  From some pics of others who have had nipple sparing, it looks like many times the nipple sparing incision goes along the IMF but I don't know for certain.  There are several who have had nipple sparing so I am sure they will chime in!  

    Good luck with your surgery!!

    Ally

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  • stepangel
    stepangel Member Posts: 35
    edited July 2014

    I had nipple sparing and yes, the incisions are along the IMF. (Under the breasts) You can't even see them without purposely looking under them.

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  • Ninany
    Ninany Member Posts: 55
    edited July 2014

    Me too, IMF.  I still have TE's in but when I have my exchange, the PS will go in through the same incisions.  Right now, the scars are thin and have healed well.  You can't see them unless really looking under.  If the breasts have a little ptosis, they will be invisible.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2014

    I had nipple sparing and my incisions are in the IMF also.  Ask your PS how he handles nipple removal if the pathology is positive, and some ladies who had nipple sparing, but later had the nipple(s) removed may also chime in.  Some docs do a lollipop (vertical) incision, some do a purse string (periareoalar).  Here are is a link for lift, but it shows some types of incisions:

    http://www.refreshcosmeticsurgery.com/procedures/breast/breast-lift/

     


     

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  • DiveCat
    DiveCat Member Posts: 968
    edited July 2014

    It always makes me laugh when people type nipple sparring.....I imagine dueling or fencing nipples! Not laughing at you OP, just the mental imagery! You are not the only one who has typed it that way :)

    I had nipple-sparing surgery and my incisions were placed in IMF. They actually run right along my IMF, partly as I was larger breasted before and partly as the BS wanted to ensure he could access as much breast tissue as possible. The scars have healed very well, are thin, and as my implants have dropped and fluffed and I have got a bit of ptosis they aren't visible head on, even only  2 1/2 months or so out. You can see a bit of them from the sides though :)

    Not all women who get nipple sparing get IMF incisions though, some do get the lateral incisions that run off the side of the nipple toward armpit, and some do get lollipop-like/anchor incisions like you would see in a breast reduction.

    There are women who had nipple-sparing who later had their nipples removed. Depending on your original incision/scar, they may just extend the incision/scar line, or it may require a new incision/scar site. If I had to have my nipples removed it would obviously mean that I would have additional scarring over my breast, but my IMF incisions are hiding so I would not necessarily look like I had extra scar lines if you looked at me.

    Even if you went into it knowing you were NOT sparing the nipples you would not be "smooth" over top, you would have scars there. Indeed, you would have to because an IMF incision won't remove the nipple :). How the scars ultimately look depends on your surgeon's skill, how your body heals, whether there are complications, and how you personally scar. 

    So, there would be scars there whether you removed them now, or later. Whether you would have an extra scar site would depend on where your surgeon did the original incision.

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  • TinaT
    TinaT Member Posts: 2,300
    edited July 2014

    Hi, my incisions were also IMF for all my surgeries.  One of my surgeons commented along the way that it is a more tedious way to do the mastectomy(ies) because the upper portion of the breast is not as easily accessible as when a central incision is used.  My IMF incisions have healed well, but I actually rarely pay attention to them because they are not really visible. 

    Best wishes!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2014

    I had nipple sparing with the incisions horizontal from just outside the nipple towards the armpit.  I forget why not in the IMF.....perhaps because my tumor was high and on the inside (10 o'clock).  They told me if they had to take the nipple, then they would just do the straight across cut like most BMX's.  

    It's been almost 4 years now and my scars are faded and you probably wouldn't notice if you saw me in a locker room. :)

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  • RainDew
    RainDew Member Posts: 305
    edited July 2014

    hi!

    My NSM incisions were periareoalar (from 10 to 2 across the areola). I'm still in TEs, but they are hardly visible because they sit in areola.

    I assume if I had nipples removed in the future they'd just go all the way round and stitch them together...

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  • Kb33
    Kb33 Member Posts: 88
    edited July 2014

    wow.  I didn't realize there were options for how the nipples were removed/spared.  Is it something to discuss with BS.  Or do they just select a certain method.  Is there a type that offers potentially more feeling or less scars?   All so confusing

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  • TinaT
    TinaT Member Posts: 2,300
    edited July 2014

    Kb33 - I'm sure there are always exceptions, but I'll venture a guess that each BS has his/her preferred technique.  Mine does inframammary whenever possible because the incisions are nicely hidden in the fold under the breast.  My PS used the same type of incisions for my exchange and revision.  No obvious scars.  

    I can't remember where I read it, but I believe I read about a study that suggested a certain type of lateral incision spared a particular nerve and resulted in a better chance of nipple sensation.  

    Best wishes!

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