Skin nipple-sparing mastectomy and immediate reconstruction

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Meritxell197529
Meritxell197529 Member Posts: 2
edited October 2014 in Breast Reconstruction

Hello!!

I was diagnose with infiltrating ductal carcinoma 7 months ago (February 28th) I decided to go for neoadyuvant chemo with anthracyclines+taxol+herceptin for 6 months. My tumor was 5.5 cm, triple positive (ER+, PR+, HER2+), grade 2, stage 2b-3a. After chemo the tumor dissapeared and I went for a skin nipple-sparing mastectomy with immediate reconstruction with permanent silicone immplants. As well as sentinel lymph nodes removal where 5 out of 5 were negative. I had the surgery 12 days ago and I am feeling quite good. But my breast is still swelling and my nipple is losing some skin (peel). I am afraid I will lose my nipple as I may not have enough blood suply to it :(. 

Anyway, I just wanted to share with you my situation to know if someone had the same problem and to know how long it took you to recover from this type of surgery as well as how much time did you need for your breast to look "normal" and not swelling.

Thanks!

Meritxell

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  • DiveCat
    DiveCat Member Posts: 968
    edited October 2014

    Does your breast feel hot? Do you have a temperature? Swelling is normal after surgery but if you are having a sudden new surge of swelling, you may be dealing with infection or a seroma. Either way, you need to see your PS.

    I had NSM/direct to implant. One of my nipples turned quite dark and got quite scabby after surgery. It was also bleeding and peeling. I just kept it moist (first with antibiotic ointment, then with Vaseline) and under gauze,  changing 2x a day. Eventually it healed and I did not have any scarring. It is not unusual after NSM for the nipple to get a little scary looking, as it has been traumatized, but if you are concerned you should absolutely talks to your PS. The main thing is to watch for signs of infection. There is not much you can do if your nipple does turn necrotic, but you can at least the and minimize risk of any infection.

    Respecting recovery, it was a process. I could do more day by day. It's a gradual thing, and not a "wake up one day and all is back to normal" kind of thing. I was walking long distances very early on, but did not start driving until 3 weeks out, and it took a week to build back up to driving without any tightness, etc. I went back to work at 4 weeks, but would go home and need a nap everyday. I'd say I was back to my full regular routine without even thinking about it by 3 months, but that regular routine included some more demanding physical activity and lifting. If not for that, I was recovered a few weeks earlier though things sometimes still felt tight until about 3 months out.

    As for cosmetics, it can take a while for your final outcome. The majority of the swelling, and so on should go down over the next couple of weeks, and the implants should settle more into their pockets (mine rode very high for a while). I am almost 6 months out and saw changes still until recently, and my PS says changes can happen for about a 6-12 months after direct to implant. 

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  • Meritxell197529
    Meritxell197529 Member Posts: 2
    edited October 2014

    Thanks for your post DiveCat,

    The swelling was there before as well, it is not new. I was expecting my breast to be normal and not swelling by now....I guess I just have to be more patient! 

    For the recovery I am happy, I still feel some pain and streching of my skin but I am able to do everything I need at home and take care of my 2 year old daughter by myself. So I guess I shouldn't complain. I just feel a lot more tired at the end of the day! I have 6 months of sick leave (I live in Spain) so no complains there either.

    I would like to ask you something, when did you start sleeping side ways, so far I have been sleeping faceing up. I sleep much better sideways but I dont know if it is convinient to do so.

    Thanks again DiveCat for your comments!

    Best,

    Meritxell

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  • clmtootie
    clmtootie Member Posts: 63
    edited October 2014

    I had a NSBMX on 9/9/14.  My left nipple had some dark spots that eventually scabbed and came off after treatment with a prescribed antibacterial ointment and gauze covering.  I changed the gauze and put on more ointment 2x a day.  After about a week it was gone and my PS said it looked great and healthy.

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  • AshleyMarie1986
    AshleyMarie1986 Member Posts: 4
    edited October 2014

    Hi. I had a nipple sparing mastectomy with tissue expanders. Both of my nipples (not areolas) turned blueish/black and eventually scabbed over. I was told by my surgeons the top layer of the scab would fall off and I would be left with a flat spot where the nipples were once 3d but this would still look better than the alternative since I would at least have my areolas. Anyway, my left nipple scab did come off after a couple weeks and I was left with very minimal loss on that side. The right nipple never seemed to heal in over a month. About a month and a half after mastectomy I noticed the scab break away from one side. It started oozing followed by swelling and pain. When my plastic surgeon saw me he removed what was left of my nipple and did a procedure in his office, pretty much tried to scrub out the infection and then stitched up my nipple. He gave me a script for antibiotics and I went home. Over the next day i became worse, swelling/pain/vomiting. When I saw the PS the next day he sent me straight to the hospital. Antibiotics through my port for 2 Days did not knock out the infection so I had emergency surgery to remove the tissue expander. I ended up having staph/MRSA.  After a 5 day stay I got to go home. Since, I have had the expander placed again and so far so good. I understand this is a rare occurrence but I just wanted to let people know of the risk.  Thanks!

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