Post Bilateral + Revision surgury fail/scarring question

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happyteacher
happyteacher Member Posts: 118
edited November 2015 in Breast Reconstruction

Hello,

In April of 2014 I had a double mastectomy, and the exchange followed in December. I had a lot of scarring and needed a revision surgury this past July. The new implant is again scarring and constricting the implant, although not as severely as before. My doc is saying another surgury, but I am wondering if there might be a way to break up the scarring without more surgury? It just seems like if I had this problem twice now, why should another surgury be any different of a result? I am thinking that if I go through with surgury, I might instead elect to have them removed. Any thoughts?

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited November 2015

    Have you tried PT with a therapist that specializes or has experience with myofacial release? Also, my surgeon during one of my revisions 'scored' the scar tissue - crisscrossed it with surgical cuts to keep it from restricting the implant. Both of these things, along with fat grafting, have helped me tremendously

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  • sas-schatzi
    sas-schatzi Member Posts: 19,603
    edited November 2015

    HT Did you and are you doing multiple times a day foob massage?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited November 2015

    There is some thought that taking Singulair, the asthma medicine, can help prevent and/or treat capsular contracture.  Here is some data linked below.  I do know of one person locally whose PS put her on it after she had issues with this.

    http://www.ncbi.nlm.nih.gov/pubmed/20601564

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  • Warrior_Woman
    Warrior_Woman Member Posts: 1,274
    edited November 2015

    I have a physical therapist who specializes in breast reconstruction. I was told that if that were to happen I'd do PT before anyone talked surgery. As you see from my signature line, I've had a LOT of surgeries. At one point my skin was glued to my ribs and PT broke it lose allowing me to finally have successful reconstruction. Not all surgeons, as I've learned, refer to PT unless absolutely necessary. Your question is a good one and well worth the investigation.

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  • happyteacher
    happyteacher Member Posts: 118
    edited November 2015

    At this point I am only now looking into other options. Perhaps foolishly, I simply went with what my PS recommended. Prior to the first revision when I specifically inquired into alternative paths to break up the scarring (massage, PT, etc.) he said it wouldn't work and that a surgical intervention was needed. Then after this revision and the scarring again became a problem, he did a 180 and said to massage the foob. A few days ago my husband (also a teacher) met a colleague at a conference and she described some type of electro something or another treatment that worked for her. That is when I started the thread here and am looking for input other than from my doctor.

    I have an appointment coming up the day before Thanksgiving. I am going to see what he has to say there, and then proceed for a second opinion. I also checked in with the chiropracter for a hip issue, and mentioned it. He started working on via massage just above the implant and into the armpit and shoulder area to try to release the adheasions/break up the scarring in that area. I frankly have no idea how to tell if it is working, other than he tells me there is progress from two sessions due to being able to work on it longer and more vigoursly prior to the redness surfacing.

    My PS did say on the next revision that he would score the pig/cow material (can't recall the proper name at the moment) and put my on steriods to keep the inflammation at bay. But why would he not have done this on the first surgury?

    Thank you all for your responses. I am for sure gong to specifically ask him for a PT or massage (again blanking on the appropriate type of massage) if what the chiropractor is doing seems to be working even minimally.

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  • happyteacher
    happyteacher Member Posts: 118
    edited November 2015

    I am just starting to massage the foob now. I was previously told be the doc to absolutely not do that, but on the last appointment he wanted me to. Got some guidance from the chiropractor today (I know, wrong type of medical professional but it was at least something to go on.)

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  • happyteacher
    happyteacher Member Posts: 118
    edited November 2015

    Thank you for the link! I have a lot of allergies and asthma anyway, so I will for sure bring this up. It would not be an issue at all to switch from my current med to singular.

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  • sas-schatzi
    sas-schatzi Member Posts: 19,603
    edited November 2015

    Ht, Didn't know self foob massage wasn't universal. Early on it was all day every day. Particularly the left. Not sure why. But even 6 years later, the left needs occasional work. Sometimes I had to massage so hard I worried something would break. Definitely in the early days I was keeping a capsule at bay.

    Pleas, ask your doc why he recommends now and not before? Curious.

    Special-Hi :). What's the deal with massage?


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  • macb04
    macb04 Member Posts: 1,433
    edited November 2015

    Hi, I am on the other asthma med, Accolate, for prevention of capsular contracture. I am actually on the generic of Accolate called Zafirlucast. I read a study about Zafirlucast and capsular contracture possibly being more effective than Singulair, because it has a broader method of action. I was having an increase in tightness in my implanted breast which is why I started on it. I take 4 ten milligram tabs twice per day. I think it is helping. It is going back to the way it was after I healed from the exchange where I kind of didn't really notice or feel my implant all the time.

    Did you have rads? I did, and unfortunately had rad fibrosis making things too tight, which was helped a lot by a combination of Hyperbaric Oxygen Therapy, multiple Fat Grafting Sessions an Pentoxifylline and Vitamin E. My skin is nearly normal now. It was terrible, like boot leather, thick and stiff. I had a large number of HBOT with my reconstruction surgeries, which has made a big difference. Which I had known about HBOT in the beginning, might have saved me a lot of grief.

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  • happyteacher
    happyteacher Member Posts: 118
    edited November 2015

    Just taking a moment to update the thread in case someone else reads it with similar issues. I had my appointment today. When I inquired about the singular, he responded that the studies were only anectdotel. It was Ok to try it since it would not hurt, but thus far at least research design has not controlled for mitigating variables. I did schedule surgury for March, and he will be replacing the implant, scoring the strattus, and I will take steroids for a period to keep inflammation at bay. Drains of course will be included. I had my chiropractor work on scar tissue above the implant/shoulder area. There is for sure a better range of motion and less pain now when using the arm (not that that pain was terrible, just noticable). I will be including that in the care from this point forward so long as the doc is good with it. I am so relieved that it appears that the insurance is covering all of the procedure from this past July. For some terrible reason, the denied coverage on parts of the surgury. Specifically they indicated that the removal of the implant part of the surgury wasn't covered due to it being a cosmetic procedure. Not sure how the heck a doctor could get in there to replace the implant, put strattus in, remove scar build up, and flush out the area without taking an implant out so I knew that I would appeal it. It appears I won't need to, but the doctor's office indicated that it was still waiting to be processed and on my end my EOB is indicating that it is now covered. Thank goodness.

    I wish everyone well and thank you again for your input- it really helped!

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