Lost tissue expander due to skin necrosis. Now what?
I am new to the world of breast cancer. I was recently diagnosed and had a bilateral mastectomy. Now I have lost the right tissue expander due to skin necrosis. Poor blood flow, lack of oxygen to edges of incisions. Had to have right one removed completely. I have been on antibiotics constantly since mastectomy. Continuing to run a low grade fever. PS called it a setback but that we would recover. We are waiting for skin that is left to heal before anything else will be done. In the meantime what do I do? I can't even face opening my bra drawer much less looking at myself in the mirror. My granddaughter's first birthday is in 2 weeks. First very public outing with friends and family. Very depressed.
Comments
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I had this happen as well. I had an area of necrosis that would not heal with the expander under it, so it was removed after several surgical tries to save it, because I needed to move on to chemo and needed to be healed to do so. The expander was out for seven months during chemo and then a month prior to surgery, then was replaced without any issues. The expander was put in place without any fill, that incision was allowed to heal sufficiently, and then was very slowly filled until it matched the right side, then they were both filled simultaneously until I reached the desired size, and I exchanged with no problems. During the time period the expander was out I just wore a soft bra (Coobie or Genie) and used the cotton insert that came with my mastectomy camisole and placed the correct amount of the fluffy stuffing inside to match my right expander size. As the left expander caught up to the right one I used less of the stuffing. I certainly hope that your PS is right, this is a setback, and that you can successfully have the expander replaced after your skin has healed.
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Thank you for the kind words SpecialK. I'm glad to hear that eventually you had a good outcome. It gives me hope. I will look for the soft bras you mentioned. I have the same mastectomy camisole. I like wearing it because it's soft. I can't stand the mastectomy bras they keep putting on me after surgery
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I completely understand. I did not have reconstruction but I had a lot of tissue necrosis on the right side. After the surgeon debrided the area it looked like a wolf had taken a bite out of my chest. It was horrible. And when I say horrible understand that I have been a nurse 39 years. I have seen a lot of horrible but this took the cake. It was so hard for me to do dressing changes and my husband couldn't even look at it.
At first my surgeon put a wound VAC on my wound. That helped healing a lot, a whole lot. At this point the wound has shrunk considerably, but it will be another four to six weeks before the wound is completely healed.
Best of luck to you. I hope you can eventually get back to reconstruction and not have any complications.
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labweb - I couldn't tolerate the mastectomy bras, the Velcro tore my skin, but I was actually allergic to the mastectomy camisole. I am also allergic to the hospital linens - have to order specially treated ones prior to each surgery. Lol! They probably hate me in pre-op - I'm a complicated patient - allergic to many antibiotics, and a number of anti-emetics are ineffective. I always feel so bad, but they seem to roll with it.
For both of you - something to consider is hyperbaric chamber therapy for non-healing areas. It can make a real difference, I have not done it personally as my later healing issues would not have been solved in that way, but I know others here have with great success - I just needed to have any foreign materials removed and I healed with no issues - that includes expander, allograft and implant. Another thing to mention and give some thought to is to increase protein consumption to 100g daily, and consider some supplementation with bromelaine and zinc, and use of Silvadene ointment.
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Hi labweb, I am so sorry to hear about your healing/reconstruction woes. I get that it is really distressing to feel like you don't have a comfortable bra to wear, that makes you feel ok about how you look. I hated having the fake boob, I was always asking my kids if I looked symmetrical. I was just always nervous that somehow it would shift/fall out. Never fell out, but it did shift, causing me to feel embarrassed a couple of times, although I don't think anyone noticed but me. Glad to not worry about that anymore with my implant. So I have had many, many reconstruction setbacks, especially because of poor tissue healing due to very bad rad damage. I have considerable unfortunate experience with poor blood flow issuesimpacting healing. I figured out for myself that I needed to improve blood flow if I wanted my reconstruction surgeries to suceed. Hyperbaric Oxygen Therapy (HBOT )improves blood flow to areas of poor tissue integrity due to 100%Oxygen flow in an increased pressure chamber. Most HBOT, is at 2 to 2.5 Atmospheres, compared to 1 Atmosphere at sea level. I don't know if you could get insurance to approve it, but it might help alot. Most doctors know very little about it. Looked up, there is a Wound Care place not that far from you in Huntsville. They say that they help poorly healing surgical wounds on their site. Might be worth a visit if you can get some doctor to refer you.
http://www.ncbi.nlm.nih.gov/pubmed/24851552
The effect of hyperbaric oxygen on compromised grafts and flaps -http://www.huntsvillehospital.org/wound-care-clinic
Good Luck. It will get better, hang in there.
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Hi labweb. Im so sorry about your healing issues. I lost a right flap after enduring 3 surgeries, (the first one of which lasted 24 hours), and then dealing with a horrific 2 weeks of packing a very large open wound and ended up having to have the entire thing removed. I felt so hopeless and depressed too. I found a stretchy bra at Target that's fairly comfortable, and I bought a lot of scarves. We are warriors!
Best of luck to you... it will get better!
Beth
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