May 2016 Surgeries
Comments
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so I know to expect loss of feeling. Is this throughout the entire skin on the breast
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Tsoebbin - I'm sorry about your path report! Did they do the sentinel mode biopsy too?
I just had my SN injection. They had me worried this time when they kept telling me that it was going to pinch and hurt (last time I barely felt it) but it was the same this time and really nothing to get worked up about. I was also obsessing about the fact that I forgot to massage my breast last time. I asked them about it this time and was told that massaging makes no difference. Needless worrying on my end!
We are off to the hotel and will try to find a nice spot for dinner. I'm already exhausted. Planning an early night.
SpecidlK and monicammariah - I hope you are on the road to recovery ((HUGS)) -
Grandma 3x - no they did not do the SNB with my lumpectomy last week. They will when they do the BMX. Is that what your dye injetion was for today?
Sending you very positive thoughts for your surgery!
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Tsoebbin- yes, it was a radioactive tracer that was injected. I thought they would also localize it today so that the surgeons would be able to find the right node tomorrow, but the technician said the tracer lasts quite a while and that the surgeons would just use a gamma probe as they did last time (when I had it done the same day).
Thank you for sending positive thoughts! -
Hi All,
I am new to this board so here is my story. I left my job on 2/29/16 to travel and enjoy life. That same day I received the diagnosis of breast cancer. It has taken nearly 2 months but on 5/25/16 I will have a left unilateral mastectomy. It has taken so long because the day before I was originally scheduled for a lumpectomy in March, my pre-op chest X-ray showed a shadow. A stat CT scan revealed nodules on my lungs. Of course the immediate assumption was metastatic breast cancer, so the next couple weeks were taken up with a bone scan, a PET scan and a lung biopsy. Fortunately, the biopsy was not cancer (they aren't sure what it is so another CT scan in September will see if it's changed) and everything else was normal. We actually celebrated, "It's only breast cancer! Yeah!" A lumpectomy on 4/28 came back with positive margins so due to the size and scattered nature of my cancer, I opted for a mastectomy. Thank you every one for sharing your stories. It's good to know what to expect. -
Lorice, welcome. I'm so sorry about everything you've been through, but can relate to celebrating "only breast cancer" - it's amazing what a perspective shift this will have on your life, isn't it? Best of luck with your upcoming surgery. Your days of travel and enjoying life are sill ahead of you!
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Welcome Lorice, I am just ahead of you for a masectomy 5/24. Sending virtual hugs, and yes it's amazing what we now view as good news.
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Home from surgery - all went well. I am another NSBMX - but lost my right nip today - almost five years after my original surgery. If I had it to do over I probably wouldn't have spared them - but it is 20/20 hindsight. I was happy to wake up and see them after BMX - made me feel better.
I did not have my port removed today. I had a PET done a week ago which showed some abnormalities bi-Lat chest. Couldn't have an MRI because I still had the expander, so it will be done soon. PS did a couple of biopsies this morning since she was in there - just to be safe, but they suspect this was inflammation and surgical changes. My last PET was several years ago when I was finishing Herceptin. I have had 7 additional surgeries since then.
I'm not too uncomfortable, in bed propped up - no recliner. I don't usually take pain meds - after that degree of surgical intervention I don't have feeling but feeling a bit tight andhave soreness from the fat grafting, so am taking some and feel ok
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SpecialK, I'm happy to hear all went well! With all that you have been thru you deserve a well earned break from all the surgeries. I hope this is the last one for you! Keeping my fingers crossed and saying prayers for you!
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I'm home from the hospital for my BMX. Had a great surgical team and both my husband and I are very pleased with the care we received. The PS had told me beforehand that he hoped to put 200cc of saline into the expander during the surgery, but realized he could confidently put in 450cc. So I'm feeling a little extra sore in my armpit areas from the stretching, but still mostly satisfied with my experience. The only quirky thing - I woke with a scratched and irritated eye that wouldn't stop tearing. For only the 3rd time in his career, the anesthesiologist scratched his patient's cornea while taping the eyes shut for surgery. He felt terrible! So I've added eye ointment to my medicine regimen, but I forgave him because he gave me great anti nausea meds yesterday.
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Wonderful news myToyStory! I hope all continues to go well for you! 450ccs, wow! 👍
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SpecialK, thanks for updating and glad you're doing OK!
myToyStory2, thanks for the update from you too! Glad you were pleased with your surgical team, but so sorry about they eye!That's crazy.
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I am at the hospital, feeling pretty calm. Ready to get the show on the road!
SpecialK and MyToySrory2 - glad to hear you are doing ok! I didn't know about the eye thing - I guess they tape them shut to keep them from drying out? -
Sending positive thoughts for you! Glad you arre having a morning surgery, so it would be done sooner. Did you have a nice dinner last night? I know I should not be talking about food or drinks this morning, sorry and wish you the best.
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I am so sorry to read that some of you are experiencing nipple necrosis and loss. So many factors can affect nipple survival. Good vascularization must be maintained intra- and post-operatively. A skilled PS isn't sufficient - you need a skilled BS to provide the PS with healthy, vascularized skin flaps. The nipples require sufficient blood supply from the skin flaps and dermal vascular plexus to survive. Mastectomies with peri-areolar incisions have the greatest risk of experiencing nipple necrosis. IMF incisions have the lowest risk, but are best suited for smaller breasts, as this incision type makes it challenging to reach the upper quadrants in large breasts, prolonging the mastectomy and potentially increasing risk to skin flaps and nipples. Lateral incisions also have lower risk than do peri-areolar. Rads and even neo-adjuvant chemo both increase the risk of nipple necrosis, as do co-morbidities, such as diabetes, or having a very high BMI, and overstretching the skin with too large a fill or implant during surgury. Ask your surgeons about your risk factors and what % of their patients experience nipple necrosis and loss. Some of this is attributable to the patient group they service, but a lot of it is surgical skill and the ability to identify, intervene and rectify potential complications when they encounter them to maximize positive outcomes.
I had NSBMX over a year ago and despite being a challenging case because of my ultra low body fat and thin skin, my nipples were healthy and pink from the get go. I also had had a previous lx with a peri-areolar incision 2 years prior with the same BS and he was satisfied that it did not pose an increased risk for nipple necrosis on that breast. I chose my surgeons carefully and had an amazing outcome. Wishing you all optimal outcomes, physically, emotionally and mentally.
Papillon1, I had direct to implant recon with my BMX, so if you have any questions, post or pm me. I have 295cc anatomicals, which are a B on me. Drains removed morning of the 4th day. I am in Canada and spent 1 night in hospital, which was more than enough for me.
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downdog, I find you information very interesting! The thing I'm curious about is the breast size and ptosis. I've read repeatedly that nipple sparing is best for smaller breasts. I'm a 36DD with what I think are very saggy breasts. To me, those aren't small breasts. My breast surgeon gave me the option of nipple sparing. I haven't met with the plastic surgeon yet. I just can't decide if I want to take the risk of seeing if it works, or go with the sure bet and just have them removed.
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husker fan - nipple sparing would be ideal from the surgeons point of view for small breasts as you lose that small area skin when you lose the nipple, so there is less skin / volume to make the new breast with.
I am a B cup so pretty average. My surgeon wanted me to keep the nipples because the final result would be "better" and possibly easier for him to make the result look good, but I don't want to (because of the tiny extra risk of cancer / breast cells associated with keeping them, for me any risk is too much, I am having a prophylactic op, so for me personally I would hate to go through all of this for the nipple to have brought cancer along with it..). PS honestly told me that if I choose to lose the nipples then my expectations of the final result should be lower. But that's fine - this isn't a boob job...
But from what I have read the choice of to keep them is usuallyan aesthetic / cancer risk choice and not because they may not take...
I want an increase in size but my PS will have to work well to get that out of my skin.. I may have fat transfer later, we'll see.
Thanks downdog - it's good to hear from someone with the same op. How long was your recovery? When did you see the breasts? Not sure if I should expect them bound up for ages?
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Huskerfan, I no longer keep current with research and new developments and techniques, so can't advise you on what's available now. The challenge with NS on large, ptotic breasts is positioning of the nipple. I do know that NOLA (Frank DellaCroce & Scott Sullivan) have been successful and published on NSM with large breasts and autogolous flap recon. Their procedure involved doing a breast lift 3 months later and correcting nipple placement. The key thing is to find a PS who is experienced and has a solid track record with the procedure you require on patients with your characteristics to maximize your chances of a great aesthetic outcome. It's well and good that your BS is flexible on a NS procedure, but unless you have a PS you are confident can produce nice looking reconstructed breasts with implants having good nipple placement, it's just going to cause you heartache and additional surgeries. A 36DD will be more successful as a NSBMX than a woman with a larger ribcage and DDs, so it's doable, you just need to find the right PS. Projection is generally less with implants than native breasts, particularly at high ccs. You may wish to ask whippetmom (aka the breast whisperer) for her advice on sizing for your particulars on the breast implant 101 thread.
Papillon, if you have good skin elasticity, your PS should be able to up you a size to a C, especially if you keep the areolas, and if not, depending on how large yours are. I saw my recon the day of surgery. I had a zip up surgical bra and every shift change, the nurses and docs all checked. PSs all have their own techniques and post-op instructions. I had tegaderm on my breasts that was removed with the drains. I wore the surgical bra 24/7 for 4 weeks. I had two and they were really comfortable (postopbra.com). I am very fit and was walking laps of the hospital the night of surgery. I have 6 pack abs and sat up easily in bed when I woke up from surgery. Walking and lower body yoga for 2 weeks, then legs and arms and running at 4 weeks (PS didn't want me in an underwire bra until then). All restrictions came off at 4 weeks for exercise, weights and activities other than no waterskiing that summer or lying on stomach until 12 weeks. Generally, the fitter, healthier and younger you are, the faster you will bounce back. Fitness and health will trump age.
Good luck to everyone.
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I'm taking a little poll, both here and on the April, 2016 board:
How many of you May ladies have had your drains removed, how long after surgery were they removed, and what was the average 24-hour output when they came out?
I still have one drain at nearly five weeks post-op that is averaging around 20 CCs of output in 24 hours and I swear I'm going to cut a B!%@# if it doesn't come out at my next appointment tomorrow. Just curious when others are getting theirs removed and what the output was when they were removed.
Thanks, all. -
Question for those that have been through it, how will you know the nerve block works? If it fails you wake up in pain?
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valstim I think greykat was exceptional - if I understood correctly she didn't have pain killers and used nerve blocks instead - which happened to fail. Most people have pain killing drugs to hide the pain, not nerve blocks. Or maybe you are doing the same
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raven4mi, I still have both of my drains 2 weeks post-op. My PS told me at my last appt that he won't remove them before 3 weeks. They are driving me nuts...so uncomfortable. I hope you get your removed tomorrow.
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hey GreyKat you've been quiet today! Hope your post op appointment went ok
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The anesthesiologist says she is doing the nerve block in addition to pain killers afterwards. Not instead of pain medicine. She said so it's not such a shock and so unmanageable when I first wake up. . I asked that question.
I had a nerve block for another major abdominal surgery and it helped post op but I still got pain meds as needed so I didn't think much of it at the time. But now I'm wondering if it fails , what happens?
My surgery involves taking most lymph nodes, etc. Maybe that's why?
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I was hoping to hear from GreyKat too. I hope all is well with her and everyone else that has been so quiet today??
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Raven4mi-I got both my drains out 10 days after surgery. BS originally told me once a drain put out less than 30cc two days in a row, I could have out. Hit that over the weekend, and was under 20cc a day by the time Monday rolled around. Still is tender to lay on sides with drains out, but felt wonderful to be able to shower without them. I was lucky, and was about to shower with drains in 48 hours after surgery.
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I hope I get as lucky as you sensitive and my drains come out within 10 days of surgery!
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hi everyone. Had to be rehospitalized with neurological problems from all this surgery and meds. Haven't been able to read or write or walk. One drain out already stopped all pain meds after four days. You'll have better luck. Can't leave hospital until can walk unassisted again. Not your typical ex
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gosh Greykat,that sounds terrible. Get well!!
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valstim - I wonder if that's routine practice? I won't meet my Anaesthetist until the big day. I don't think I will even ask.. Just trust they know what they are doing. It'll be fine...(mantra ..) Xx
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