Tissue necrosis following prophylactic bilateral mastectomies.

Necrosis occurs after mastectomy because the skin has not formed a complete new blood supply with the underlying pectoral muscle, there are areas where blood supply is lacking and tissue/skin death occurs. During the mastectomy the breast tissue was removed, along with the blood vessels - so, new ones have to be made as the skin connects with the muscle. For some of us, this does not happen as well as for others. There are several approaches to improvement that include topical ointments like Silvadene, hyperbaric therapy, and diet modification to increase angiogenesis. Necrosis usually heals, but it can take some time, so don't be discouraged if you don't see rapid improvement. I would definitely advise not expanding until the situation is well in hand - fills two weeks after mastectomy are a bit rushed anyway. I would add protein to your diet to reach 100g daily and also supplement with bromelaine (found in pineapple also), zinc, and Arnica Montana - with the approval of your physicians, and speak to your plastic surgeon about using a topical ointment.

ladeedoc - you absolutely did nothing wrong - there is just an unlucky number of us that have this happen - up to 20%, and I am so happy that my response was helpful. Drawing on my experience and using it to help others is my silver lining! I had quite a bit of scattered necrosis bi-laterally, it did resolve and I have no scarring from it, so hang in there! You are sweet to include me in your novena, what a lovely thing to do - I so appreciate it! I just looked up St Agatha and saw that included in her patronage is breast cancer - very fitting!

maya - for me, it looked like black scabs, similar to what a bad scrape or healing wound looks like, but black and soft/oozy in some places. I would say google It but the photos online are pretty graphic. I had some that were tiny scabs along the incision lines, but also had some that were pea sized to dime sized scattered all around, and one that was the size of a 50 cent piece - that one was the rouble maker. Also, rather than tissue necrosis it is really skin necrosis because all of the tissue has been removed in the mastectomy. Mine developed fairly quickly - within a week or two, basically as long as it took the skin to die from lack of blood supply.

I had an enormous seroma in the left breast and massive tissue necrosis in the right breast after my BMX. It was horrible, like a wolf had torn a huge chunk of flesh out of my chest. I've been a nurse 39 years and I have rarely seen a wound so bad. My PS started me out packing both wounds, but quickly went to a wound vac on the right for 7 weeks. I was diagnosed with PTSD, as well, due to depression and feelings of mutilation. It took 16 weeks to fully heal. I am still working through the depression, but it is better than it was.

Thank God, I didn't hsve traditional reconstruction. I would have lost it all. As it is, I was left with terrible scars. I don't know if I will ever be over this BC experience.

Hi,

I have some necrosis too, also in my right breast... The oncologist didn't think mine was too concerning and said that it would be part of my "new normal." I am having my port removed in 10 days though, and I am looking forward to hearing what the plastic surgeon has to say.

KD

I am so sorry you are going through this! I had the same thing happen to me. I was also very depressed and felt like I was pedaling backwards. I remember sitting in my closet crying each morning I would get dressed. One person mentioned "chunks". I had two huge "crater" looking places. My plastic surgeon requested authorization from my insurance company to go in and fix the places. While waiting, the places filled in on their own - all of a sudden - about 8 weeks out of surgery. My surgery was in February and I still have te (mainly because of waiting on insurance).One thing I did do was increase my vitamin c intake with supplement I had read that your body gets rid of vitamin c that you don't need. As someone suggested above, I did make sure that I ate protein. I pray that you will heal in the very near future.

SpecialK, are you all over your necrosis problems? I haven't come on this forum for a while because I'm just so disgusted with my progress that I haven't even wanted to talk about it. So far I've had 3 revisions for necrosis and it looks like I might have to have another one. My implants are delayed of course. I had my BMX in February and if I'm LUCKY I'll get my implants in December.

I had necrosis on one nipple. It was really stressful. I used antibiotic ointment for like a month. One day my nipple actually fell off ( which was really weird). I kept using the ointment. Now I have a scar that looks mostly like a nipple. I think I was lucky really.

Well finally for the first time since my mastectomy I don't have any stitches or holes in me. Shortly after I wrote my last post, I found an old suture poking out of the dime-size area that wasn't healing and looked about to become necrotic. I got some tweezers and pulled on it until the knot was showing and removed the suture myself. A bunch of serum flowed out, then I bandaged it up and - miracle of miracles - by the next day I could see the area was healng. That is the same area where I've repeatedly had problems after revisions, and I think that sneaky suture was causing the trouble all along. I saw the plastic surgeon this morning and he said it looks like we might finally be out of the woods and he scheduled my exchange surgery for November 2. Knock on wood. He said if all goes well (knock on wood again) I can have my nipples done by the end of the year. Thank God!!!!! I do wish I didn't have these horizontal scars. Why would they do horizontal scars right in the middle of our boobs? Why not take a more aesthetic approach? PLUS one of my scars is quite slanted. Why on earth would they do that to a person?

I had a bilateral mastectomy with immediate reconstruction. I had the flap surgery. I too had areas of necrosis. A large area on right breast and a smaller one around the nipple area stitches. My surgery was feb 11. I was using an ointment and keeping it covered at ps direction. After about a month, he told me to stop using anything on it and leave uncovered. It finally fell off in early April. Hope this helps.