Revision time! It's not quite flat enough.

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ravzari
ravzari Member Posts: 277
edited February 2017 in Living Without Reconstruction After a Mastectomy

I should preface this with it was something I kind of figured I'd have to have for a few reasons:

1) I had large, saggy breasts.

2) I'm overweight.

Those two things together heighten the risk for dog ears, left over fat pockets, and weird lumps of fat that didn't seem like they'd present a cosmetic issue at the time. They also make it harder to guess right the first time as to what's 'too much fat' to leave behind to avoid having concave spots. My BMX was prophylactic so I didn't have to worry about margins, they just needed to get all the actual breast tissue out—and I had a decent amount of fat to work with so she could try to make sure I didn't have concave spots.

I did not have reconstruction other than to have my nipples re-grafted on; the only other instruction was to, "please not leave me concave if it's possible."

What I have at the moment:

- Left side: What looks like a tiny AA pancake breast due to extra fatty tissue. When I stand in a normal position it looks almost like it's frowning with the scar. Needs to have the excess fat removed. In t-shirts it's pretty noticeable and looks like a tiny deflated boob, which I don't really like. For awhile, I figured it was just swelling, but the swelling has mostly disappeared now and there is a lot of fatty tissue left on that side.

- Right side: Small dog ear, and on the outer edge of what was my breast there are two lumps of fatty tissue. The center is flat. Under shirts that one looks weird and it is noticeable.

- Because neither side is truly flat, the nipples remain slightly stretched in an oval shape. If I pull the area flat (which I can do either with a hand or by stretching my arms up in a Y shape), they go round like they should.

I sent a message to my PS' office as my 6 month followup is January 9th and let her know what the issues were and that I wanted to get revisions discussed and scheduled at that appointment. I also let them know that I need the area to be as flat as possible and didn't need/want the appearance of small breasts because I plan to tattoo over the scars in late 2017, so the area needs to be flat as a board by that time.

It was super pleasing that they got back to me within 15 minutes of sending the message to schedule a call; I chatted with the nurse and we went over everything, she asked a few clarifying questions, asked if I could send pictures so the doctor had an idea prior of what was bothering me (I sent those yesterday afternoon and got confirmation that they were received), and she just wanted to make sure everything was clear and in my file so we didn't forget to go over anything next month.

Not really worried about a second potential surgery, as I doubt everything I want fixed can be done under local, just mostly want to get the ball going on it as the sooner it gets done the less I'll have to push back the scar covering tattoo appointment.

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  • Icietla
    Icietla Member Posts: 1,265
    edited December 2016

    Hi ravzari. I hope they make it all perfectly to your satisfaction. Do you have your tattoo design planned already? We like to see those.

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  • ravzari
    ravzari Member Posts: 277
    edited December 2016

    I do; I've actually wanted a big Romulan crest (TNG style) across my chest but figured it'd never happen due to having breasts that kept the area from being suitable for a large, flat tattoo.

    Now that they're not there anymore, I can have it done. Plan is for winter 2017.

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  • ravzari
    ravzari Member Posts: 277
    edited January 2017

    Preauth for the revision was sent in today.

    PS agreed that I need it, as it looks like I have two lumpy 'bra rolls' for breasts and they're both different sizes. I also showed her some areas of puckering still on the scar, and that the fat is so uneven on the right side that it makes the nipple fold in half; no arguments from her as she could see I wasn't just being ultra-picky. Had a lot of pictures taken to go over later, and since it's about 100% certain the revision will be authorized they're making plans for the surgery already.

    I also showed her that the weird, lumpy shapes (including the crease of the folded nipple!) are visible under a regular t-shirt, which she also found to be unacceptable (thankfully, because I sure found it unacceptable!).

    Her preliminary though is that the big 'bra roll' on the left and the dog ear on the right can be excised and hopefully we can get the rest of the excess fat out with liposuction instead of having to open the whole area back up.

    Hopefully, insurance doesn't give me a hassle with this and gets back with an authorization in a couple of weeks so I can get the revision out of the way.

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  • ravzari
    ravzari Member Posts: 277
    edited January 2017

    Revision was done today. It was mostly liposuction with, as far as I know right now, the only excision being on the dog ear.

    I did a lot of reading up on lipo, even though most of it is to abdomen/flanks, just to know what to expect pain wise and man, they were not kidding.

    I feel like I either way overdid it on the lifting or someone gave me a good, size 16 boot sized kick to the chest!

    There isn't much for external bruising, it's all internal and I can't say I find it painful (but, to be fair, I have a super high pain threshold), but it sure is something you're aware of.

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  • Luna52
    Luna52 Member Posts: 147
    edited January 2017

    Glad you were able to get your revision. I'll be looking into that, probably this summer. At a minimum I want to get rid of my dog ear.

    Was yours done under local, in-office... or at the hospital?

    Speedy recovery!

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  • ravzari
    ravzari Member Posts: 277
    edited January 2017

    Luna52

    Had my revision done on 1/26 which was super short notice (by that I mean they called me on 1/24 and asked if I could do surgery on 1/26!), but they had a couple augmentation cases cancel last second!

    Since I needed quite a bit of lipo, mine was done under general and took about 1 1/2 hours to complete the liposuction, dog ear excision, and fixing the big bra roll on the left.

    My surgery was at 9am and I was home by 1pm and feeling pretty okay, just a little tired. It was done in an outpatient surgery facility.

    I'm still really swollen, but I can already tell it'll be flatter when things settle down. That could take up to 6 months, and I might feel sore/bruised for 3 months! Back in the compression vest for another 6-8 weeks as well, but I don't mind, as the compression helps keep the pain down.This time I got steri-strips and internal dissolvable stitches; the strips should fall off on their own in about 3 weeks but if they're still there, they'll get removed at my 3 week followup.

    I do have to say that lipo has been more uncomfortable than the initial mastectomy (even counting the drains). I feel like someone kicked me super hard in the chest and left a massive bruise. A massive bruise is kind of what I DO have under the surface, but the skin on top looks fine.

    I took Thursday off (obviously) and Friday, and plan to work from home next week just because I'm pretty sore. It's not bad enough to require narcotics, but it is kind of uncomfortable--that huge bruise feeling and all.


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  • Icietla
    Icietla Member Posts: 1,265
    edited February 2017

    So glad for you, ravzari. I would rather be flatter and not dog-eared, but I am satisfied with all the improvement, and my chest is still (figuratively) moaning No More Surgery! And with each successive surgery -- I had four last year -- it took me longer to come out from under the anesthesia effects. I am about seven months past having had mine fixed. I will post some pictures pretty soon on one of these Flat threads.

    I looked up the design type you contemplate -- Wow! I especially like it with so much chartreuse coloring.

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  • ravzari
    ravzari Member Posts: 277
    edited February 2017

    Icietla

    This revision looks like it did the trick; even swollen an bruised (lipo is something! I couldn't imagine ever doing it on a larger area!) everything appears flat. After the initial BMX my left side always looked 'bigger' like there was a pec/deflated breast there, and the dog ear on the right was evident from the time the drains came out, as was the 'lumpy' appearance of that former breast.

    When I had the BMX I came out of anesthesia pretty easy, this time they told me I took a swing (like with my fists!) at the plastic surgeon while she was trying to put the post-op binder on me! I was reasonably mortified, even though I don't remember it, and did message her an apology; she laughed and said it was all right, and that people do all sorts of weird things when waking up sometimes.


    I am, however, already tired of having to wear the binder. Alas, I'm only 1 week out from surgery, so I have several weeks of that left.

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  • Lisey
    Lisey Member Posts: 1,053
    edited February 2017

    I"m getting revision surgery in April for some small puckers in the inside part of the incisions. He said I'd be very tight afterwards and I'm praying they don't open up. Yikes.. scary stuff but I want to be perfectly flat and these puckers are detracting from the clean smooth appearance of my chest. I hope it works out.

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  • ravzari
    ravzari Member Posts: 277
    edited February 2017

    Lisey we discussed the minor scar puckering I have in some areas near the outer edges as well and, in my case, decided to leave it alone as it was pretty flat, especially if my arms were up or out, and tightening up the scar might leave me with pain or tightness when it came to raising my arms or stretching them out (not to mention the possibility of the incision opening up during healing), which I didn't want.

    I found the puckering I had on the scar line looked pretty bad for about the first 6 months then started to smooth out a bit, so I'm hoping the extended scar areas (dog ear excision and removal of the 'bra roll' on the left) will do the same. If not, well, those two incisions are basically under my arms at this point, so I'm not too fussed about it.

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  • ravzari
    ravzari Member Posts: 277
    edited February 2017

    I got the OK at 1 1/2 weeks to go to lighter, sports bra compression (mostly for the sides where the larger incisions are) after chatting with my PS over the hospital's messaging system and letting her know that the tighter compression was REALLY irritating the incisions--making them red, swollen, and itchy, but not painful or hot so no infection.

    When I switched to the awful velcro tube top I got with the original mastectomy those problems stopped, so she OK'd me to wear either that or a sports bra.

    One problem: I got rid of ALL of my bras after my mastectomy! Figured I'd never need them again, but, man, the velcro tube top was pretty uncomfortable too due to the bunchy velcro.

    Ordered an Under Armor compression sports bra a size smaller than I'd normally wear (when I had the DD's I'd have worn a large or XL, so I went with a medium), paid extra for 1 day delivery and, aside from it being an adventure to get on since it's technically a bit too small, it fits nicely and is actually comfortable. Comfortable is a nice change from the last couple weeks. :D


    It feels...foreign to have a bra on again though, I've been not wearing one for so long, and it reminds me of how much I disliked bras anyway! Plus, having one on makes my brain assume, "Hey, you got boobs again!" and I keep expecting to find them there!

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