Redness on breast 3 months post-exchange
HI Ladies,
I'm over a hear post-BMX but reconstruction has been less than perfect. To make a long story a bit shorter, my implant on the right side has caused issues. First an infection, resulting in starting over with TE and a new implant a few months after that. That same breast then developed capsular contracture and the implant was again replaced 3 months ago. Since my last surgery, I've been diligent about doing massage to try to reduce risk for CC again and it seems to be working so far. However, this weekend as I was getting ready to get in the shower I noticed that the same breast has patches of redness and warmish (normally the implants cause my foobs to be are cool to the touch). The redness has not gotten worse or better since I first spotted it yesterday but past problems seem to cause "worst case scenario" thinking. First of all, is it even possible to get an infection so long after exchange? Do you think it's OK to just keep an eye on it before calling the doc (don't want to over-react)? Any idea what might be causing the redness if not infection?
Thanks in advance for any thoughts or guidance.
Hugs to all!
Comments
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marketing - yes, it is possible to have an infection anytime - any foreign body (implant of any kind, joint replacement, stent, etc.) can be affected by a systemic infection, or a localized one. If I were in your shoes I might try to see whether this is a skin problem first, and maybe try a steroidal topical ointment and see if this helps at all. Draw a circle around the redness with a marker, then apply the ointment, and see if the circled area gets larger or smaller. If that doesn't work, you might try an antifungal ointment using the same process. Or, if you are really concerned see if you can text a photo to your PS and ask about either of these approaches first. Good luck - keeping fingers crossed, you know that I know you are worried.
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Thank you SpecialK!! Always appreciate your wisdom. Really good advice regarding drawing the circle and trying a topical ointment. I'll definitely do that this evening and see how it goes.
Hope you're feeling and doing well!!
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Let me know what happens! Hoping it is just a skin thing that happens to be in an anxiety provoking location. I am doing just fine, thanks for asking! I had my final surgery last Nov. Had my port removed after 6 years (just saw my MO last Thurs., and when I told him that he high-fived me, lol! Love him!), left nipple removed - had the right one removed in May, and lipo in that weird mushy spot beneath both underarms, so that is smoother, and a little FG for good measure. I am ALL DONE - yay!
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That's such great news!! I'm really happy for you. My last surgery included lipo on the underarms (one side) but still mushier than I'd like. Great it worked well for you!
My redness is no better or worse this morning so just hoping it disappears on its own. No itching or other typical skin reaction but perhaps it can be dermatologic without itching? Anyway, I'm not panicking.
Here is another question for you or anyone who might reading this thread. After my last surgery and with the implant he put in, the nipple on my right breast is now sitting close to my armpit -- really far from it's proper place. I had nipple sparing so I know I'm lucky to have them at all but wondering if a PS can move the nipple to its proper place or does that create too much risk that I'd lose it altogether.
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Mine ended up in vastly different places from each other - zero symmetry. When I had to downsize the implant on the right I asked my PS if she could take the right nipple in a classical mastectomy incision and place the smaller implant that way and use that incision to make the skin envelope smaller. She was glad I suggested that option. I was somehow less bothered by having one nip than I was by the asymmetry. When I had this last surgery she removed the left one - we were unsure if she could do it because that is the problem area that has spawned so many of my recon issues. Removal was successful with no new crises, so I am now the same on both sides - just not how I originally pictured it when I was offered nipple sparing BMX 6 years ago, lol! The nipple could possibly be moved for you - this is what some PS do with larger breasted women who want a nipple sparing surgery with smaller breasts - the nipple is relocated. You are correct though - there are some odds that it won't survive because you are separating it from the existing blood supply and asking it to form one again. I would ask your PS what their experience is with this, and if they have none or little, ask for a referral to someone who does if it is something you really want. I totally get how disconcerting it is for it not to be where you want and expect it to be. Mine were perfect after the BMX, the symmetry was disrupted by the sheer number of procedures on the left side, and the TE in/out/in, implant in/out, another TE in/out, another implant in, combined with half a dozen skin excisions.
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You've got it exactly. I was originally totally symmetrical but I guess all the surgeries (especially on that right side) have created this problem. I'll talk to my surgeon at my next visit about his experience with this. I know that PSs who do a lot of general breast reductions often have to move the nipple. As he does so much, I'd hope he has the experience. But yes, I'll definitely ask him. I'm growing increasingly frustrated with this nipple -- which actually pops out the side of my sports bra if i'm not careful. I just don't want to invite more problems...
Do you mind having your nips removed? Will you do any kind of reconstruction to have them "remade"?
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I actually am far less bothered by having no nips than I was by the asymmetry, and once the right side came off I had no problem with removing the left side either - it was actually the one that was most displaced. I will not have nipples "built" because that would be too invasive and dangerous in the left side area, but would like 3D tattoos. Due to the thinness on the left side my PS wanted to see what healing looked like at least six months from the last surgery before she would give permission to do it, so that decision can't be made until the summer at the earliest. It usually takes a while to get in to have the tattoos done so it might be another year before I can have it done, if at all. If I can do it that would be great, but at this point I really would not mind if they stay the way they are, and I am risk averse at this point. I would not want a nip tattoo to be the reason I lose the left side recon again. My recon is all about having two similar objects in my chest at the same time, it is not about aesthetics after this much surgery - they will never look good, so tattoos will be a bit of a "lipstick on a pig" situation.
How is the red area?
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Your logic is sound -- as always. It's sometimes tough to know what will ultimately make one "happy" post-reconstruction. I know I don't want to open up a can of worms with my nipple issue or create undue risk but I also am growing increasingly unhappy with how it looks. Finding that place where you are comfortable in your own skin and not looking too hard in the mirror at the problems is much harder than I would have expected. I admire that you seem to have gotten there and I'm very happy for you.
Redness is a tad better -- more pale pink. I think I overreacted and it will go away on its own. I'll admit to a lot of paranoia with my right side. I just don't trust it!
Hugs!
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