Anyone had Nipple sparring mastectomy ?

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piano
piano Member Posts: 9
edited August 2017 in Breast Reconstruction

Hello,

I am meeting new surgeon this week and very anxious and still have not decided on saving nipple or not. My previous surgeon who left practice suggested me nipple sparring. My oncologist does not really like this fairly new method to save nipples. She said to just have BMX without saving nipples. I honestly don't know how I would feel like looking at myself after mastectomy but I want to go with best decision I can make. I had lumpectomy on my left breast in June. They have not done node biopsy at that time. With BMX, they will. I am also afraid about that too. I guess if node is positive, no reconstruction would be pursued right? Just too scare to meet up with new DR and this is final appt before surgery.

Anyone went through with nipple sparring mastectomy? How and why you made that decision.

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  • Lula73
    Lula73 Member Posts: 1,824
    edited August 2017

    I did. They won't know for sure if they can spare the nipple til they get in there and send some tissue from under the nipple for quick pathology. So you won't know for sure what you'll have when you wake up.

    I like my nipples, how they look, size and how they are positioned (so does my DH) and even though they no longer have sensation, they do still respond to touch and cold. So we decided keep them if possible and if not I'd get the 3D tattoos from Vinnie Meyers. I opted for DIEP flap natural tissue recon immediately following the BMX (all done in the same surgery). Other than being slightly larger, my breasts look just like the originals. And my tummy is flat! They'll reduce the size at stage 2 and work on symmetry and scars then too (although it's all looking VERY good as is). I would do the nipple sparing with natural tissue recon again in a skinny minute.

    Whether or not you continue with recon during same surgery asBMX over node status may have to do with the type of recon you're having. With TEs and implants probably delayed recon if rads are necessary. With natural tissue recon you can go either way: continue the course and wake up with breasts or opt to delay. What type of recon are you planning? Or have you decided yet?

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  • beach2beach
    beach2beach Member Posts: 996
    edited August 2017

    I did also. I did not even think that was an option but my surgeon is a breast oncologist surgeon and she had told me she thought it could be done for me. Just as Lula said they really don't know until they examine it under the microscope. I had a BMX and had sentinel node biopsy on both sides also. From what I read and heard it depends also where the cancer is located. I had asked my surgeon if it was safe and she said very. I had not met with an Oncologist beforehand so I don't know what he/she would have said.

    Due to the fact that I'm rather thin, doing DIEP or any other type was not option for me according to my PS nor would tissue expanders because of tight skin. I went right to an immediate implant. Anyway, while I was a bit concerned about keeping the nipples, (but then I again I had/have ILC) I researched and most everything I read said in the hands of a skilled surgeon, it is very safe. Studies done that I had read did not show any increased risk of recurrence. I'd read up on it, it may make you feel better, ask more questions to your surgeon.

    I told my ps/surgeon if they could do it, do it, if for some reason they couldn't even if the implants wouldn't work, to just sew me up and call it a day. In the end, I'm happy with the way it looks.

    What was the reasoning behind your Oncologist's view? I'm new to this all, but also with DCIS it is stage 0, no invasion, I'd think chance of anything is even less.

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  • Herculesmulligan
    Herculesmulligan Member Posts: 175
    edited August 2017

    I had bilateral nipple sparing mastectomy in February. I'm glad they could save the nipples because it does give a more natural appearance but I've gone to a lot of trouble since to cover them under clothes. They always seem to be poking through my shirt. So it wouldn't be the end f the world if they hadn't been able to spare them.

    One note.... 4 days out from the surgery my right nipple turned black and I thought I'd have to lose it anyway. But eventually the necrotic tissue sloughed off and there was healthy pink underneath.

    Oh one other note...., I have no feeling whatsoever in my nipples. I don't know if anyone does.

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  • beach2beach
    beach2beach Member Posts: 996
    edited August 2017

    Hercules,

    I have to laugh, that's me too. They poke through everything! I'm only 15 days out and not supposed to wear a bra, it's been so hot here and I've been trying to wear tops that are a little loose but it's like my tee's and tanks etc, cling right to them.

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  • Legomaster225
    Legomaster225 Member Posts: 672
    edited August 2017

    I had nipple soaring also. I think they look great. My breasts look pretty much just like they did before. I am pretty small ( 5' 6" usually 115 lbs but currently 102). I went direct to above the muscle implant so my reconstruction was essentially complete at the time of my BMX. It will depend on the location of your tumor and pathology testing in surgery as to whether this will work for you. I am very happy with the results 8 weeks out.

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  • EastcoastTS
    EastcoastTS Member Posts: 864
    edited August 2017

    Add me to the nipple-sparing list. I had great surgeon at MD Anderson and was not worried about saving them, IF they could. I did have issue with left (cancer side) breast/nipple but it cleared up after a couple of weeks. Antibiotics but nipple had necrosis. They look good. It's amazing actually that the surgeons can do this...although I have no sensation. But I have not mourned that too much because I was expecting it.

    I have Exchange surgery in two weeks. I'm petite, too, and had no options for DIEP, etc.

    One suggestion for erect nipple issue is silicon nipple covers. That said, I used those before BMX all the time. I was small and I could go braless with these but the normal ones did not "fit" over my TEs. Round baseballs. Someone recommended the ones you use when you nurse. Those are great -- and larger! They stick on, last forever. ;)


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  • muska
    muska Member Posts: 1,195
    edited August 2017

    I had nipple sparing with expanders four years ago. Like the others have said, they check the tissue near the nipple during surgery and only leave the nipple if there is no cancer near to nipple. Also, even though they discovered positive lymph nodes during surgery they proceeded with reconstruction and I am glad they did. I now have good looking breasts even after radiation.

    Overall, I think that is a great surgery and I recommend it to everyone who has the option to get this surgery. Just make sure you are working with a surgeon who is experienced with this type of surgery.

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  • Sunrisefish
    Sunrisefish Member Posts: 67
    edited August 2017

    Hi ladies, I also had nipple sparing direct implants over the muscle on May 17th. I even had previous radiation in 2015. My results have been great. No complications. Breast size is similar to before. My radiated nipple is numb and has slow erectile resoonse, but my non radiated nipple has normal erectile response and does have feeling, just a little more tender than before. It's a great way to go, I was prepared to lose my nipples, but am so glad I have them!

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  • buffyjc
    buffyjc Member Posts: 61
    edited August 2017

    Hi ladies! I, too, had nipple sparing (and skin sparing) SMX of my right breast in April. I'm pleased with the appearance and will have exchange surgery next month. I don't have the "always erect nipple" that some of you have mentioned. In fact, mine is the exact opposite...always smooth unless it's touched! LOL! My DCIS was not near my nipple (mine was upper outer and lower outer quadrants) and my final pathology confirmed this. As already noted in several previous posts, I would also recommend as long as your medical team feels it's a safe option for you.

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  • RunsWithTurtles
    RunsWithTurtles Member Posts: 2
    edited August 2017

    I had a nipple sparing mastectomy with same day silicone implant placement. I have very small breasts (36B barely) so my surgeon said the same-day implant was possible. It went very well, although since I'm 41 and have breastfed 3 children my "new" breast is much perkier than my "old" one, but wearing a bra you can't tell. I'm very happy with my choice. If you decide for nipple sparing make sure you go to a surgeon who has a lot of experience with this technique. Feel free to message me if you have any questions

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