Specific surgeon consult questions for larger breasted women?

I am so sorry about your diagnosis and the dreadful time you are going through.

If you are going to have mastectomy surgery, and if you think you might wish for reconstruction later, having some excess skin left would probably make the reconstruction process much easier for you.

If you are going to have mastectomy surgery, and it is important to you to have the skin on your chest smoothed against your chest, tell your Surgeon so and have him or her agree to try to give you that result. You could shop for another Surgeon if you feel the need. You could have a Plastic Surgeon added to your Care Team. Understand that even the best efforts of the best Surgeons might not achieve the ideal "flatness" with a single surgery. The chest has complex curvature, and the skin to cover it has its own curvature and (often wider) area to be seamed up across the chest. The fit (or conformity) may not be perfect.

I had a second surgery to tidy up my chest. There are skin folds and "dog ears" under my arms, but that slack disappears when my arms are extended upward. The slack there is a non-problem for me.

You might ask to what depth tissues are to be removed in your particular surgery, so you will know better what to expect. My first mastectomy surgery took down to and including deep fascia of some chest muscles. My chest has some concavity from that. It is a non-problem for me.

Make sure you and your Surgeon have clear understanding and agreement about the expected condition of your chest after your surgery.

We have a very supportive "flat" bunch here, in our Living Without Reconstruction After A Mastectomy forum section. Some of us are "flat" by choice, some by medical necessity, and some are waiting to start their Reconstructions.

There are Surgeons specialized in what is called "Top Surgery." You might look at examples of their surgery results on the Internet.

About the pre-op tracer injections – Ask well ahead of that procedure that they do whatever they practicably and properly can to make that procedure tolerable for you. There is a Search feature over there to the left. You can use it to search in the Surgery Forum/Category for the word Tracer.

If you have bilateral mastectomy, you will need someone to help you and watch out for you, at least through the first few days and nights following your surgery. Your assistance person should not be a person having a substance abuse problem, nor a person in a close or (even likely) enabling relationship with any person having a substance abuse problem.

If you have mastectomy or bilateral mastectomy, you must take great care not to fall. You would be at more than the usual risk of falling because of the pain medicine. See, your chest would be injured already, and your chest area would feel badly injured already, and with your arm use so severely limited, you would be incapable of the usual reflexive arm motions to catch yourself or minimize the impact to any parts of your body. You must not fall! Have your Doctor order the Hospital to supply you with a walker to take home with you. You want an ordinary lightweight walker (not a rollator) having a pair of wheels at its front/leading feet. The hospital personnel should make any necessary adjustments to its height for you. Then use it whenever you are to be up and about.

I understand you are to have Chemo -- or a trial of a couple of rounds of it -- before your Surgery. I think (?) you will be advised (or warned) not to have blood pressure readings done from your arm on the side of your body in which your Chemo port is installed. [Check on that.]

Is it contemplated that the Chemo port will be left in place for some extended period beyond the discontinuation of your Chemo treatments? [Check on that.]

If you have Surgery before all your (planned or expected) Chemo has been done, would your Chemo port be left in place, or would it be removed for the Surgery and later replaced?

Some of your lymph nodes will be taken from the side of the diseased breast in connection with your Surgery. The loss of your lymph nodes there will put you at increased lifelong risk for Lymphedema in and around that nearest arm. After that Surgery, it is advisable never to have that arm (or extremity) used for blood pressure cuffs, blood draws, nor injections.

So I am wondering if your Chemo port installation should and could be done in the same side as will have some lymph nodes removed (the diseased side)? Or would that interfere with your Surgery? [Check on that.]

I went a different route--I am also allergic to three major antibiotic groups (penicillins, sulfas, quinolones including Cipro) and had been putting off getting a Medic Alert bracelet. So I got a Medic Alert plaque with rings on both sides (Lauren'sHope) and attached it to a faux Pandora stainless steel bracelet with lobster claw clasps at either end. So I combined my Medic Alert with charms reflecting my hobbies, life and travel. (I also have a real Pandora with geniune Pandora charms for the other wrist). My LE doc suggested swapping out the plaque with the red symbol for one with a pink symbol, since that's the color emergency personnel identify with LE. On the back are engraved my name, "Lymphedema R arm--no ndls/BP," "Algy PCN Sulfa Cipro" and two ICE (In Case of Emergency) contact phone #s--my landline and husband's cell phone. I got free pink bands from my BS and the hospital where I just had my colonoscopy. But the free bands look like hospital ID bands and once snapped on are impossible to remove (at least that's what I've found) except by being cut off.

BUT also put all your health and emergency contact info on a card in your wallet as well as the Health app in your smartphone.

You are welcome.