Mastectomy bulges under arms

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited February 2017

    I wonder if my issue is different or similar. I like having a term for it (dog ears). My dog ear (right side only) results from the surgeons re-using the same scar site for my drains over and over. I ended up with an adhesion that has an ear hanging down over it. It is between my implant and underarm and I cannot wear certain sleeveless things (sun dresses cut a certain way or tank tops). It is annoying, and never resolved even after all these years. It hasn't really changed with weight loss or gain. Not really interested in having any "elective" surgery, but an in office procedure to clip the adhesion and remove any excess tissue/fat might be workable. Anyone have any experience with adhesions?

  • Mariajoe312
    Mariajoe312 Member Posts: 4
    edited April 2017

    Drains and pain were horrifying

  • Mariangel43
    Mariangel43 Member Posts: 136
    edited April 2017

    Hi, ladies, I had my right Mx last june and the bulge appeared for the first time. When I received my expanders the PS made another incision and left the bulge ear just as the BS had left it. I thought the PS would correct the weird thing on the implant surgery but NOTHING. I am still disgusted and feel deceived because I thought PSs looked for perfection and beauty and I found out they are not. I think this is a money business. The PS told me it would cost me a special price ($3000) to have my right mx corrected from size B to size C (by lipo) instead of making a correct breast reduction (left breast from C to B).

    If you want something done, better check with the PS and make it clear with him/her that you want them out. Otherwise, they will follow you like the song says. Good luck to you all, recon or not!

  • Erica3681
    Erica3681 Member Posts: 1,916
    edited April 2017

    Mariangel43,

    I'm sorry this happened to you. One thing I've learned since starting my non-profit website, BreastFree.org, and hearing from thousands of women: It's extremely important to be very clear with your surgeon about what you want to achieve. For those of us who choose not to have reconstruction, that means a smooth chest with no extra skin and (if a bilateral mastectomy) symmetrical incisions. And also request that the surgeon try not to leave dog ears (lumps at the end of incisions). Breast surgeons are sometimes not as expert as plastic surgeons at achieving excellent cosmetic results. If you're left with dog ears, a plastic surgeon can usually correct this with a procedure that's a minor, outpatient surgery.

    In your case Mariangel, I would consult another plastic surgeon to see if you can get the reconstruction result you desire.


  • Likea
    Likea Member Posts: 4
    edited October 2017

    I have the same problem , skin indentation and a lot of flab and Folds, it looks hideous. they do that on purpose so you can go back, so they can get your money. Before surgery I ask the doctor if any loose skin left, is there any way you could cut off? He said no, i would have to come back and have it removed. Which did not make since at all, why couldn't he done it then when i was under anesthesia anyway. Scam! Its a way to have you come back for the money.


  • MTwoman
    MTwoman Member Posts: 2,704
    edited October 2017

    Likea, I am sorry that you are having that experience! I would gently and respectfully disagree. I do NOT believe that is what my surgeons were doing. I believe that they were doing the best they could. My adhesion came from their efforts to leave me with fewer scars (hence using the same spot for my drain tube after each of my 5 surgeries). I trusted and still trust my surgeons. My BS actually came in on the only day he had scheduled off right before Christmas, his scheduler tried to stop him, but he was determined. He came in early and was with me during my nuclear med plotting of my sentinel node, when he didn't have to be. That was not because I was paying him, that was over and above what was expected of a BS.

    And my PS worked to make sure that I wasn't going to get any additional bills, as my final surgery was at the end of the year. I had 2 years where I paid my max out of pocket to insurance (first surgery in Dec 2002 and last in Dec 2003). He included all the cost related to follow up appointments so I wouldn't get billed for anything from his office in the third calendar year - even though I had follow up appointments then.

    I'm sure there are surgeons, like every other profession, that are 'in it for the money', but that has not been my experience and I want to be clear that not all surgeons should be lumped together in your negative assessment of them.

  • ravzari
    ravzari Member Posts: 277
    edited October 2017

    ^ Agreed.

    I had dog ears at first as well, because my PS wanted to err on the side of caution and would rather have had to go in and remove extra skin/fat later than remove too much to start with and leave me with a longer healing time, potential for the incision sites popping open if I raised my arms too high, and leaving me with extra tight skin (especially when trying to reach overhead).

    I did end up with two pretty big dog ears and extra fat on the front that they removed in a revision surgery. I have a little extra skin now, but nothing that looks abnormal (it looks more like a dude's chest than anything, complete with pecs since I've been working out the last few months, as most men don't have totally flat chests). When I asked her why, she asked me to raise my arms then see if I could pinch any extra skin, which I couldn't; it was taut when my arms were raised, and she said if she removed much more that I'd have difficulties raising my arms fully over my head or would end up with wider scars as they stretched to allow me to easily reach fully over head.


    Some surgeons, even if you request flat, will still leave extra skin 'just in case' you change your mind to make reconstruction easier. While I understand doing that if a patient says she'll want delayed recon, surgeons who do it because they assume you'll change your mind kind of need to stop, especially since, even if their patient DOES change her mind, it's still possible to do reconstruction without having had extra skin left. It may take a little longer to get to the end result, but it's still a possibility.

  • Momine
    Momine Member Posts: 7,859
    edited October 2017

    Erica, my surgeon left small tufts of skin at the end of each scar near my sternum. Nothing awful, but weird-looking. He told me it was in case I wanted to reconstruct down the road, and that those tufts would help the PS "anchor" the recon. But he also told me that they should smooth out eventually and that if they didn't he would happily fix them. He turned out to be right, they did become smooth after about 6 months.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited November 2017

    My surgeon told my husband and I before surgery that he always removes the dog ear flaps, which I didn't even know about! As for the extra little bulges, I do have some that my surgeon is going to smooth out. He said he always leaves the incisions loose instead of tight so that the skin doesn't pull. I will be having drains, and I'm not looking forward to that but it will be worth it to be more comfortable.

  • Thea29
    Thea29 Member Posts: 1
    edited January 2018

    I had a double mastectomy and immediate reconstruction..I too have small bulges. They said they could take care of them at the final surgery coming up for an extra cost... Apparently insurance doesn't cover that it's not my boob... I was like whatever I know others include this in the final revision. I guess the final outcome isn't important to my surgeon. So I will live with them. I am not spending another dime on CANCER! My deductible twice is enough!🙄

  • Snickersmom
    Snickersmom Member Posts: 926
    edited January 2018

    I have Medicare plus a supplement and fortunately, all of my treatments, surgeries, etc. related to my BMX are covered. So I'll go ahead and have the surgery.

    Sorry your insurance doesn't cover this. They certainly should!!

  • Susaine
    Susaine Member Posts: 28
    edited January 2018

    Have you gone mastectomy partially or completely.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited January 2018

    i had bilateral. Full mastectomy.

  • hapi2bee
    hapi2bee Member Posts: 19
    edited April 2018

    Snickers, glad to hear that Medicare and your supplemental paid for your surgeries and treatments. I am BRCA1 positive, had ovarian cancer in 1996 and was diagnosed with DCIS left breast. Chose to have a bilateral mastectomy 3/26/2018 and haven't been sure whether insurance would cover the right breast removal. I too have Medicare and United health care supplemental (best I could get). Dealing with seroma and some healing issues right now - at 73 this isn't a lot of fun.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited May 2018

    I would think your insurance would cover it. I think it might sometimes depend on how your surgeon's office codes it as to whether or not they pay for it. I hope yours will. You are right - it's not a lot of fun but hey, we are alive to complain about it, right? This whole cancer thing positively sucks

  • hapi2bee
    hapi2bee Member Posts: 19
    edited August 2018

    Snickersmom:

    Everything went great with the insurances, worried about nothing, other than cancer. lol Saw my lady doctor about the "down in the dumps feelings" she said she would've been surprised if I didn't have those feelings since I went through a "loss" and amputation. Prescribed a mild anti-depressant and it seems to be working great. Am dealing with the smoke from forest fires now.

    We are safe but have fires burning in British Columbia and Eastern Washington, if the wind blows one way we get Canadian smoke if it blows another it comes across the mountains from Eastern Washington, am certainly praying for all those affected, either directly or indirectly.

    Thankful for your time, is nice to know there are others approximately the same age ( not that all feedback isn't welcome) it's just nice to know that that you can glean information from sources that have unfortunately experienced the same treatment, side effects etc.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited August 2018

    Hapi2bee - so glad your insurance came through for you! That's always a huge relief. Yes, there are lots of emotions you will have to deal with. I jumped right back into my "normal" life and then that came to a screeching halt about 6 months ago. I suddenly started falling apart on Sunday mornings, but it's only Sundays that bother me. So I am trying to work thru that with my therapist. Have to find my new "normal" now. My therapist says we all suffer from a form of PTSD and she thinks I haven't grieved yet over my loss/amputation. Ugh. This is so annoying, isn't it!!

    I have a niece who lives on a boat in Seattle, and she has sent pictures of the smoke over the mountains. I hope by now they have gotten them under control and you have gotten some rain. You stay safe out there.

    Thanks for letting me know you are okay and your insurance paid everything. Keep in touch!

    Ann

  • lisap62
    lisap62 Member Posts: 22
    edited September 2018

    snickersmom it is one thing that I learned is that the grieving process can be delayed but not denied. I !earned this not through my cancer, my mom's and her death nor my sister and her cancer and death, but my son's death. He died 12 years ago at 14 from a traffic accident. This cancer club is not something we all wanted to be in but found we were in like it or not. It is the same for anyone who has had a child die. Do the grieving work for as long as it takes. Acceptance does not mean we have to like it, but we all have to accept it. That means thinking about recurrence and what our new normal is. I can tell you that I will never like my son not in my life or cancer to be part of my new normal. Sending healing hugs and light to you and all. 💓

  • Snickersmom
    Snickersmom Member Posts: 926
    edited September 2018

    thank you Lisa. I am so sorry you lost your son. I have learned that the grieving process can tak a long time and doesn’t necessarily happen right away. I have finally been able to do a little writing so I know I’m on my way to my new normal. I guess it will just take me some time.

    Stay well and thank you for your support.

    Ann

  • Freudosa
    Freudosa Member Posts: 8
    edited November 2018

    They should cover the prophylactic removal of the other breast. I had this done, but like most others here, I’m dealing with the bulges and am really frustrated that it isn’t considered as part of removing the dog ears. I just had that done and looked here because I still felt the bulge (my bandages aren’t even off yet). This is extremely frustrating and I agree that we have to really idiot proof our discussions with the surgeons and confirm that we’re on the same page. I’m considering switching surgeons as I feel this was somewhat deceptive.



  • PollyOne
    PollyOne Member Posts: 21
    edited November 2018

    Thanks everyone for the information about the dog ears and also grieving. I'm still early days, and experiencing more pain and fatigue than expected so it's helpful to be reminded that there's healing and hope ahead 

  • Snickersmom
    Snickersmom Member Posts: 926
    edited November 2018

    Polly - none of us wants to be here but here we are, all sharing this awful disease and trying to find our new normal. You will be tired for a while, and you need to just listen to your body. When it tells you to take a rest, you need to do it, even if you don't want to. It has been 18 months since my BMX and I still want to nap every afternoon for a while. Sometimes I do, unless I am busy or out of the house. I do seem to be at a standstill with grieving. I have been so busy and we have had nonstop company so I just haven't had time to even think about me!! Maybe that's a good thing.

    Anyway, hang in there. We are all here for you whenever you need us so keep posting.

    Ann

  • PollyOne
    PollyOne Member Posts: 21
    edited November 2018

    Thanks snickersmom. One of my biggest concerns has been needing to return to work to keep a paycheck and insurance. I tried working from home on Tuesday and ended up really uncomfortable after just four hours. I realized it's still way too early so am taking time off through the end of next week to deal with multiple appointments. I'm really hoping pt will help with the pain, but disappointed to learn that losing weight won't necessarily help the bulge under my arm. It's so sensitive when I bump it right now. Hoping the sensitiv at least will get better?

  • Snickersmom
    Snickersmom Member Posts: 926
    edited November 2018

    I really had no pain at all but I think it depends on the person. I went home the next morning and I was stiff but that was it. I was able to start my lymphodema exercises after a week and when I had my pre-op, my surgeon sent me to their lymphodema specialist in case I needed her. But I didn't have any problems so just did the exercises at home and that was enough to loosen up the cordon under my arms. That was really the most uncomfortable thing and even now I can sometimes feel my arms tightening up where the cording is. So I just raise my arms up over my head and then sway back and forth from side to side, and that seems to be enough to loosen it up.

    Did your surgeon take the stupid dog flap? I never even knew what that was but my surgeon apparently told my husband about them and removed them. He said he always does. So I don't have any bulges under my arms. The only sensitivity I have is under my right arm when I shave. Thankfully, there's very little hair now (yippee!) so it's not much of a problem.

    It will get better, but if you are really miserable, talk to your surgeon. Maybe he/she can do something for you so that you feel better. Just remember - give yourself time, both physically and emotionally. It's a hard road but we are tougher than we think.

    We are always here for you.

    Hugs,

    Ann

  • Aussie-Cat
    Aussie-Cat Member Posts: 5,168
    edited November 2018

    I had my bilateral mastectomy in June and I don't have bulges under my arms but along with the fat ridges that I knew would be left, the bits in the centre are somewhat pointy. I'm hoping I can have revision surgery for that some time but since it's a public hospital, I haven't even seen my actual surgeon since surgery! I thought I would be sent a letter about an appointment with a breast surgeon there (usually a registrar) but I haven't been sent it yet. There have been so many things about my treatment that I've been disappointed about so I'm not expecting much but I hope they will do revision surgery and do it better than the first time around. I don't have insurance so I can't go to a private hospital.

  • PollyOne
    PollyOne Member Posts: 21
    edited November 2018

    Snickersmom and Aussie-Cat,

    I do have the flap under my arm and the sensitivity is very slowly getting better. The physical therapist suggested putting a sock in my bra to apply pressure but haven't tried it yet. Although my surgeon said it's hard to know how much to take out, the physical therapist thought maybe he left enough tissue so I could have reconstruction later. I've been very clear that I was not interested in any more surgeries. That's why I opted for the MX in the first place.

    My BS told me right after surgery that I would have some pain but those areas would be less numb after I recovered. It's proving to be true, there's only a small area around the incision that's numb, and it's somewhat disconcerting. I'm actively working on coming to terms with the final result of my choice. It could be so much worse.

    I ended up being off work six weeks instead of four, and went back to work half days on Monday. Apparently I'm still recovering because my chest was very sore by the end of the day Tuesday. I'm somewhat resigned to this taking as long as it takes but hoping to still have a job when I'm through recovering from the surgery.

    I'm trying to focus on what I can do. What I do have. What each day does hold, although it's still a bit of a roller coaster of emotions, especially when I go somewhere I haven't been since the surgery.
  • Aussie-Cat
    Aussie-Cat Member Posts: 5,168
    edited November 2018

    PollyOne, I hope your surgeon didn't leave extra tissue intentionally after you were clear you didn't want reconstruction. Sometimes there can be left over tissue that can't be helped but sometimes they do it intentionally and it can be hard to tell unless they say so clearly. I agree that the numbness is disconcerting but mine wore off quite quickly. I'm sorry that your chest was sore at the end of Tuesday. I hope it settles down soon. I agree it can be a roller coaster of emotions and there are sometimes things that are unexpected.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited November 2018

    Polly and Aussie - I didn't have big bulges under my arms because my BS took off the dog flaps. I don't even remember the conversation about that, but apparently he did tell us before my surgery that he always removes them. I was clear about not wanting recon but because your arms are not straight down at your sides during surgery, they have to leave a little looseness so that the incisions don't pull. I had a BMX, so I have two incisions from under my armpits to breastbone. He did leave about 1-1/2 inches between incisions at my breastbone. Under each armpit I do have a small bump at the beginning of the incision. I did have scar revision surgery in February of this year to smooth out a few lumps but mainly to get rid of a pocket of lymph fluid that developed after my BMX. Now I am much more comfortable, especially if I want to wear a bra,which isn't very often!!

    Emotionally, this is a very scary roller-coaster ride. I thought once I got rid of the girls, I would bounce back and continue my life as before. Ha!! That just doesn't happen. I actually did recover very quickly and was doing just about everything and then 7 months after my BMX, I had a major meltdown and stayed in bed the entire day crying, which is very unlike me. That's when my oncologist told me I needed help. So I have been going for therapy since then. I know it has helped (along with the Zoloft) but I think I am still stuck in the grieving process. This cancer thing really sucks.

    Hang in there, Polly. We are here and it's going to get easier.

    Ann

  • Aussie-Cat
    Aussie-Cat Member Posts: 5,168
    edited November 2018

    Snickersmom, thank you for sharing more of your story. I thought I would bounce back faster from having surgery too because I don't have cancer and it was prophylactic. I didn't realise that I would be left with lumps in the centre of my chest and not even have the opportunity to talk about it with my surgeon at all since surgery. Having ongoing nerve pain and taking Lyrica has also limited me being able to move on. I am already having therapy and I'm planning to go back on to St John's wort again soon, which I had to stop before my surgery. The fact that my identical twin sister has stage 4 breast cancer spread to her liver and has a limited time to live has also made this process much more awful. Even though I think I'll need revision surgery, I am very relieved that the mastectomies are over.

  • Snickersmom
    Snickersmom Member Posts: 926
    edited November 2018

    Aussie, I feel so bad for your twin sister and I hope you two are able to spend quality time together. That can't be easy for either of you. I did have cancer - a very small tumor but nonetheless, a malignant tumor. I do still have residual nerve pain now and then but I have been taking Gabapentin for nerve damage in my back and leg, so I think that might help with the nerve pain in my chest. It has gotten less and less the farther away from surgery I get. Since you just had your BMX in June of this year, you should see a difference and a lessening of nerve issues, I would think, as more time passes. As for the little lumps on my chest, I probably wouldn't have had scar revision surgery had it not been for the fluid lump under my arm. It was right where any armhole hit me, no matter what I wore. Now I feel much better.

    Give yourself time. You are dealing with a lot right now and you shouldn't feel frustrated because you haven't been able to move on. I'm not sure any of us truly do move on, we just accept it and try to move forward. I'm still looking for my new normal and somedays, I think I have found it. Other days, I wake up thinking wow, what a horrible nightmare I'm stuck in. Stick with your therapy and ask for something if you need it. I've been on Zoloft since my diagnosis. And I actually had a "friend" say "gee, you're still taking that stuff?" when I was about 6 months out. I wish I had known a smartass comeback but I think I was too stunned to say anything. Now I would definitely have something to say. And it wouldn't be very nice.

    I spent 6 lovely wonderful weeks in Australia 4 years ago and I loved every single minute of it. I was visiting a dear friend who lived in a Sydney suburb. She took me to Uluru and the Outback for a week, Cairns to snorkel on the GBR, and on a cruise from Sydney to Tassie for a week, with the rest of the spent in Sydney. I would love to come back and see more!

    Hang in there and keep talking. It's good therapy, even long-distance like this.

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