Skin flap necrosis
I am so sad and upset. I had a DMX with expander placement one week ago.
I went to the plastic surgeon today and I may be having skin flap necrosis. My surgeon says I should not worry as worst case scenario is that I have to go back in the OR and he will have to cut away the dead skin basically. And then we move forward after that heals.
I have cried so much. I don’t understand all this or why it isn’t taking. Please if anyone has gone though this and can give me advice or encouragement I would appreciate it so much.
I am just devastated. I have been though so much with chemo, and surgery and all of this.
Yes I am crying 😢
Comments
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@LOJ - I'm so sorry you are going through this. I have no advice but want you to know I am thinking of you. Please keep us posted on how you are feeling. It's okay to cry and we are here for you. (((Hugs)))
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LoverofJesus - Cry away! You are entitled! I don't have any experience with this situation and I hope someone else who has, chimes in. Just want to let you know that I am praying for you and that this situation be resolved so that you can begin to heal comletely!
Best wishes!
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Hi Lover, I didn't have the exact experience but similar. I had a BMX and tissue expanders and 8 months later I had implants under the muscle. I had a lot of distortion so we decided to put them above the muscle and during surgery it was discovered my right implant had ruptured. On day 5 after the surgery i was admitted to the hospital for a breast infection. I was in the hospital for 8 days on IV antibiotics. I was released and 3 days later the infection increased and I had to have my implant removed. It's been 6 months and I have an appointment next week to discuss what's next. My PS is worried I won't be able to go the traditional implant route and may need DIEP flap surgery. I understand your frustration and feeling overwhelmed. Unfortunately, these things happen. I hope yours is an easy fix and you feel better soonand heal well.
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Are your expanders under or over the muscle? how much was added to your expanders, if any? How tight is your skin across the expander? I had skin and nipple sparing BMX with immediate expander placement under the muscle. I had an extremely thorough mastectomy, unusually thin pectoral muscles and thin skin. This combination is a perfect storm for necrosis, which occurs when there is not enough blood flow to the skin and it dies. The inadequate blood flow can be caused by factors such as mine, but I have also seen it if too much is added to the expander, in essence pressing the skin too firmly and not allowing the tiny new vessels to be established. I had a moderate amount of necrosis on the cancer breast, but much more on the non-cancer side. I had several tries to revise the skin (what your doc is indicating would be done in the OR) but the expander ultimately had to be removed. Once that was done the skin healed. I had chemo after surgery, so once that was complete I had the expander replaced. Several things you might consider doing - make sure you are eating enough protein - aim for 100g a day to aid in healing. Silvadene cream, by Rx, on the necrotic areas. Taking some supplemental zinc, arnica montana, and bromelaine. Ask about getting some hyperbaric chamber time to provide intensified oxygen to help with healing. I know this is challenging, but hang in there.
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LOJ,
I have not faced the same challenges that you have but in the course of bc tx a lot of things might not go as smoothly as hoped. For instance, most things went smoothly for me except … I had an extraordinary rare complication from port installation. My lung was nicked which resulted in a kind of slow leal over the course of two weeks until I had a full blown pneumothorax, a life threatening emergency! I spent a week in the hospital and a month at home with a portable chest tube. So I didn’t have several smaller things go wrong, I just had one big life threatening problem!
I’m sure many of us could share “war” stories with you but in this complex world of bc treatment problems we have to understand that sh*t happens. Take good care.
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"My surgeon says I should not worry as worst case scenario is that I have to go back in the OR and he will have to cut away the dead skin basically. And then we move forward after that heals."
This was my experience. It was a same day surgery, no big deal really.
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ok ladies, who can tell me if you developed skin necrosis, did you have to take your expanders out??? And if you did have the have them out why? Was it because of infection or something else?
Thank you Naya for your input. If they have to trim
It I’m ok with that. I just do not want to lose my expanders.
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Hi ladies. I had Debridement yesterday. The PS said all went well, to keep my arms to my side, and limit arm movements. I did come out with a tube. He said because he wanted to be cautious. So here we are.
He got mad and reprimanded me for calling after I go home from surgery to ask non emergency questions. I called about it 7 pm. Just had some questions to be answered because he didn’t tell my husband much of anything after surgery. I realize he is in a hurry and had a lot of surgeries yesterday. But should I not be able so ask questions?
Anyway I guess I’ll not do that again. It’s like he does not like me to ask anything. And with the Holidays coming up and. It seeing him again until Monday I just needed to ask a few things.
I’m doing ok I guess he has me all bandaged up so I have not a clue until Monday which seems like a long time to go without checking a fresh surgery. But lord knows I’m not calling him to ask about that. I’m sorry this is more of a vent than anything. I trust the Ps he is one of the best. But his communication skills stink.
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