Reconstruction Following Mastectomy - Boston, MA

Decided to go through with reconstruction...

Decided to go through with reconstruction following mastectomy. Due to some pre existing medical issues, I was not a candidate for TRAM flap, so went with the expander and silicone implant on one side with breast reduction and lift on my healthy breast. The transition has been very difficult for me, mostly the cosmetic " look" of my surgical breast. I went from a DDD naturally to a C or small D. The skin is quite thin, rippling with some pitting, but I was told this was because there is no fat under the skin, so my PS will attempt fat grafting in the next couple of months. The shape is disappointing, very flat, feels a but hard, no protrusion, but maybe the fat grafting will help. But I have to understand it is a process, but I will be honest, so far....I'm disappointed. I should have asked more questions about kinds of implants, shape of them, the feel of them, silicone vs saline, and my doctors expected outcome post op. But at the time, I was still trying to get over the diagnosis of having cancer. I am not having the nipple reconstruction. Frankly, I can't feel anything on my mastectomy side anyway, and I'm not planning on nursing any more babies, so what use do I have for a nipple? Just one more thing I have to keep covered.

2 months post op, not happy

So it has been two months since my reconstruction on one side and lift and reduction on the other. I am not happy with what it looks like, but some have told me it takes time for a good result, sooooo, I'm asking for comments, good or bad. Should I be happy or is this not normal?

Inspiration

This sun reflexion photo was taken by my brother the morning of my surgery last week. It stayed on the wall for about 20 minutes, then faded away? Awesome, right?

Implant tight?

I am three months post implant on the left following mastectomy, three weeks post fat injection to correct rippling, folding and shape. My implant is still having trouble dropping, is very tight, and my scar is becoming ropey or thick. The chest muscle is very tight, especially under my left arm and the outer area of the Implant despite ROM and stretching excercise. It is becoming very uncomfortable. I did finally find a PT who specializes in post reconstruction and breast cancer, but she does not take insurance and is too expensive for me as I have not been able to return to work yet. Any suggestions?

Diet

Has anyone come across a good book that tells breast cancer patients what food is good and what to avoid?

8 weeks post fat injection

Hey all. Thought I would update. I'm 8 weeks post revision of implant surgery due to implant shifting, large fat pocket on top of breast and lots if pitting and wrinkling. I underwent fat injection to the breast and liposuction of the large fat pad, ( see original photos ). The pitting and divots and wrinkling are much improved, although I have noticed over the past week or so, some pitting in the middle inner aspect is returning a bit, but I was warned this may happen as usually only 50 % of the fat will be absorbed by the breast. I will probably have to have another fat injection in a couple of months and from time to time, but I am so much happier with the appearance. The breast continues to be very tight though, so I consulted a PT who taught me some stretching excercises to do a few times a day to help stretch the entire chest muscle. Even being a Nurse, I never realized how large our chest muscle is and that you need different kinds of stretching to loosen the entire muscle. One thing that helps a lot was laying on my back to the edge of the bd. allow your arms to go over the top of your head and fall behind you while holding a one pound weight. This stretches the inner, or cleavage area, of the muscle stretch out. This has helped a lot. I am developing som very ropey like scarring over my scars which the PT told me can be helped with cross friction massage? I just have to find someone who can do this as a lot of places do not. Going back to work next week!?!? After three months off, my stamina is still not up to par, but as a Hospice Nurse, right now I can. Make my own hours, so that will help. So, for all who asked, here are some photos to compare with my originals. Notice the missing fat pad, ( I think it moved to my butt ), and the fuller, more protruded breast. Wrinkling and pitting is also better. Hang in there friends. If there is anyone in the south shore of Boston area out there, we should chat privately. ( I think private emails are allowed). I have found the support from this site so helpful and comforting and I found a great support facility in this area to share. Take care of yourselves and eachother.

Important help for scarring and tattooing

I almost forgot!
Last week on the Doctors, they did a segment on a new group that began an organization, http://p-ink.org, that helps women with Breast cancer who may be considering tattooing to cover surgical scars etc. these great ladies match you up with tattoo artist that match your profile, ( what kind of tattoo you are looking to get ) with Tatoo artist who will either tatoo you it at minimal cost or sometimes for free!
They are hoping to Travel through the states this summer to offer these services
To women who are interested or considering tatooing over breast scars, ( or are interested in donating money or time to help women who are considering tattooing , ) . I contacted them and have been talking to the woman who started it and I have offers my help in time and Nursing care if needed. I think it is a great organization and worth checking out. They do have a face book page which, if you " like " will send you out updates on where and when they will be around. You may be able to google p.-ink on The Doctors and see the piece. It gave me a lot of hope as , because of an abnormal scarring condition my family has, my scars look terrible and I am considering getting one tattooed. Just an FYI. Have a good weekend!
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whoever did your reduction did a fabulous job. ive seen photos of women who still have a large breast and they give them this tiny areola and nipple that looks silly- yours looks so natural..hope with the fat grafting you can get the other side to match...I listen to trilife health broadcasts with dr roger billica and he days methylparabens are a known carcinogen yet they still put it in lots of things even makeup..and now the are brominating vegetable oils to preserve drinks and most all commercial breads and lining inside canned goods with this toxic bromine..and we wonder why our country has such a high cancer rate
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Thanks for your recent update Nanamama. You're really making some serious progress. Let us know how it goes when you return to work. Try to take it slowly if you can. Glad you can take a break from surgeries before the next fat injection.

A new member, by the name of lafordj might be interested. If you get a chance ladies, feel free to check in with her. She may also be interested in the tattoo information!
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Alternative medicine has been my saving grace too...I wish I would have had a team on board at my diagnosis. I regularly see a naturopath, an acupuncturist, and my physical therapist (who is also an intuitive healer). Along with counseling, these wise healers work on my whole body (physical, emotional, mental, and spiritual).
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I know this whole bc experience would have been much harder without my alternative drs. My Naturopath sent a blood test to a lab in England that took a look at my genes to see why I got cancer. The results came back that "methylparaben attached to Caspase 8 gene". This is a gene responsible for life, death, reproduction of genes. Methylparaben has been found in biopsys of lots of types of cancer: breast, prostate, and intestional. I have been taking suppliments that help to leach this out of my body. Also after my diagnosis, before surgery, I was in a car accident. My stress level skyrocketed. My Chiropractor used a de-stressing technique and by the time I went i to surgery I was not stressed. Chiropractor also helped with the frozen shoulder I had after 2 surgeries for infection in my lymph nodes. My wish is that MDs and all alternatives would work in harmony in health care.
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What was the blood test that your ND sent to England? I'm so interested!
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A retired forensic scientist started a small lab to look at what was causing living people to get sick. Quite often it is environmental contaminants that attach to the genes and there are suppliments that I had never heard of that will leach these out of the body. The lab is so small that he limits his practice to England and select countries in Europe. My Chiropractor is friends with the guy and he is the only USA practitioner (that he knows of) that he accepts bloodwork from. My Chiropractor is in Portland, OR. If you would like contact info we probably should do this by email. I also have the name of the guy in England and his phone number.
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On the paperwork I have it is called "DNA ADDUCTS (genomic DNA from leucocytes)"
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yes, I would love the info. Handy that I'm in the Portland area! email me ***** Thank you so much for sharing!
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I have always relied on alternative medicine providers - Naturopaths and Chiropractors. Cancer requires 3 things to grow: sugar, acidity and inflammation. So eliminate sugar and heavy carbs such as pasta and potatoes, junk foods. Drink lots of water. There are books out. One that I was just given is "Crazy Sexy Cancer Survivor" by Kris Carr.
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Ask your PS for a referral to a physical therapist. Mine just referred me immediately after the surgery and insurance had no problem with paying. The one I had was in the same building as the hospital and has physical therapy for all needs.
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What did the PT do for you? Has it helped?
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Mainly exercises that are designed to help strengthen and stretch the muscles around the chest and arms. It was helpful. I also have been going to a chiropractor that has helped a lot with a frozen shoulder situation that happened after surgery for infection in my lymph nodes. For helping with skin softness I have been using coconut oil that is used for cooking. I was told to stay away from the preservative methylparaben and the other parabens that are found in lotions. My PT actually recommended the coconut oil and it works. The muscles in my chest object to all of this also. It reminds me of being engorged with milk from my nursing days. The PS and PT said that they do eventually relax. There are some products that help scaring, ask the PS.
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I did notice one area on my breast that has become very dry and scaley almost? I met with a PT last week who reviewed several excercises that will help stretch the chest muscles that I had not been stretching. It has loosened up a bit, but hopefully will get better. But I understand what you mean about feeling engorged like. The breast feels tight and hard? But my PS assures me this will get better in time. I did notice that some of the fat injections I had done are beginning to thin out, which I was told would happen. My PS wanted to do a nipple reconstruction soon, but knowing I will need another procedure in a few months for another fat injection, I think I wil wait and have it all done at once. Four surgeries in five months is a bit more than I can deal with right now. I need to give my body a rest! Thanks for all of your help.
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We are in this together. I have benefited from all of you on this site. I have had 4 surgeries also over 4 months. I see my PS the end of this month and will be scheduled for another one. It will be my first fat injections and switching out my implants to larger ones so that I look like I have breasts. I know at some point I will say enough is enough and not buy my PS another new car.
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Wow, that's a very cool reflection photo taken by your brother. Very symbolic and yes, awesome!
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Beth. I panicked for a moment thinking people would think my brother took my breast photos!!! Now I know you mean the sun reflection!! Too funny. But, he and his wife, have been incredibly supportive. I had another reconstructive surgery 6 days ago to help fill out the pitting and folding of skin of my left breast. I will post some photos. It looks much better, doesnt feel any more real, but it looks a lot better which makes me feel better. But i now understand, and have to accept, it is a process; a slow one; but a process. Take care
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Oh yes, I meant the sun reflection photo. Too funny but sorry if I alarmed you! ;) 

I wish the recent surgery made your breast feel more real. Maybe more healing time will help? In the meantime, I'm glad the pitting and folding of skin is less noticeable. Looking forward to your photos. Best wishes!
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I also went for the expander implant because I was so afraid of the stories I heard about necrosis and other complications with the tissue flap reconstruction. Now I'm not so sure whether I made the right choice or not after all. The expanded "breast" (I don't even want to call it a breast, I still feel like I have only one breast, and one balloon in my bra) is hard, tight, numb and I'm disappointed with the shape. I have a long scar right across the breast from the mastectomy, and the scar tissue did not give in as much as the PS had hoped for, so the shape of the breast is kind of "flat" from the side. I know I should go back to the PS or het another opinion, but I'm still in the process of finding the energy to get it done. All the best to you! You are not alone.
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Selenadee: Don't give up. If you read my last couple of posts, I was exactly where you are! The expander is foreign. Mine was as high as my left collar bone when fully filled, ( at 800 cc ), hard and numb. When I had the implant done, it too, was flat and numb and not at all even. It was very difficult to deal with, especially when it began to show pitting, dimpling and a large fold of skin over the top. I was sooo depressed and doubting my choice. But with the support of my PS and the great ladies on this site, I hung in there. 6 days ago, I underwent another surgery using fat injections to " plump up" if you will, the mastectomy breast. It is much fuller, more even and round and has some protrusion like a normal breast. The scar is still there, which MAY fade in time. It still feels foreign though, numb, kind of like it did when the expander was in. It just doesn't feel right or mine? It is also quite hard, but again, all my " girls" tell me with time, it will drop and loosen up. I will post some more photos today after my Oncology appointment. One of the most depressing places EVAH. As we say here in Boston. But I have decided to wear all tye dye today. My daughter makes the most fabulous the dye items in the world! Give the others something fun to look at other than the floor or the one fish that clings to life in that friggin tank!. But hang in there, check out what I shared, we sound much the same! When you need a hug; find one. And if you can't, wrap your arms around yourself, that's why God made them so long !!!
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Thank you so much for your supportive words! Sometimes I do feel a bit alone with these problems. I have supportive friends, and a husband who all think I look great, and are happy that I am now cancer free, but none of them have experienced what we cancer survivors have. You were actually so encouraging, that I suddenly got an energy boost, picked up the phone, and called my doctor about a referral to the plastic surgeon. She wanted to wait until my next scan and mammogram in april, but then she will send me to see the ps. So happy! (I live in Finland, and my social security covers for reconstructional surgery after cancer, that's why I have to get a referral from my oncologist first. Then the surgery is almost for free, you only pay for your stay in the hospital and some other small payments) Maybe I will get this process to the end after all! I hate the feeling of the saline in the expander implant, it feels so uncomfortable when bending forwards. So I really hope to get a silicone implant instead. And I also hope there is something the ps can do about the symmetry. All the best to you!
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Nanmama: I am new to this as I have just had a bilateral mastectomy 5 weeks ago. I have the tissue expanders in and they are just SO tight! I see that you said that your implants are tight as well. Did you get the saline implants or silicone ones? I was looking forward to that step so my chest would feel softer.
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Clarey I got silicone implant. According to my docs, they feel more realistic, last longer, and look better. But I don't have much to compare them with. One thing I learned is that, in my case anyway, they removed so much breast tissue that when they put the implant in, ( after having the expanders in for 12 weeks or so) they put it under my muscle, and because I had no real breast fat or tissue left, there is basically my muscle and just the skin over it. That is why I had so much folding and pitting of the skin and why the breast was flat rather than having any roundness or protrusion. But I had fat grafts two weeks ago and the appearance does look better, but my docs say it will probably have to be repeated again over the next year as only half of the fat grafts usually take? But it still feels very tight, the muscle is tight, so I do PT and stretching at home. It also feels very firm, numb and just not quite mine if that makes sense. The expanders are just aweful, but necessary. I keep saying it feels like someone shoved a grapefruit in there and covered it with skin because I have no real feeling there. It feels kind if like a had novacaine injected in there, but I am hoping it will get better. But I have realized it is a process, a loooonnnngggg process and I am not very patient! Most Nurses aren't when it comes to ourselves being sick. My PS did show me one implant, I believe it was silicone, that was shaped much like a natural breast, tear drop almost shape vs. the flatness of a traditional implant. It did feel softer than the silicone too. But she said that this kind of implant goes over the muscle, right under the skin, and moves around a lot? According to her, lots of woman get this because the shape is better, but end up having it switched to the traditional implant because it moves around so much. Look into what they have to offer, ask for the pros and cons of all, and keep checking with women on the site. They are a huge valuable source of information. Good luck.
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Thanks for your reply. I just had my last expansion and I have to say it is by far the worst one get. I guess it is because the expanders are at their capacity. In 4 weeks I will get my implants and I chose silicone that is a teardrop shape but thanks to you I have to find out where my PS is going to place it....I don't want it just under the skin if it's going to move around. I'd rather just so this implant surgery one time. Thanks for your valuable info.
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I had the transflap 20 years ago and it was great. I was back to work in 3 weeks. I had a total of 6 surgeries and 8 chemos. This time is with the expander and after 3 months my incision has not healed, still draining and it just plain hurts. It looks awful and I am so tired. This makes no sense. Before 30 limp nodes removed and 3rd stage cancer in 13 nodes. This time stage 1. Not in nodes, found after 3 years of mammograms, ultra sounds, every 3 to 6 months. It was in my milk ducts. I am allergic to metal and told PS before the surgery. She was not concerned. It really itches at the port and 2 weeks ago, the incision had to be redone with 25 stitches. Will find out tomorrow if healed enough to remove stitches. Just today, looked down at my shirt while in grocery store and front of shirt was wet ( soaked). The bandage was not an hour old. If not better soon, I am going to have expander removed and just let it heal. Hope you feel better soon!
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Good luck to you as well. You have been through so much and you deserve some peace and healing! I hope your more recent surgery heals soon...
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