Upcoming Mastectomy with Reconstruction - Conyers, GA

I will be having a reconstruction after mastectomy...

I will be having a reconstruction after mastectomy. Today I went to a different PS and she suggested that I do a two step reconstruction...tissue expanders, then silicone implants. I originally wanted saline but the doctor recommended the other. I didn't qualify for the DIEP or TRAM flap due to previous abdominal surgeries and a hernia I have present. It was suggested that I do only implant based reconstruction at the time. I will be getting 800cc implants but I was told today I will probably only be to a C cup at the maximum....which I was very upset to hear but technically there is no cup sizes involved...its cc. My doctor did say after the tissue expanders are filled, if I wasn't satisfied with the size I could do the latissimus dorsi route with the implants to add a bit more volume.
I do have to say ...todays appointment didn't go quite as I had hoped. In my future I had planned on getting breast implants and I was expecting augmentation results. I had to snap back to reality and realize its not going to be like that. Reconstruction is totally different than augmentation.
I also wanted to note that it seems as though finding any pics and information on breast reconstruction on larger patients is scarce....especially on patients that have lost a significant amount of weight and are still large but comfortable where they are at.....Sometimes I feel as though many think that just because one is larger than average..or has saggy skin from weight loss.....there is no need to reconstruct "nice and perky" breast.....and that's not the case at all. ( I understand that some reconstructions don't turn out great...but it seems as though most do)
I hope that any woman who has had a mastectomy or a mastectomy on a larger woman.....doesn't feel that they aren't fit enough.....or attractive enough to deserve to have your breast reconstructed because I have met doctors that certainly feel that way.

Pain from expanders

I had my mastectomy and its been 3 weeks. I had breast reconstruction as well with alloderm and tissue expanders. I had 4 drains and had 2 removed 2 weeks later and then the other 2 came out on week 3. Those drains were so painful. I hate the TE. They are so hard and I am just now starting to be able to deal with the pain. My expanders are very hard and uncomfortable. My muscles have spasms. I was filled to 500cc at the time of surgery! I have heard that is waaaay too much. But anyways things are improving and I am getting better. Still trying to decide on silicone or saline implants. My exchange surgery will be coming soon...

Week 4 of my journey

I am in week 4 of my recovery from the mastectomy and reconstruction. I have had two expansions of 60 cc in each breast each week and am currently at 620cc. The expansions are horrible. I have severe pain for about 3 days then I seem to be back to just moderate pain. I am still on pain meds and muscle relaxers. Whenever I say that I am still in pain, the nurses say..." its normal to feel like a heavy workout". I am thinking to myself......."WHAT?! A heavy workout my ass....I feel like someone took a baseball bat and beat the crap out of my chest!!!.....HEAVY WORKOUT MY ASS!!!!!" I never in my life thought that the breast reconstruction would be the worst pain in my life and I have had 3 c section, a tubal ligation and 2 LCL reconstructions on my left knee. The breast reconstruction takes the cake for sure. I cant believe how much pain I am still in after 4 weeks post op. I fear my nurses and doctor think I may be a pill popper because I ask for a pain med refill each week due to the pain of expanding and in general since my surgery. I am a nurse myself and I know that sometimes medical staff can be quick to judge. I have also heard some people say that their breast reconstruction journey was a breeze....hats off to you...I wish I can say the same. My second expansion of 60cc wasn't that bad....for my right breast...but for my left breast(underneath) it has been soooo painful. I seriously cried....for hours last night. Anyways....to anyone who reads this...if you are going through the same thing...I am so sorry, I feel your pain! I also wanted to give anyone who reads this and is going to have an upcoming mastectomy with reconstruction a heads up of the reality of this surgery. It often seems to be sugarcoated by many people....like...".oh at least you get perky boobs"..."oh...so and so had that done and she loves her new look" or " oh don't worry youll be fine" ...." When I got breast implants it wasn't painful at all"....It is very nice for people to try and relate to you BUT the pain of breast reconstruction is very real and a very different procedure than a simple augmentation and it may have been a breeze for so and so but this is YOU. I had a great friend who had breast augmentation and I remember her saying it was painful....but she was up shopping at walmart the next day! Its been 4 weeks and I have not stepped foot in any store...and I LOVE me some retail therapy!!! I just hope you plastic surgeon has told you the true reality of the surgery. IT IS PAINFUL AND A VERY LONG RECOVERY FOR SOME....like me. I wish the best to everyone and if I can be of some help...please by all means leave me a post and I will do my best to help you through this. Just remember your pain level is what YOU say it is and no one else can deny it. Be an advocate for yourself and dont suffer...if youre in pain ask for a refill on pain meds.

4 months post op

Hello....it has been about 4 months post op. A couple of months ago I finally got done with my fills. I am at 770ccs. My ps said my skin was in great condition so we could stop. I was thankful! I am not in any real pain anymore. I feel great so far. I am having some side effects of the tissue expanders though. I am starting to develop a uniboob. When I wear a bra I have a booby bubble. If I lay on my side or push my expander...they move to the middle of my chest and I can feel them touching. When I look down...I hardly see the separation and it seems like righty is getting smaller. I have called my dr and my nurse reassured me that in july, everything will be fixed and revised. My boobs are way smaller than my natural ones...and I hate that. I will be getting 800cc silicone implants. I wanted 800cc saline overfilled to 960cc but my dr didn't seem impressed and said they could overfill them but not much. I have lost 25lbs since my surgery in hopes that with me losing weight, my boobs will appear larger. So far... I haven't noticed a change...and I am still trying to lose more weight. I miss the squishy feel of my boobs. These expanders are so very rock hard and everytime I move, I can feel them scrape across my rib cage. UGH! But anyways...I cant wait until July 17!
Even though I seem a bit complainy....I am thankful for this opportunity to share my experience with anyone who reads this and I love my dr as well. She does one hell of a job.
Here are some pics from week one until now....
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Hi youcantfind me, I read your review and wanted to thank you for sharing your helpful and honest story. I'm glad the community is supportive, especially with your recent fever. Hoping this gets resolved soon. I'm piecing together some of the comments below. It sounds like you may have gotten your surgery on July 17th, right? Sending good thoughts your way. 
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Oh my that's terribly irresponsible on their part. . The hospital may have a safety committee that could help mediate.. But I wouldn't let the fever go without getting it checked out.. Could just Be an inflammatory response to surgery or an underlying infection. Ask diane ..expander nightmare.. she is a surgeon
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I have been to see them twice. They just don't care at all. I have actually found a new plastic surgeon willing to see me. If I worsen, I assure you I will go to the ER. I promise.
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my dr did do a good job on my breast but there are things that need attention and she makes me feel like I have to "settle" for how I look. I don't have to settle and I wont. Not to mention I have had a fever for a week and NOTHING has been done
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Fever is a temperature over 100.4, and if you really do have a fever you definitely need to be seen by your surgeon. It's possible it could be coming from your lungs because of shallow breathing while under anesthesia or recovering, a bladder infection of you had a catheter during your surgery or an infection in the breast. Only an in person visit can sort that out. Please call and insist that you are seen or consider being seen in the ER where your surgeon is on staff. (They have to provide ER coverage and so the ER staff will be able to get through to your surgeon). I hope your recovery sees you feeling better and happy with the results. Diane
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I have actually seen them twice and they keep putting it off like everything is ok(once yesterday) They know of the fever and haven't even mentioned what the cause could be. Today my drain started to expel bright red and cloudy fluid. It has been clear serous fluid. I placed a call and have yet to hear from anyone. My fever is gone as of now but I don't feel good. I am having a lot of pain in my abdomen and the fluid is turning more of a pink color now. I will go to the ER if I continue getting worse. Thanks ladies and Diane I appreciate your response!
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Thanks for chiming in.. I'm just a pharmacist so I can't give that insightful medical advice you can. Post op fever sounded scary to me..I spiked a fever a week after mastectomy ..came down with a cold..lack of good breathing along with fever turned my burns into full thickness burns in 2 days..had to have surgery to get them closed up..and wait an extra 6 weeks to start expansion...now I have to wait an extra month before exchange to see if burned tissue will expand
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Just a pharmacist? That's great! You are very helpful in every way! You can give helpful tips on medication etc. Here is a question for you!! I have severe nausea when I take Percocet that cant be tamed with Zofran or promethazine ...any suggestions? I did notice after surgery I had some congestion in my chest...I have asthma and always use my spirometer anyways but started to use it more than I usually do. It really does help...and sometimes...since some of us are in the medical field (I am a nurse) we tend to either go over board on precautions or become quite hard headed (which I am guilty of sometimes). I am so sorry that happened to you. I know it sucks to have to wait for the expansion and exchange. I hated my tissue expanders. They were awful and I mean awful for me. For me, getting expanded was almost as painful as going through reconstruction all over again. The exchange surgery was a breeze compared to the other. I do love the squishy feel of silicone and they re so much more comfortable on your ribs.
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oxycodone is very nauseating to some people even if taken in the middle of a meal..sometimes Pepcid ac can help calm the acid response but I think hydrocodone is better tolerated myself..all narcotics stimulate histamine release and cause itching so you cant go by that side effect..i tell people to break them in half and take them a little more frequently to help offset side effects.. remember u cant cure nausea only prevent it..once the chemical is released from the brain u have to wait until it is metabolized to be gone..so prevention is the key..promethazine potentiates narcotics so 2 and 2 make 6...so that might be the key to cutting down your nauseating dose of oxycodone!!!
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Oh thank you so much I will try this!
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MAY THE FAT GRAFTING CAN GIVE YOU BACK SOME OF THE VOLUME YOU DESIRE..GLAD THE PAIN HAS SUBSIDED..MINE HAS TOO..TOOK A MONTH AFTER LAST FILL AND USING E STIM TO GET THE SPASMS CALMED DOWN..I CAN EVEN SLEEP ON MY SIDE..REAL SELF HAS A VIDEO ON SYMMASTIA TO SHOW HOW THEY SURGICALLY REPAIR THE POCKETS FOR THE UNI BOOB PROBLEM- IT IS REALLY INTERESTING..I WISH THEY COULD USE TONS OF ALLODERM TO REINFORCE OUR NATURAL THIN FLAPS SO AS TO AVOID EVER BOTTOMING OUT..THESE IMPLANTS HAVE TO BE MUCH HEAVIER THAN OUR OWN FLUFFY FAT WAS
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Thank you for sharing your journey with us on RealSelf. I'm glad to see you're already meeting some other members that have been in or are in similar situations. I realize reconstruction is a very unique for each person, but it's nice to have some support during the process. Have you met Trinalll and Cindy588? They're toward the end of their reconstruction but have been helpful in the community. Wishing you the best with your reconstruction process. Please keep us posted!
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It is so important to be told that this process is nothing like augmentation; I was never told that! And that this can be a long process as well. I am thankful to be alive, and had to come to terms with the fact that these breasts are not like real ones. But a good surgeon will work with you to make you happy. Find one you feel you can trust (and trust them - listen to their concerns). God Bless you on your journey!
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Thank you so very much! I am hoping for the best..but my life is way more important and I think now that I have actually scheduled everything....I am starting to come to terms with the reality.
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As a"bigger" girl I know what you mean. I hope your surgeon told you that with a BMI over 30% (I'm 5'7 200 lb which is BMI of 32) that you are at significantly higher risk of infection and lymph edema. I ended up with both. Since you are close to Atlanta I am sure there has to be someone trained and experienced in fat grafting. I traveled from Western PA to Miami to have mine done. Sorry to say I don't have after photos because I am still under construction, but you can see what my original expander reconstruction looked like before I went to Miami for a do-over. I am thrilled with the results thus far. You can send me a private message if you want more info but I am having surgery tomorrow Jan 15 . My doctor here in Miami is not only making me feel whole again, he is making me feel even more beautiful than before. In any event, I wish you a safe procedure and speedy recovery. Love, Diane.
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Awww..that was so nice of you! I hope your surgery goes great! They did tell me all the complications that could arise. My doctor seemed confident in my health other than the breast issue. The PS and the breast surgeon recommended this step first and I trust them....but I almost feel like when I express the concern of my breast reconstruction looking nice...they think I am doing this to get implants and cosmetic work. This is to save my life and hopefully make the future a bit more easier...but I also hope they turn out great. My surgery is Feb 5....and the doctor is performing a skin sparing mastectomy. I do have some asymmetry to begin with and I hope they address the issue and at least fix that before inserting my tissue expanders. Well anyways...good luck to you...I hope you recover fast and get the results you deserve!!!
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I want to let you know I have been praying for you to have a safe surgery today. Breast Cancer is devastating, but thankfully your Mastectomy will remove the Cancer and you will have beautiful Breasts from your breast reconstruction. Although you will need to go through a series of fills in your tissue expander, it will be worth wait. Take your time getting that done. It will be worth every minute. It is sad that people may feel Weight or BMI should affect anyone's decision on Breast Reconstruction. You have every right to feel feminine and happy with your body image, regardless of body weight or anything else. Your Breast Reconstruction will go great. I have heard some negative things of the TRAM FLAP Breast Reconstruction. With Breast Cancer, health insurance should not only cover implants but also a breast lift which is an added bonus. Keep in mind, it will take some time to get your results and more than likely slight revisions to make sure your final results, implants and the breast lift the way you want them. As hard as it is, please try and be patient. It can be a long process. I had 6 monthes of Chemo, no radiation. The entire process has taken about a year and a half. Please keep the faith. You are not alone. Sending hugs and prayers your way. Please keep me updated. You are not alone in your struggle. I am just a message or post away. Make sure you take your pain medication exactly as scheduled, I took 2 Percocet every 4 hours. Whatever you do, do NOT wait for the pain to start or you will be in agony. xoxo ~hugs~
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Thank you so much! I am struggling with so much pain and its been 4 weeks and I am still on pain meds... I wanted to do 100cc at each filling but 60 cc is too much pain already. I cant imagine how that would feel. I just posted an update...feel free to read. I will continue to keep you posted on this journey...I have learned that patience is required in this journey!
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who are u seeing in Miami and how did it go? im from Pittsburgh but willing to travel for right dr
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Dear eve sue...you can private message me or call me for the low down. I am about 2 hours from Pittsburgh and would even be willing to meet you personally and show you my before and after results thus far. I am a physician at Nason hoSpital OBGYN and you know my first name from my previous post so you can track me down that way. I don't show up on some websites because I am fairly new to the practice. Feel free to call during office hours and leave your name and contact info and I will call you back in the evening. Alternatively you can use my private email which is D (my last name) DO @ aol without the spaces or parenthesis Sorry to be so cryptic but they won't let you post actual phone numbers or email addresses here.
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I have read your story and it's so similar to my own. I also am on the fuller figure side, but my PS NEVER explained to me that my breasts would not look the same as my expanders. I was initially filled with 330 cc's at double mastectomy and add 50 cc's each time...except for the first 2 fills he put in 100 each. I also felt the same pain as you & although I was already taking Suboxone for chronic pain it was at times unbearable. The expander is made of very hard plastic and that's what caused them to hurt so much. I would be concerned about the uniboob. I'm not trying to scare you but everything I've read sounds like you might be heading for an unhappy result. I also had the muscle spasms. Once my silicone implants (of which I was allowed no other option) were in under the muscle, my breasts jump on their own all day long. Also, the implants did not fill in all the skin that the expanders had pushed out. So...I was left with saggy 750cc implants w/fat grafting (all of it died and now I have lumps from the dead fat in my chest) loose skin on both sides around my scar and especially when I bend over. When I told my dr that I was unhappy, he said that he thought I looked " pretty good". I COMPLETELY AGREE WITH YOUR STATEMENT THAT JUST BECAUSE WOMEN HAVE BREAST CANCER DOESNT MEAN WE TAKE WHATEVER GARBAGE JOB IS DONE FOR US...AND I TOLD MY DR JUST THAT. My implant surgery was 1/23/2014 and I am going for my second...second opinion this Friday. However, I feel very confident that this dr will be the one to do my revision. It's so bad my insurance company is paying for it. My advice to you, is to go see some other plastic surgeons for a free consult before it's time to put in your implants. August 26, 2014 will mark my 1st yr as a breast cancer survivor...AND YES this is the most important thing, but finishing up this process will officially put it in my rear view mirror. I hope anything I've said has helped. Please feel free to contact me any time.
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I am feeling much better but I went to my pro op appointment and I am slightly disappointed because I now have big fat flaps under my armpits and my ps will not cut them off because she said that's its cosmetic...but honestly isn't have breast reconstruction cosmetic in nature? I was told that they would be removed and now its cosmetic? I am frustrated. I really used to love my ps but now I am feeling like its all for the money with her. I have read about women having tummy tucks with abdominal work...liposuction, thigh lifts etc that have been paid by the insurance companies because it was part of the process to take from other sites etc to aid in the reconstruction process. But my ps refuses to do any of that. I have a feeling I will be receiving revisions down the road. I do think its absolutely ridiculous that implant companies only go to 800cc silicone when that is pretty small wen you have no breast tissue for larger reconstruction patients. I will be keeping in touch with you...this has been a very expensive journey even with insurance.....(big sigh)
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I get my next surgery July 17 .....
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I hope your new ps gives you amazing results because you deserve them! Ill be thinking of you and will keep in touch
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Good Luck!! I hope everything turns the way you want!!
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