My history with large breasts go back many years. ...
My history with large breasts go back many years. I started wearing a bra when I was 9 and by the time I was in high school I was a 36 DD. I was into sports and hiking. I bound them when I was playing softball because I was teased that I would give myself a bloody nose when I ran. I have had neck and shoulder issues since high school. I have 2 children, nursed them both. I thought I was a 40 DD until just last week when I used the measurement calculations that put me at a 44 G.
3 years ago, I found out I had breast cancer and decided to have a lumpectomy, 2nd surgery for the margin clearing and Radiation. Chemo wouldn't help.. Since the radiation, I have bad nerve pain under the breast. I was burned from radiation treatment and the spot under the breast, where a bra usually sits, has the worst nerve pain. Bras are pretty much out. [I also ended up with another lumpectomy 1 year after the first surgery (no cancer but no drain was used) I ended up with a 4th surgery to remove a seroma that wouldn't heal.. That surgery, they put a drain in and I have had no problem with healing.]
At this point. I wear compression tanks or a binder to help stop the movement. When I just walk for exercise, I keel over, the pain gets so bad. I have had pain management work-ups, mammograms, ultrasounds to see what causes the pain and nothing has been found, just the thickening from the surgeries and radiation. Was told the first year that it was from the radiation and SHOULD subside. Well, it didn't. I have been through pain management (full circle 3 times). At this point, I realize that pain is going to stick around. I have been working with an acupuncturist for the last 5 months and through her treatment, I have realized that she can lessen the pain. One problem.. the pain subsides only to come back when my large breast start moving. So, I asked my primary doctor, my pain management doctor and my acupuncturist if they thought a reduction might help. They are all in agreement that 'Possibly" if I was to have a reduction, the smaller breast would be less movement and might help the nerve pain to lessen but better than that - it could also help my neck, shoulder and clavicle pain I have had since before the Breast Cancer.
That brings me to here.. I started researching the possibilities of breast reduction. I have my first consult with a certified plastic surgeon, Dr Shane C. Kim, that does alot of reconstructive-type surgeries. He also does Breast reductions. He did my friends reconstruction and she is doing quite well. After getting a few referrals, I decided to get an appointment with him October 13th.. The paperwork the office sent me, is very thorough.. Have it filled out and almost ready to go.
A bit nervous, but also think there are other benefits to the reduction - less tissue means less chance for a recurrence with the BC? I'm weighing all the pros and cons.. The pros are winning.
Side View pictures of the breast now.
Just wanted to add a few photos of the side views of my breasts now, as a baseline for what is ahead.
Forgot about one important possible complication.
I have lymphedema in the torso and upper arms. It has been mild with only a few flares in the past 3 years. I am not sure how this will complicate matters, but I would still like to do the reduction.
Having a rough day - Waiting is the pits.
My consult is coming up in another 9 days. I guess this is the time when I start in panic mode and questioning everything I am doing/thinking of doing. This is so new to me, even though I have thought about what would help me for awhile now. My primary doc wouldn't have referred me if she didn't think it was a good idea. Right??? I am so grateful I found you and I can get input on what to do. Breast reduction.... reconstruction... mastectomy... I just want to get it right and not have another surgery later.. I have had 4 different type of surgeries on the right breast already... It Looks pretty good considering that fact.. Am I crazy to want them smaller and hopefully be able to actually exercise? I hate being a couch potato..... Ok vent over... Encouragement would be nice right now.
Initial consult is tomorrow.
Anyone that believes in prayer, I need it tonight . My son in law showed me how to get to the medical center today . I am so ready for this. I'm sure its going to be hard for me to do my computer job in the morning.
I went shopping with daughter yesterday and caught myself looking at cutie bras lol.
Why am I so stressed about it? I need to think positive and say the PS will be able to do a reduction.
What happened at first consult meeting
Nurse took me to the room and asked a few history questions. Went over what the doctor would do.
Doctor came in and verified that we were talking about a breast reduction. Had me explain what I was thinking and told me what he needed to do to get an insurance acceptance. ?Explained insurance and how they play games so they don't have to pay for it. But said, if you keep trying, you might get them to budge.? Asked me what size I wanted to be. I told him: Small enough to lessen movement – B/C.? He measured my breasts and looked at my lumpectomy scars. Said my breasts were good after radiation and should not have too much issue with the scarring. He said that my expectations made me a good candidate for the procedure because he could take what was necessary. He thought it would be about 500-600 mL. He also showed me how small my breast could be. He also suggested that he could make me a nipple on the right side. To think about it.
He asked me if I had any questions. He had answered everything I had on my list. Told me it would take him about a week to put the authorization for insurance together. Then the insurance would probably take at least another week. He said don't be surprised if they deny it. I had a 50/50 chance they would. If they did, he would appeal with more info. He also said he would do a phone consult if I had any questions. That way I wouldn't have to drive 3.5 hours for an appt.
Easy as pie. Don't know why I was so stressed.
Devasted
I decided to try on an old bra I used pre-Breast Cancer - the bulging out under the arms was a devastating picture. I can't believe that 44 DD was that small. It was squashing everything out the sides. And yes, the nerve pain under the breast is still there. Hence the reason for not wearing the a bra. I just want this request to insurance to go through. I hate waiting...
Question about hearing back from insurance companies.
If I don't hear back from the insurance company right away, is that a good sign? PS said that if they are going to deny the request they do it quickly. What has your experiences been?
Insurance requested more information from the doctor.
I was looking online at my insurance companies EOBs and they have paid the PS for my visit. And so I called my PS because I thought under the EOB it was saying the payment for the Breast Reduction. Of course, I read it wrong. DOH! Before I figured that out I called the PS office and they told me, it is a process and the insurance asked for more information. The doctor was working on a response.. Boy, sometimes I feel so dumb.. But at least, I haven't gotten a denial yet.
PS called me today.
Dr. Kim called me to ask a few informational questions about any physical therapy I tried in the past and my list of pain meds. He also said they wanted more pictures (Dr. Kim already sent the pictures to them). Supposedly, that is the only thing the insurance is waiting on. Anyway, as far as physical therapy - I went to my PT's office and found that they are in the middle of moving their files and couldn't get to mine until next week "Maybe". I asked the good Lord to give me an option.. Then I thought about my Primary Doc. She has to have at least a PT report from the PT office. I was right! I picked up a copy at the docs office and they faxed another copy to the PS. Dr. Kim also said (after I stated my concern about approval) that I have a valid issue and the insurance should pay for this one. He says not to put a time limit on this and he will just keep after the insurance to pay. I think it is awesome that he is putting up the battle with insurance for me. I am supposed to sit back and let his office do the work. He is pretty confident now, that he can get them to pay... I sure hope so. I asked him how much it would cost if the insurance didn't go through -He wouldn't tell me at first and said, "let's just keep on appealing I am sure I can get it through." He did mention about $7200 for the surgery and I shouldn't have to pay that. Sorry for the ramble - it is late but needed to type this before I forgot.
No News is Good News?
Still waiting for the ok from insurance. Haven't received an actual denial letter yet... But its going on a month of waiting for a reply. Hopefully soon...
Today...
Today, has been 1 month since my first consult. Dr Kim and staff have been conversing with the insurance company and working things out, I hope. I feel "out of the loop" even though the doctors office did call me this week. Everything is up in the air until insurance says yea or nea... "Patience is a virtue" yeah, about that....
Received an email from PS
This is what they said, "Dr. Kim just got me the letter to send to your insurance company , so they will get it today along with the proof of physical therapy. I will let you know as soon as I hear anything."
This is the major prayer time... Hopefully, I will have good news soon.
In Shock.. and panic is setting in.
Just got an email - " Good News! I just got the authorization for your surgery J I have forwarded on to the scheduler and she will contact you when she has a date. Please know this will have to be done by 12/31/14. Have a great day!"
A Sad Sad weekend.
Wasn't going to share this, thinking it didn't have anything to do with my breast reduction. But in a way, I think it does:
Saturday my wonderful doggy, Tigger, died in my arms peacefully at 15 years old. She was a crazy hairless wonder (Whippet and Chinese Crested mix). She had used up all of her 9 lives (we think she thought she was a cat) . She was my companion during my trials with breast cancer and actually found my cancer. She never gave me grief, only snuggles and licks. She loved chasing the turkeys on the mountain and laying in the sun, with her legs spread out belly on the dirt. She loved licks of my diet coke off my mug and loved husband's jelly bean treats. I know she is up chasing the turkeys, free of pain and just having a good old time with all the other pets.. I will miss my crazy mutt. I loved her dearly. Thank you, Tigger for being there for me..
I find I need to grieve and get it out. I will then, be able to concentrate on my surgery that is coming up quickly.
Phone Appointment.
Lined up the questions and PS answered them - Condensed version:
Overnight stay
Drains because of my radiated breast
They supply the Surgical bra
Post-Op in one week and hopefully, drains out. He will see me at one week increments until he feels I'm healing well.
All the tissue goes to pathology
Bring my cpap to the hospital
And if everything goes well, I should be able to work from home on computer in a weeks time. He said it depended on my pain level.
There is a risk, it could make my nerve pain in my breast worse - the anchor scar runs right over the area.
Stop my fish oil and anti-inflammatory meds.
Think I got everything answered.. Have a nice thanksgiving all.
I am very excited/nervous at this point - Tomorrow will be one week away!
This week is it
Just looking myself in the mirror this morning and wondering what I'm goimg to look like next week.
Surgery rescheduled
I ends up in urgent care yesterday. I was tested for the flu. Test was positive. Got me on Tamiflu and antibiotics for the bronchitis. Rescheduled surgery for the 11th. Hoping I get over this in time.
Pre-Op tomorrow
Well, my pre-op is here - Have to drive 3.5 hours both ways tomorrow for pre-op. I still have a bit of a cough. Hoping everything is a go though for thursday. Think calm..... I am more nervous about him saying I'm not well enough. Even though I have a bit of a cough, no fever for 2 days now. Any suggestions?? on how to stay calm and get rid of the cough...
Packing day today
Ok, working this morning then we are leaving for daughter's home for the night. She is closer to the hospital and I will be recovering at her place. Added bonus, Grandsons to visit me. We are making a big bandaid sign that says Grandma has a boo boo - no jumping LOL. My husband is so tired and cranky - they put him on the Tamiflu when I got sick, last pill is tonight. Hoping he will start feeling better. I keep going through waves of panic. But then I think of small tatas and Christmas with the family. I miss my doggie.. But must admit, it is nice not to be running and caring after a senior doggy with dementia issues during this time. My mind is going a mile a minute right now. Ok Need to breathe.... and not cough.
Home from hospital
Found out that there are 3 PSS that help you through the healing process .Didn't see Dr. Kim while I was awake. Hubby said surgery went as planned. Took 640 600 tissue out. Had doctor rip off surgical bra because it was too tight. Told me I could use my mastectomy Cami or get me a shelf bra tank top. With my radiated side,circulation is more important than compression.
My very bruised itty bitties
My dear hubby took off the gauze pads for me. I am a bit shakey and felt like Passing out. My daughter had a shelf bra that I put on. Not really in pain just off.
tight feeling in the breasts..
When I sit up,my breasts feel stretched to the max. They just feel so tight. Anyone else feel that way?
Please no more 'Comfort Food'
I'm one week post op. My chest is very tight and looking at my first post op visit in the morning. I am having trouble sitting upright, but every day is a bit better.
Problem right now is that get well presents are coming in and it is Comfort foods. Wish it was fruit baskets or something good for you. LOL love my work mates and dear Hubby's company he works for. Hopefully, there are only cards to look at when I go home from daughter's home.
Cookies
Forgot to add this gift basket from work.
10 Days post op
Doing OK today. Actually, got up showered and went to church with dear husband. Made sure I was well medicated. The little opening on the left breast is something I put Neosporin ointment on. He warned me that it would peal off and be really raw looking. Glad for the forewarning.
Pathology report
The PS wasn't expecting anything in the pathology, but with history of cancer, it was good to see all tissues were clear of cancer. Day 13 post op - Got off the oxycodone yesterday and switched to my other pain med - Tylenol #3s. Doing ok. The triangle of open wound is getting smaller and hubby says it is looking good. Having a bit of burning in the scars and tightness, but everyday seems a bit better. I am getting used to the smaller size and definitely have lessened movement. I suspect I'm a B and I am very ok with that. After all, I was trying to get rid of the pain and so far, the pain has lessened.
2 weeks post op
Still very swollen in arm pits but wound looks better. Wonderful yellow/brown color bruises.
My old shirt fits with room to spare
I decided to try on one of my shirts that I loved when I bought it, but never fit through the chest. Decided to wear it to church this morning. It Fits... That was an emotional boost for the day.
Here's the picture
Picture wouldn't load - will try again.
2nd post op
Had my second post op today. Nipple stitches out and Dr. Kim said everything looked great for being 2.5 weeks post. He was amazed that the radiated side is healing better than the non radiated side. The open wound is better but still needs care. Said it should be fully healed by next visit in a month. Told me to rest one more week, then let the pain be my guide.
Pictures after stitches out.
I keep telling myself wound is getting better and better, but after the 3.5 hour drive home today, I just don't know. What do you all think?
Pictures going to PS
Sent some pictures to the PS this morning. Concerned about the look of the nipple. A pinhole yesterday seems to be opening up today. Just not sure and the scar below - one day its yucky and the next day it looks fine. No fever. Breasts are warm but probably from what I am wearing..
5 weeks Post op
Saw Dr. Kim yestetday. Said even though my wound looks gross, it is healing nicely. He would prefer to let it heal on its own instead of doing a skin graft. He then found a few stray stitches and a staple, took them out. Said to let pain be my guide, but I am free to do what I can and just keep treating the wound as I have been. Also told me he preferred I use bacitacin ointment rather than coconut oil.
Before and after photos.
Photos in the same shirt before and after.
Try again. Before and after
These pictures are better I think.
Try Try Again
These pictures are in the same shirt without my grandchildren.
Updated pictures of wound.
Thought it would help me and others to document the healing process of the open wound. Hope this helps.
6 week PO
Finally on the downhill run, I think. Still swollen in the evenings when I took these pictures. I hope the swell goes away and hope it's not part of my lymphedema.
Two more pictures
I really hate when I hit the post instead of add pictures button. These pictures were supposed to be with the one above.
Almost healed. 7 Weeks 3 days
Wanted you to see there is definitely light at the end of the tunnel. Was up all night because the scar was itching. I put a bandaid on it last night and forgot some adhesives I am allergic too. Guess I picked the wrong bandaid.
I saw my acupuncturist and my lymphedema therapist this last week and both told me to rest and that would help the healing. Both of them worked on relieving my stress. It is getting better but I am so tired of hurting and being tired.
I see pain management doc today
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18 Feb 2015
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2 months post
Today will be the first time I will be seeing my pain management doc since the surgery (9 Weeks PO). He is the doc that controls my pain meds. (He has an agreement with my other docs, so none of my other docs will dispense pain meds to me. He controls what I take.) I think he will be happy to hear that all my neck, shoulder and clavicle pain is gone. The nerve pain I had in my breast before the BR is also gone. The only pain now is the incision and surrounding areas. At least that pain comes and goes, it's not constant like the other. I'm am hoping, with time, it will disappear too. I still need pain meds at times and when the pain comes, tylenol doesn't cut it. So I will still have to use my PM doc for awhile.
Oh - I will take pictures a bit later - my wound is healed but still a bit raw - so any elastic or cloth under my breast will still make it red and painful. I still have a lot of swell.
Pictures 9 weeks post op
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18 Feb 2015
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2 months post
Here are the pictures I promised including the side swell and incision irritation.
Actual Post-op with PAC
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21 Feb 2015
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2 months post
Saw the plastic surgeon's PAC yesterday - looked at my scarring from surgery and he asked point blank: "Did Dr. talk to you about revision?" Say what??????- "I see you don't have a nipple... Was Dr going to make you one? - I said we discussed it and decided it is not necessary. Then he replies; "Oh great, then he can take care of your 'dogears' in the office. It will take about an hour with local anesthetic." - Ok, I didn't see that coming..even though I had that question.. He also said the dogears won't get better at this point, they need to come off. Guess they lyposuction the extra swell under the arms then flatten out the pointy scar.. It seems like they haven't billed me for any of my post-op visits. Starting to think that is included in the surgery. But I will be glad to have the extra 2 boobs under my arms gone...(Dear Hubby calls them a quadra-boob LOL).
Update 10 weeks
Received a call back from PS about the revision of the dog ears. He said he is happy to revise it for me but he would like everything to heal first. I am to see him for a 3 month post-op this month and will discuss the revision further. He would like to wait until I'm 6 months post-op - which means June. I am doing a bit better every day - Have started using both arms but the closed wound skin is very thin. Our new dog jumped on me accidentally and through all the padding I was wearing , it opened up a bit. Long healing time for me I guess.
12 week Post Op visit
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20 Mar 2015
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3 months post
Saw my plastic surgeon Wednesday - he will be doing an "in office" revision in July or August - The open wound scar is very thin and keeps opening. He wants to pull it together and give it better skin to heal - He will also fix the dog ears. He also mentioned that he used to have a cone shaped device that he uses for lipo in office, but they don't use it anymore. He said he would figure out a way to still do the lipo 'in office' so not to cost me more money. He still is suggesting I do a 3-D tat on my breast with no nipple. Told me to think about it - that I deserve to look nice. At my age, I'm just not sure its necessary..
Earlier, I mentioned the pull on the nipple when I raise my arm and move my elbow away from my body - he said it is probably scar tissue. Told me to massage the scars and if the healed wound area gets irritated take a few days off of massage and/or wearing a bra, being that seems to irritate it. I guess it will keep on doing that until the PS does the revision. I do like the way they look except for the fat and dog ears on the sides.
I found the end of the tunnel - Almost there.
I have been doing better. Both breasts getting softer and feeling more like part of me and not glued on. I still have very thick scars that are being massaged. Doc just wants me to heal up and revision will be in July. My skin, where the open wound was, is very thin still and after a day wearing a bra, gets irritated and breaks open. Heals back up quickly, but PS is talking about giving me a better skin there. He wants to take out the thin skin and reclose the area. We shall see. I am up and doing more now and the original nerve pain in the breast, before the BR, is gone. I am glad I did this, even with all the bumps in the road of healing.
Before and after
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14 Apr 2015
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4 months post
Just wanted to put these side by side - definitely a difference. Still happy I did it. Warning to others, as they heal and get softer they do start to sag again. Keeping support on them is a good idea.
5 months still issues
Bras are still irritating after 5 months. Dog ears are scheduled to come off in July PS is also talking about redoing the open wound scar because the skin is so thin, it becomes raw and irritated. Hubby doesn't want him to touch it, thinking it will become another open wound. I just don't know what to do.
On the Mend - 7 months Post Op
I'm 7 months PO now. My open wound has healed but the skin is so thin and I have some crazy dog ears on my sides. PS has decided to cut out the old scar and replace it, hoping it heals correctly this time. He is fixing the dog ears at the same time. It is an in-office procedure, so I won't be put under and it will be done with a local. My revision is scheduled for July 17th. I just want this whole thing over.
The good news is - My nerve pain I had before my BR surgery is completely gone. I'm off all the pain meds I was on for 4 years post radiation for Breast Cancer.
Fixing of dog ears and open wound scar.
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19 Jul 2015
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7 months post
Well, it has only been 3 days since in-office surgery and trying to bandage these babies have been a chore. My husband had to go away on a business trip and I basically drove myself home 3.5 hours - 24 hours after surgery. Not sure these pictures will help or hurt me at the moment but hoping to see the swell go down and things looking better - right now it kinda looks like I traded one pair of dog ears for another. Think I should have waited until after I lost some more weight.
Day 5 post revision
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22 Jul 2015
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7 months post
The scars are starting to look better. I was having alot of side effects with the antibiotic and the PS said that I could go off of them being there was no sign of infection. The scars are starting to look better. My picture for the left scar didn't turn out, so will hopefully get a better picture later.
the other picture I promised
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24 Jul 2015
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7 months post
Think I got the Left breast scar for you..
Revision Stitches out
I am very pleased with the incisions after the revision. It's only 2 weeks post and everything looks nice. Doc took the leftover knots off yesterday and said in a few days I should be able to start massage so they don't get ropey again. I do still have a scar issue with the ring around my nipple. I didn't think to have him revise that scar, but after the wonderful job he did on the other scars, I'm thinking about it. What do you all think?
3 months after revision
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28 Oct 2015
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10 months post
Well ladies. I found out I'm most probably sensitive to dissolvable stitches. My scars are inflamed. I also have one scar from the original BR that needs revision. I'm hoping the other issue will get better with time.
A year later
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28 Nov 2015
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11 months post
Well ladies, I am a few weeks short of a year since my breast reduction. Looks like I'm going back in for another revision at the end of December - Didn't take a picture of them but I have two keloid scars on my sternum that he is going to fix. Now that we know that I am sensitive to the dissolvable stitches, He will fix these without that type. I am thinking of having him redo the left side scar again too. Guess I should probably ask him before the surgery date. He wanted to wait 7 months on that one which will be January. Problem is I might not have insurance come january.. It is what it is and maybe I should just make sure these heal before trying the big one on the side. Even with all the issues I have had healing, I would do it again.. It was well worth it.
Another Revision
After finding out I'm allergic to the dissolvable stitches, the doctor decided to try one more time. I was only going to have the left side and the sternal scars redone but when the doc saw the other 2 he said they needed to be revised too. So he just did them all.
Getting frustrated :-(
Hi all, I went in to see my PS for a 4 month check after my 2nd revision. He scrunched his nose again and started talking another revision. For some reason, some of my scars heal very nicely, but my nipple and both underarm scars are red and raised. I would say the heck with it if they weren't so sensitive. I told him this time that they looked better than last, let's give it awhile to see if the silicone strips and gel help.. I see him in October unless I change my mind and want to try another revision. Any ideas? Encouragement is welcome.
Scar Revision
I have had a bit of healing issues from my surgeries lately. Again, my scars became inflamed and painful. The Plastic Surgeon is giving it a final try by excising one of the bad scars and injecting it with steroids. This should stop it from having the inflammatory response. If it doesn't, I will have to live with the painful scars. When I originally, had my reconstruction/reduction surgery, the hope would be that the nerve pain would go away but there was a risk that something could happen. I still believe that this surgery was wonderful. The "nerve pain" is gone and I am able to be more active. It was still worth it, even if I am left with the scar pain.
Update: I had my scar revision with steroid on the 17th. A bit more painful than the last revision. Thinking it might be from the steroid. My reasoning is that when I have had steroid injections before, it always hurt before it got better. The scar looks good. At least I think so.
One week post revision
Just having some weird pain in the arm pit that radiates from the scar. I think the scar is ok... hmm.
Can't catch a break - But this soon will pass.
I think I'm done with revising scars.. I have one more to do. This time he revised it and injected me with steroid to hopefully stop the overgrowth. The scar itself is looking good post 3 weeks then got a sudden pain, red spot and then 2 days later started leaking out a hole in my incision scar. I found out through sending pictures that the doctor thinks it was a hematoma that enough pressure built up and the incision opened and started draining. It was a bloody and white discharge. This is day 4 of the ordeal and it just has a slight leak to it and the pain isn't as bad as it was a few days ago. What we do sometime to relieve one pain only to trade it for another.
Feeling a little discouraged. Probably because I'm in the middle of another bump in the road.
Recheck next week.
Things are looking up. Everything is healing and the scar isn't as large as before. Before and after scar revision below. Will see the PS next week to reevaluate. He will determine if I need another steriod injection or move on to another scar.
Still not there - very slow process
In May 2016 - I had a revision done on one scar with steroid injections, to see if it would get rid of the overgrowing scars.. I see the PS next week in September and the scar feels good except for one spot, but not sure how good it looks.. I am now trying to figure out if it is even worth doing the other scar that hurts constantly - What does it feel like you ask? It feels like a dozen tiny slivers you can't see and you rub over them.. below is a picture of the one scar before surgery and 3 months later.
Not good news but...
I saw the PS today and he basically said that he was done. The scar didn't heal the way he had hoped. The one he redid with the steroid looks ugly, BUT IT DOESN'T HURT... I wanted him to try the other side but he said no.. He sounded very frustrated and disappointed. So am I..
On a good note though. When this whole journey started, I was in pain and on multiple pain meds and very much a couch potato. Now I am only taking tylenol with an occasional stronger pain med. I am able to do some exercise so that is all a plus..
Thank you all for encouraging me through this. Through all this I would still recommend Dr. Kim. It wasn't his fault my skin won't heal correctly. And I am not sorry I had the reduction/reconstruction. If I had it all to do over again, I would still do it. It has changed my quality of life tremendously!
