This entry is meant to give information not complaint. It is information that I wish I had previous to my reconstruction. I may still have made the same decision because breasts, even artificial ones, are near and dear to a woman’s heart. However, I am putting this info out there so that women know what they are doing with this type of breast reconstruction.
Before I had my mastectomies, I read about reconstruction. However, I did not dig deeply enough. My understanding of the process was grossly incomplete.
I only recently found this out when I started investigating. My searching began because the Alloderm, a fabric made from cadaver skin, is failing around my implants which are now directly under the skin in places instead of being held snugly in place by the Alloderm fabric. The plastic surgeon instructed me to watch and wait . And he said those dreaded words, “Be careful.” If the skin is stressed enough, the implant can push through it to the outside. At that point another surgery is inevitable. ( I have already had 4 surgeries related to the reconstruction, 2 of which were unplanned.)
Since the Alloderm failure around my implants, I have checked online for side effects and problems with this cadaver fabric. I also read about the surgical procedure. ( These are searchable on the web from reliable sources.)
The most common method of breast reconstruction in North America is the type which I had. In this type of reconstruction the lower portion of the pectoralis major muscle is detached from the bone so that it rolls up like a shutter. The implant is placed under the upper pectoralis muscle which is still intact and held in place by alloderm, a mesh type fabric made from the skin of cadavers.
It is hard to make decisions when your life has become chaos because of cancer. But I offer the info from my experience to women considering reconstruction. Additionally I tender the following advice: Ask many questions. Dig deeply. Make informed decisions. You may trust your doctor, but you deserve all of the facts laid out before you.
I have to do some serious eating of humble pie now. Last Friday, February 27th, I tore my left pectoral muscle and had emergency surgery. Now I am taking it so easy and protecting so much. It is my prayer that there is no more bleeding and no infection. Going back into a fresh surgery is not a good thing and putting the same prosthesis back is not either. Yet God provided for me in that a plastic surgeon was at the hospital seeing another patient when I came to the ER. If he had not been there the left breast probably would have burst open according to that surgeon. He said that he barely got the surgery started in time to stop the incision from breaking open. The ER doctors had no idea what to do with me. As it was, I lost 1 1/2 liters of blood and my hemaglobin dropped to half of what it had been.
So here is the addendum to the previous info. Do not lift, hold babies, or do overhead stuff even if it feels okay. I was working a lot mostly with my right arm and my left pect is what tore. But if I could do it again, I would protect, protect, protect. I was told not to lift heavy things which I did not do. instructions were also to avoid anything that hurt, which I also obeyed. Nothing hurt until the tear occurred. I had no warning signal that it would tear.
Additionally, I have to wonder if the deep tissue massage in the early stage of healing ( 2 weeks post implant surgery) was a good idea. The plastic surgeon at the ER said that my pect looked like overcooked pot roast with the fibers falling apart. The worst area apparently was the area in which I did the massage to break up scar tissue as I was instructed.
So here again is the voice of tough experience. Take it very easy after reconstruction.
Here are some interesting things I have learned since my last entry. With the leather ( a supportive mesh placed in after the mastectomies to strengthen the lower breast areas) put in, the reconstruction is very stable. Activity is no problem except very heavy lifting. I have been working like crazy, painting and helping remodel our son’s new house. I have had no problems at all.
Also deep tissue massage to relax the pectoral muscle and to break up scar tissue can be started as early as 1 week post surgery. It is relaxing the tissue around my left implant which is higher and bringing it down to be more in line with my right. It also makes the implant feel better. Before it felt like I had on a very tight and uncomfortable bra.
Of course an individual should check with their surgeon for instructions relating to all of this. I am just giving my experience.
One other thing which I unfortunately learned too late is this: if you have radiated tissue on one side, do not let them overfill the other side. Keep them the same size or you may end up with different size breasts even if they use the same size implants. You unradiated skin stretches way more and lets the breast look bigger.
Be your own advocate. Forewarned is forearmed.
This posting is for those who are dealing with breast cancer and want more info on what to expect in the reconstruction process.
The second surgery in the reconstructive process (replacing the tissue expanders with permanent implants) was done last Friday the 13th. I was told that it would be much easier than the first surgery, and that was absolutely true.
This was an outpatient surgery which started around 9:30 and lasted 2 1/2 hours. After recovery room time, I ended up going home mid afternoon.
My surgery involved some adjustment because the breast heights were different due to the radiated left side. I am assuming that someone without previous radiation treatments would have it even easier than I did.
There was very little pain involved and I could have done even without tylenol afterwards, but I took it the first night just because my throat hurt. (It was a little sinus cold thing.)
I was sent home with a loose dressing which I took off the next day before I showered. A few drops of dried blood were on the dressing, and long steri strips are still across the incisions now. I am to do no heavy lifting; otherwise I have no restrictions. I am not working on recovering my range of motion yet, as I did early after the mastectomies. However, I am already helping in Kev and Wendy’s new house–cleaning etc. So far other than some soreness on the left, radiated side, I am having no problems.
The permanent implants that I had put in are silicone. The choice of silicone over saline was made after research and talking to others who had them. They are soft like real breasts, which is so nice after the saline tissue expanders. Those were hard as rocks.
The cosmetic results are not perfect because of the inflexibility of the skin on the radiated side ( there is still a little height and size difference). Overall, however, I am pleased. It is already apparent that these implants will be more comfortable than the tissue expanders.
Tomorrow is my follow up appointment with Dr. Kim. When I find out more about the last step in the reconstruction, I will post that.
This is for any women who want to know what to expect after the surgery when the tissue expanders get filled. It has been a boon for me all along the way to have advance knowledge on what to expect.
After about 7 to 10 days you will get the drainage tubes out. It is totally painless. As a matter of fact, it feels like heaven to get them out.
They will take out the stitches in the breast incisions and make the decision about when to start filling. I got a fill up of 60 cc. per side 1 time each week until I decided I was a good size, then they filled it one more time to allow extra room for the next surgery.
The nurse did each filling with what looked like a scary huge syringe and needle. However, because the nerves are cut from the surgery, there is no pain when they put the needle into the port of the tissue expander. They find the port using magnets, then the nurse marks it with a skin marker. You hear a click when it locks in then she fills the prescribed amount.
The filling causes the pectoral muscles and the skin to stretch and there is soreness from that for a few days each time. This improved for me after I started using lanolin which helped the radiated skin to stretch better. (The incision must be completely healed to use lanolin. It can be bought from the pharmacist by request and costs about $2 to $3 a tube.)
Because of the radiated skin, I have filled a little unevenly but the nurses assured me that Dr. Kim can correct that in the next surgery. I am going for one last filling on the radiated side to try to look more even. Then I have to wait at least one month before the next surgery. I was told that it is even better to wait longer to let my body recover and be ready for the next go round. I am told to expect the next surgery to be easier, and that I will probably be out of commission for a week this time.
I am available to answer any questions or support however I can. firstname.lastname@example.org.