Final reconstruction question

VirginiaBorn06

Hello, I'm fairly new to this network and have mostly been learning through looking at other people's issues and answers. But now I have a question I hope you can help me with.

I had a single mastectomy in September with latissimus reconstruction and an expander. Only after surgery my docs determined I needed chemo followed by radiation. I just finished chemo last week (YEAH) and my final reconstruction is set for the end of January. My plastic surgeon says I then need to wait a couple of weeks before he constructs the nipple and then wait a month before radiation. My question is about the nipple. I don't know whether it's worth it. I'm 60 years old (single again) and don't know if anyone other than me will ever see the breast. The nurse has told me that the doctor will have to make the nipple quite a bit larger than normal because it is expected to shrink -- however sometimes they don't. Also, I don't know what reaction the radiation will have on everything.

Any comments would be appreciated.

Jean 0609

Hey there,
I had my exchange surgery on December 1, 2010. I was lucky that my plastic surgeon did my nipple at the same time. She told my husband afterwards to let me know that the nipple would be bigger because of the swelling. I didn't know what to expect. It wasn't actually as big as I thought. I had no pain at all from the surgery, except for my belly button (had ovaries removed at same time).

I didn't have radiation, so can't comment on that. Good luck on your upcoming surgery.

xoxo
Jean

betsymorgan

just got my nip
my Christmas present to myself was my nipple 4 months after a reconstruction (tram-flap). My ps used a bit of my other nipple to reconstruct my new one. I haven't seen my new one yet--but the bump under the bandage looks promising. My remaining nipple is somewhat misshapen, but it's only been a week. The stitches, bandage and drain (yes, ugh) come out tomorrow. My husband thinks my "old nipple" looks like nothing happened to it. I, of course, have a different vantage point, and can see the difference...but I suppose in the grand scheme of things it doesn't matter. I'm 52. I did it for me.

I had it done because I wanted to be able to look in the mirror and not see what cancer had done to me quite so immediately. I wanted to feel whole again. I wanted to be able to take a shower and wash my chest and not see the difference. I know other women, however, who have no nipples...just never got around to getting them...and soon forgot what it was like to have nipples. One friend told me she had seen her daughter nursing her new baby and was surprised at the sight of nipples!

I can't speak yet to the size of the new nipple since I haven't seen it--but it doesn't look bigger. I suppose it depends on where the tissue to make the nipple comes from. If your ps uses your remaining nipple, make sure s/he doesn't just lop off the top: that can kill nerve cells and you may never have any sensation there again. My ps used a technique in which he removed a diagonal piece and then folded over the top (I think I have that right) so that I have good nerve cells all over my remaining nipple.

I did not need radiation, so I can't speak to that either, but if the radiation doesn't touch the nipple, I would think you'd be OK.

good luck!
betsy

jendrey

you should do it for yourself
At the same time as the mastectomy, I had a tissue expander put in place. Then I had chemotherapy followed by radiation. I had to wait three months after finishing radiation before the plastic surgeon would exchange the expander for the actual implant. Now I have to wait for six more months before they'll consider a nipple reconstruction.

My radiated skin is somewhat different now perhaps even a bit 'leathery' (for lack of better word) and it's still quite numb in some areas! About the only problem I had from the final implant surgery is that a stitch was poking out from the wound and had to be snipped. Unfortunately, the wound has been stubborn to completely healing ONLY in that area. That surgery was on November 15.

On second thought, leathery isn't really a good description. More like when say your leg 'falls asleep' and but before you begin to feel it 'wake up' how like you really can't feel your foot but yet you still can feel it and how if you touch the skin before pins and needles/tingling feeling it feels so very oddly different. If that makes any sense, that's sort of how the radiated skin felt/feels. Over time, it gradually gets better and ever so very slowly the numbness begins to wear off and it seems with that some buoyancy is also regained.

Really, I'd say go for the nipple reconstruction if you can. Just because your 60, or you're thinking right now that you may not ever have cause to share this aspect of yourself with anyone anytime soon is not --in my opinion-- any kind of reason to forgo the nipple.

You should do the nipple for yourself. You already made the choice to have your breast reconstructed; so don't stop midway through just because your doctors have diverged from the original plan.

About the nipple being a good deal larger because it may shrink, or not shrink, well, they have to throw in all of the bad things that could (but probably won't) happen don't they now?!!

Hope this helps

jendrey

betsymorgan said:

just got my nip
my Christmas present to myself was my nipple 4 months after a reconstruction (tram-flap). My ps used a bit of my other nipple to reconstruct my new one. I haven't seen my new one yet--but the bump under the bandage looks promising. My remaining nipple is somewhat misshapen, but it's only been a week. The stitches, bandage and drain (yes, ugh) come out tomorrow. My husband thinks my "old nipple" looks like nothing happened to it. I, of course, have a different vantage point, and can see the difference...but I suppose in the grand scheme of things it doesn't matter. I'm 52. I did it for me.

I had it done because I wanted to be able to look in the mirror and not see what cancer had done to me quite so immediately. I wanted to feel whole again. I wanted to be able to take a shower and wash my chest and not see the difference. I know other women, however, who have no nipples...just never got around to getting them...and soon forgot what it was like to have nipples. One friend told me she had seen her daughter nursing her new baby and was surprised at the sight of nipples!

I can't speak yet to the size of the new nipple since I haven't seen it--but it doesn't look bigger. I suppose it depends on where the tissue to make the nipple comes from. If your ps uses your remaining nipple, make sure s/he doesn't just lop off the top: that can kill nerve cells and you may never have any sensation there again. My ps used a technique in which he removed a diagonal piece and then folded over the top (I think I have that right) so that I have good nerve cells all over my remaining nipple.

I did not need radiation, so I can't speak to that either, but if the radiation doesn't touch the nipple, I would think you'd be OK.

good luck!
betsy

um,...
oh, and the nipple will indeed most likely be radiated or so close that it may as well be.

GreeneyedGirl

jendrey said:

you should do it for yourself
At the same time as the mastectomy, I had a tissue expander put in place. Then I had chemotherapy followed by radiation. I had to wait three months after finishing radiation before the plastic surgeon would exchange the expander for the actual implant. Now I have to wait for six more months before they'll consider a nipple reconstruction.

My radiated skin is somewhat different now perhaps even a bit 'leathery' (for lack of better word) and it's still quite numb in some areas! About the only problem I had from the final implant surgery is that a stitch was poking out from the wound and had to be snipped. Unfortunately, the wound has been stubborn to completely healing ONLY in that area. That surgery was on November 15.

On second thought, leathery isn't really a good description. More like when say your leg 'falls asleep' and but before you begin to feel it 'wake up' how like you really can't feel your foot but yet you still can feel it and how if you touch the skin before pins and needles/tingling feeling it feels so very oddly different. If that makes any sense, that's sort of how the radiated skin felt/feels. Over time, it gradually gets better and ever so very slowly the numbness begins to wear off and it seems with that some buoyancy is also regained.

Really, I'd say go for the nipple reconstruction if you can. Just because your 60, or you're thinking right now that you may not ever have cause to share this aspect of yourself with anyone anytime soon is not --in my opinion-- any kind of reason to forgo the nipple.

You should do the nipple for yourself. You already made the choice to have your breast reconstructed; so don't stop midway through just because your doctors have diverged from the original plan.

About the nipple being a good deal larger because it may shrink, or not shrink, well, they have to throw in all of the bad things that could (but probably won't) happen don't they now?!!

Hope this helps

single nipper~
I had a unilateral (single) mastectomy, and chose to not have a nipple reconstructed. I just didn't want another surgery.

Different Ballgame

Nipples are worth it
I had a contralateral mastectomy at 65 with breast reconstruction being completed at age 67 Nipple and tattoo make a big difference to reconstruction. Go for it! I can't imagine not doing it.

Hugs,
Janelle

Megan M

Jean 0609 said:

Hey there,
I had my exchange surgery on December 1, 2010. I was lucky that my plastic surgeon did my nipple at the same time. She told my husband afterwards to let me know that the nipple would be bigger because of the swelling. I didn't know what to expect. It wasn't actually as big as I thought. I had no pain at all from the surgery, except for my belly button (had ovaries removed at same time).

I didn't have radiation, so can't comment on that. Good luck on your upcoming surgery.

xoxo
Jean

I had a lumpectomy with
I had a lumpectomy with rads, but, wanted to wish you good luck!


Hugs, Megan