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Category Archives: Incisions

Nerve Damage With Breast Augmentation

10 Apr

With any type of surgery you can expect to lose some sensation. Sometimes it’s just temporary. Sometimes the nerves are just so damaged that there’s no way you’ll regain all the feeling you had before. Breast surgery is one of those situations where you will never be the same.

Even if you have a transumbilical breast augmentation (TUBA) there will be some nerve damage. Nerves get torn, cut or separated causing a loss of sensation. There can be wide swaths of numb areas. It depends on what type of surgery you have as to how much nerve damage and loss of sensitivity there is.

There are three major types of incisions used in a breast augmentation:

Periareolar – This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites. The incision is placed at the bottom half of the areolae. Consider that there will most likely be severe reduction in nipple sensation with this type of implant insertion.

Inframammary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding. This incision is placed in the underside crease of the breast. The reduction in nipple sensation probably won’t be as severe with this type of implant insertion. Consider that a big bag of water is being shoved up under the muscle or skin. There WILL be some reduction in breast sensation.

Axillary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast feeding. This incision is placed in the armpit. The loss of nipple sensation won’t be as severe as with the periareolear, but again, you’re having a big water bag shoved under the skin or muscle. There will be loss of sensation.

No matter what type of insertion you have for breast augmentation, there WILL be some nerve damage. Whether it is temporary or permanent is an individual experience.

 
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Posted by on April 10, 2010 in boob job, breast, breast health, breast implants, breast lift, complications, conformity, cosmetic surgery, education, Healing, implants, Incisions, mastopexy, nerve damage, plastic surgeon, plastic surgery, post-surgical, Recovery, recuperation, scar tissue, Scars, Surgery, Surgical complications, Uncategorized

 

Latissimus Flap Breast Reconstruction Photos

14 Feb

Since I posted the necrosis photos and a description of each one yesterday, for Valentine’s Day I am celebrating the Twins by sharing with you just what a latissimus flap reconstruction looks like not long after surgery. For those not familiar with this type of breast reconstruction, please see this link for more information: living_latflap.htm#how

This is not graphic like yesterday’s post. The link above is actually more graphic and shows part of a lat flap procedure.

The first photo you see is my back. The long scar lines is where the latissimus muscle was removed from before it was migrated under the skin of my armpits. And yes…I AM a tattooed chick ;-)

Where you see the gauze, that is protecting the entry point of my surgical drains. I have talked about those in previous posts. Just do a search for surgical drains for more information. on those.

The second photo below is of the flap itself. It is the oval-shaped inset. This is VERY soon after the surgery. Those wrinkles relaxed over time and I no longer have them.

And finally,  below we have a happy pair of bouncy baby Twins! I went from a C cup with my original breasts to no breasts to an E cup. I still have nipple reconstruction when we can afford it, but right now I’m just thrilled with my Girls. I’d like to add that these results were accomplished WITHOUT breast implants. Those breasts are all my own, natural tissue.

The white tape you see outlining the flaps is to help the scars heal flat. This reduces the chances of keloid scars. I’ve talked about those in other posts too. If you have any questions, please don’t hesitate to contact me at boobcast (at) gmail.com

 
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Posted by on February 14, 2010 in breast, breast reconstruction, breast reconstruction photos, Incisions, Latissimus flap, Latissimus Flap Breast Reconstruction photos, latissimus flap reconstruction, plastic surgeon, plastic surgery, Reconstruction, reconstruction surgery, Surgery, Uncategorized

 

Cross Fiber Friction Massage

23 Jan

Yesterday I had a long and very enlightening discussion with an experienced massage therapist. We talked about the plastic wrap sensation I have in my back still. He explained to me that after surgery sometimes adhesions form in the connective of fascia tissue.

An adhesion is a band of scar tissue that binds two parts of your tissue together. They should remain separate. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands. The tissue develops when the body’s repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation.

The massage therapist explained that he had dealt with adhesions before and they appear as described above: cable-like or thin sheets like mine. He talked about a deep tissue massage technique that is used with great success. it is called cross fiber friction massage.

In this technique the fascia, a strong connective tissue which performs a number of functions, including enveloping and isolating the muscles of the body, providing structural support and protection is manipulated in order to break up the adhesions.

Cross-fiber friction involves doing transverse movements to the connective tissues, like tendons and ligaments, in order to loosen up their fibers.This can be performed by opposing thumbs or the heal of the hand, especially on the iliotibial band, a band of muscle in the thigh.

So basically a trained massage therapist uses deep tissue massage going across the grain of the adhesions in order to break them up. This takes quite a few sessions. According to an article in Massage and Bodyworks Magazine, the therapist should keep your pain level at around a 6 on the 1-10 pain scale for 20-30 minutes per session.

The therapist I spoke to explained that yes, it IS uncomfortable and there is a great deal of deep breathing involved in a session. But once the adhesions are broken down it is easier for your body to heal. You will have better range of motion and, best of all, no more plastic wrap feeling!

Because the therapist I spoke to is so far away, I’m going to look into finding someone close by who has the experience to handle this. But before I go, I’m going to call Dr. Elliott’s office and talk to his nurse, Patti. I want a medical opinion on this before I go and do something that may cause me more harm than good.

As usual, I’ll let you all know how it goes.

 
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Posted by on January 23, 2010 in adhesion, adhesions, breast reconstruction, complications, cosmetic surgery, cross fiber friction massage, fascia, Healing, Incisions, Latissimus flap, latissimus flap reconstruction, Pain, Pain Management, plastic surgeon, plastic surgery, Reconstruction, Recovery, Scars, Surgery, Surgical complications, Uncategorized

 

The 200th Post

18 Jan

As the title says, this is the 200th installment of BoobCast. Today I am writing about you, dear reader. Today’s installment is all about the support and the stories that people have shared with me since I first started this blog on Oct. 11, 2008.

When I first started writing this, I was also fairly active on a website called All About Plastic Surgery (http://www.allaboutplasticsurgery.com). When I posted what had happened to me it didn’t take long before I was inundated by questions about various aspects of the surgery. You can find that entry here: http://boobcast.net/2008/10/14/questions/ People expressed a great deal of concern about how well I had checked out the surgeon, what indications I might have had and what legal recourse I might have taken. During that period so many people gave their support and I am grateful for it. So my thanks goes out to the women of the All About Plastic Surgery forum. They were the ones who inspired the idea for BoobCast.

Now you’re probably asking yourself, “Gee Maria, why do you call it BoobCast? Were they wrapped in plaster or something at one point?”

No, dear reader. There are reasons this site is called BoobCast.  In 2007 the podcasting community lost a precious member by the name of Joe Murphy. He died of a vicious type of cancer that took him quickly. During his medical treatments he talked in vivid detail about what was going on, the testing and all of it. His strength inspired me. I wanted to be as strong and as brave as Joe Murphy. So I planned to podcast what was going on with my breast necrosis. The name of that podcast was going to be BoobCast.

I never met Joe but his life inspired me. It just turns out that I’m not that strong or that brave. To honor that bravery I have kept the name.

I also owe thanks to a very dear friend, Tee Morris. When I was trying to find the strength to create BoobCast, He was there for me. He gave me mental and emotional support by letting me know that I *could* do it. I’m sorry I disapointed you Tee but want to thank you for being a friend when I needed one.

In the time I’ve been writing BoobCast I have had people email me directly for advice. Of course, after reading the email, my advice was always “Contact your PS (plastic surgeon) and ask for [fill-in-the-blank]. Whether it was about bruising, skin texture or pain, I advised talking to their doctor. If they couldn’t get a decent answer from that doctor, talk to another one.

The one that really broke my heart was the husband of a woman who, a few days previous the email,  had the same procedure I had. According to her husband, the pain pills her PS had given her weren’t doing much and she was in constant pain. She couldn’t eat or sleep and she was suffering. I told her husband to call her PS immediately and insist on different pain meds and not take NO for an answer. i explained that, right now it was his job to advocate for his wife since she couldn’t do it herself.

A couple days later I got an email from him saying that her PS had changed her meds and she was doing MUCH better. It’s emails like those that made BoobCast well worth the emotional pain of writing those early posts.

I also want to thank everyone who talked to me about BoobCast at DragonCon last year. Being told in person that I’m making a difference means the world to me. Thank you for taking the time to talk to me.

Finally, my thanks to Carol Montoya, Lolly Daskal and the Woman At Denny’s. I promise that once I’ve had nipple reconstruction and recuperate from that, I WILL write the book. The foundation is in the works already.

My thanks to you all for reading, commenting and talking to me. Here’s to another 200!

 
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Posted by on January 18, 2010 in anchor breast lift, Anxiety, barter, boob job, Bra Fitting, bra sizes, Bras, breast, breast cancer, breast health, breast implants, breast lift, breast reconstruction, breast size, breast volume, Cash fees, checkup, chemotherapy chemical, clogged surgical drains, communication, complications, compression bra, compression dressing, cortisone, cosmetic surgery, cryotherapy, debreiding, debridement, deformity, dehiscence, Depression, Drain, Drugs, emotional healing, emotional scars, Excise, excise fluid, fear, Flashbacks, flourouracil, Fluid, granular tissue, granulation tissue, Healing, Hospital, Hospital fees, Hosptial Costs, implants, Incisions, Infection, Insurance, interferon, Invisibility, keloid, keloid scars, laser, Latissimus flap, latissimus flap reconstruction, malpractice, mammogram, mastopexy, Medical, Medical Insurance, memory, Nausea, necrosis, negligence, Nipple prosthetics, Nipple reconstruction, Nipples, Pain, Pain Management, plastic surgeon, plastic surgery, Plastic Surgery Disaster, podcast, Post surgical depression, Post Traumatic Stress Disorder, Prescription Drug Addiction, Prosthetics, PTSD, radiation, Reconstruction, Recovery, Scars, Seroma, serous fluid, Sex, silicone sheets, situational depression, Sleep, slow healing, suicide, Surgery, Surgical complications, Surgical drains, Surgical Fees, Ta Ta Tuesday, Uncategorized, V.A.C. machine, Vacuum assisted wound closure, wet to dry bandages, wheelchair

 

Massage

14 Nov

During the trade show I was selling at today I had my first massage since the latissimus flap reconstruction. Granted it was just a 10 minute chair massage but it was still manipulation of muscle tissue by another person.

I kept anticipating pain. Now I was already IN pain in my left shoulder. I was just waiting for screaming stabby pain in my back. Surprisingly it didn’t come. She did go very lightly because she didn’t want to cause harm. I think that I would want a massage therapist with a few years of experience if I were going to have a long massage.

I asked the therapist if she wanted to look at the scar lines so that she would know what she was dealing with. She gave me a look like she had just sucked on a lemon and told me no. She further explained that the latissimus spread from shoulder blade to waist. In hind sight I don’t think she really understood exactly what she was dealing with. I think she thought that my scars were that long…from shoulder blade to waist. They’re not. They really just go from just below the bra strap to about three inches above my waist.

Even though it relaxed my shoulder and eased my back a little bit, I really think that I’m going to seek out a massage therapist that has experience with a post-surgical back patient. That would be my advice to my readers as well. An improperly trained or inexperienced massage therapist could cause harm through ignorance. That’s the last thing anybody needs is more pain.

 
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Posted by on November 14, 2009 in Incisions, keloid, keloid scars, Latissimus flap, latissimus flap reconstruction, post-surgical, Recovery, recuperation, scar tissue, Scars, Uncategorized

 

Check Up Part 3

04 Nov

I forgot to include something in yesterday’s post. Dr. Elliott had mentioned that he wanted to make sure that my breast tissue has become softer. For the first few weeks right after surgery, my new boobies were really hard and stiff. They were actually very hard. It reminded me of how hard my breasts were after the initial implant surgery.

I pointed out a place across the top of my left breast that, to me, felt harder that the rest of the breast tissue. After gently prodding at it a bit in examination Dr. Elliott explained that the harder area is the top of the muscle flap. He also explained that in comparison to what HE meant my hard it was actually very soft and pliant.

Something that I found to be extremely bizarre is that where I thought had keloid scarring, upon examination, appeared to have nothing of the sort. I am chalking this up to a slightly poor fitting Caique bra from Lane Bryant. It is just a little too small and it makes the scar line feel a little lumpy after a whole day of wearing that type of bra.

That’s one more reason to have a proper bra fitting done. Even if you think it’s been done properly, sometimes it hasn’t. Even though their customer service is really, REALLY bad,

 
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Posted by on November 4, 2009 in boob job, Bra Fitting, bra sizes, Bras, breast, breast health, breast reconstruction, breast size, breast volume, checkup, cosmetic surgery, Healing, implants, Incisions, keloid, keloid scars, Latissimus flap, latissimus flap reconstruction, plastic surgeon, plastic surgery, Reconstruction, slow healing, Uncategorized

 

Check Up Part 2

03 Nov

Dr. Elliott is EXTREMELY pleased with how well the Twins are doing. He’s thrilled with how much they’ve softened and how well the scars are fading. He’s also pleased with how my back looks.

While he was looking and “groping” (forgive me Dr. Elliott, I don’t know what else to call it when you check to see how they feel) we talked about the things I was curious about. First, I found out the reason my back has that plasticky feeling like someone set down a layer of plastic wrap across a wide section of my back.

The reason for that is that he basically disected my back, probably doing more surgical maneuvering back there than in my chest. The crackly feeling is where scar tissue has formed in kind of a sheet. It will probably take another six months or so for that to release. He gave the same prognosis for the numb areas, although those could take even longer.

We also talked about how subjective the term “recovery” is. You “recover” in the recovery room. You “recover” in the hospital. You “recover” after the surgery and that can take over a year dependent on which aspect of healing we’re talking about. For instance it took me about six months to get my endurance level back to where it was. Some people take more time. Others take less.

It’s subjective.

We also discussed nipple reconstruction. I told him it probably wouldn’t be until this time next year. He said it didn’t matter. We could do it tomorrow, next week or five years from now. Personally *I* was just relieved that he wasn’t planning to retire any time soon.

Another thing we touched on was doing a breast lift. His concern is that there wouldn’t be much point to it because as heavy as the Twins are, they would end up right back where they are in no time at all. I would have to lose at least 30 pounds before it would become feasible.

My big issue with that is around that point the Twins will start getting smaller. As I’ve written before, to watch them shrink away is like watching my original breasts rot away. I just can’t handle that right now. I just can’t. As i sit here typing I can feel the panic rising and the tears filling my eyes. I CAN’T lose them again.

Okay, okay, I know logically that I’m not losing them. They’re a part of me and I love them dearly. I’m just SO not ready for that. And for the first time in my life I’m content to weigh 218.

We also discussed the two little places on my sides that look like little handles. he called them puckers I think. (Dr. Elliott, if you read this please leave a comment and correct my verbage). He said they were normal and occurred as part of the surgery. We could do a little lipo to lessen them but to tuck the skin would require another incision. Dr. Elliott didn’t seem very keen on another couple of incisions on me and I’m really quite okay with that. He explained that when you do the tummy tuck type breast reconstruction you get the same thing at the hip bone area.

Dr. Elliott made a point of mentioning that he was SO happy we had gone with the latissimus flap reconstruction rather than the tummy tuck. We both had been extremely concerned about possible complications. The tummy tuck procedure simply carries more risk and more risk was the LAST thing I needed.

So all in all the Twins are doing great. He wants to see me again Aprilish for my one year check up. In the mean time I REALLY hope that he checks in. He seemed really interested in my blogs.

And in case I haven’t said it enough, he’s an amazing doctor. Every woman who has to go through reconstruction for ANY reason should go see Dr. Elliott at Atlanta Plastic Surgery (http://www.atlplastic.com).

 
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Posted by on November 3, 2009 in boob job, breast, breast implants, breast lift, breast reconstruction, breast size, breast volume, checkup, cosmetic surgery, Healing, Incisions, Latissimus flap, latissimus flap reconstruction, mastopexy, Nipple reconstruction, Nipples, plastic surgeon, plastic surgery, Reconstruction, Recovery, Scars, slow healing, Surgery, Surgical complications, weight, weight loss

 

Keloid Scars

30 Sep

I may I have covered this topic before but not as it applied to me, personally. I noticed something last night after I took off my bra. There is a two to three inch area on the underside of each of my new breasts that has some keloid scarring. These spots didn’t have tape on them consistently as they are furthest out towards my sides and the tape kept coming off there.

Imagine if skin could simmer like water and then be frozen in that state. That’s what keloid scars look like. Here’s a photo of keloid scars on someone’s chest.

keloid_3_060802Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation could be related to the process of keloid formation, but these changes have not yet been characterized scientifically.

The methods now available to treat keloids are:

  • Cortisone injections (intralesional steroids): These are safe and not very painful. Injections are usually given once per month until the maximum benefit is obtained. Injections are safe (very little steroid gets into the bloodstream) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
  • Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site after cutting away the keloid. Radiation after surgical excision has also been used.
  • Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
  • Silicone sheets: This involves wearing a sheet of silicone gel on the affected area for several hours a day for weeks or months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
  • Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens the site of treatment.
  • Interferon: Interferons are proteins produced by the body’s immune systems that help fight off viruses, bacteria, and other challenges. In recent studies, injections of interferon have shown promise in reducing the size of keloids, though it’s not yet certain whether that effect will be lasting. Current research is underway using a variant of this method, applying topical imiquimod (Aldara), which stimulates the body to produce interferon.
  • Fluorouracil: Injections of this chemotherapy agent, alone or together with steroids, have been used as well for treatment of keloids.
  • Radiation: Some doctors have reported safe and effective use of radiation to treat keloids.

This is not a very common complication, but it can happen. There doesn’t seem to be a bias. It happens equally in men and women as well as all ethnicities.

 
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Posted by on September 30, 2009 in boob job, breast, breast reconstruction, chemotherapy chemical, cortisone, cosmetic surgery, cryotherapy, deformity, flourouracil, Healing, Incisions, interferon, keloid, keloid scars, laser, latissimus flap reconstruction, Medical, plastic surgeon, plastic surgery, radiation, Reconstruction, Recovery, Scars, silicone sheets, slow healing, Surgical complications, Uncategorized

 

Complexus Inferioritus

10 Aug

Today marks a fresh start for the BoobCast blog. It may be occasionally sprinkled with updates on my current status but for the most part I’ll be talking in detail about why I had the initial breast augmentation and lift. I’ll also add much more in-depth detail to what happened to me and why it may have happened.

Today I’m going to talk about the reasons I had the surgery done in the first place.

I was always pretty socially awkward in high school. I was about 20 pounds overweight, only a couple friends, unpopular and an easy target because I had absolutely no self esteem. Add to that, when I went in for a bra fitting, the sales woman told me I had tubular breasts. I had absolutely no idea what that meant and at 16 was too embarrassed to ask.

This is what tubular breasts look like: http://tinyurl.com/mp3cwv

Fast forward 10 years, add breast feeding two kids and gravity and I REALLY hated my breasts. They weren’t pretty. They were just a couple of hanging flaps of skin. Add to that my nipples were so overly sensitive that if my partners tried to stimulate them, I was hanging from the ceiling because it was just too much sensation.

It was about that time that I became determined that by the time I was 40 I would have beautiful breasts. It wasn’t always at the forefront of my mind but the idea sat in the back of my mind and became cemented. Every time I went bra shopping the notion that my breasts were horrible and I needed a boob job became more and more firmly cemented in my mind.

At 39 I became completely obsessed with the idea that I HAD to get something done. I started researching plastic surgeons in the area. It took me about six months before I finally decided on one locally. So I made an appointment for a consultation.

With everything else that had been going on with major family issues , school and the business, I finally went to an appointment in the spring of my 40th year.

After taking a look at my breasts, it was announced that I had degraded as far as I could and it wasn’t going to get any worse. This article explains the Gurley Stages of Breast Regression http://tinyurl.com/2d3ds3 and I was a Gurley Stage II

The doctor used a different scale but I am unable to find it. It basically amounts to how big your areolaes are and how much droop you have. Mine were the size of Coke bottle bottoms and my nipples pointed at the floor. So I was told I would need a breast lift to make them look perkier and an implant to replace the volume I had lost from breast feeding and age.

She put a VHS tape in that explained the anchor lift procedure and left me alone to watch it. Please look here for a diagram and description of a full (anchor) mastopexy:   http://tinyurl.com/ku5wy5

I will continue this tomorrow since this post is running long.

 
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Posted by on August 10, 2009 in anchor breast lift, Anxiety, boob job, breast, breast size, breast volume, cosmetic surgery, deformity, Depression, Incisions, mastopexy, plastic surgeon, plastic surgery, Uncategorized

 

Midnight eMails

26 Jul

Regardless of the fact that I knew I had to be up early this morning to travel back home from Atlanta, I was down in the lounge at the Westin around midnight. I had, as usual, forgotten to ask Dr. Elliott a few things about the revision surgery we talked about at my appointment on Thursday afternoon.

We had hoped that the little spot near my cleavage would have rounded out a bit more by now, but it is still kind of squarish, So he’s going to kind of pinch that skin together to round it off. He has also suggested doing a breast lift because, as you’ve all seen from the first photo, the Twins are kind of droopy.

Of course, as part of my late night meanderings, I did research on various types of breast lifts. He did not mention a specific type. However in his reply to my email he DID say that there would be no new scars. He would simply make use of the ones I have now. This leads me to believe that he’s thinking of using THIS type of lift: http://www.breastlift4you.com/techniques_incisions.htm

As you can see, this type of crescent incision would use the scars I already have and would be a moderate lift. If the lift is included in the cost of the revisions and nipple creation, I have the general attitude of “Why the hell not?”. He’s going to be doing surgery anyway and I’m paying for it so why not just do the “one stop shop” deal and get it all done and over with at the same time? Dr. Elliott is enough of a pro to be able to do it and do it well.

There ARE other types of breast lifts that, as with the crescent lift above, do not reduce breast tissue volume the way the Anchor Lift does. http://www.plasticsurgery4u.com/procedure_folder/breast_ptosis_surgery2.html This site shows some good examples of the Donut and Lollipop lift.

I always feel better after talking with Dr. Elliott. So I think that, when we can manage the cost, I’ll be having the revision surgery. One thing I learned from my mother-in-law before she died was :Never Settle. So I might as well get what I want.

 
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Posted by on July 26, 2009 in boob job, Bras, breast, breast reconstruction, cosmetic surgery, emotional healing, Incisions, Latissimus flap, latissimus flap reconstruction, Nipple prosthetics, Nipple reconstruction, Nipples, plastic surgery, Plastic Surgery Disaster, podcast, Prosthetics, Reconstruction, Scars, Surgery, Surgical complications, Uncategorized, weight

 
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