Tissue expanders and reconstruction

Here's the link Julie

http://www.bcna.org.au/network/groups/61026/blog/63269

Thanks Louise, will try to find the photos - didn't know you could post photos! My PS told me its best not to have nipples put on until the breast has settled down as they drop in the first few months and the nipple could be in the wrong spot, so that's why I'm still waiting for them. Isn't it interesting that all the surgeons have different advice, yours obviously had no problem doing them straight away.

Sorry Julie....I haven't been on here lately!

The nipples were created when I had the expander changed over for the permanent implant (so under general anaesthetic).  I have put some photos up in the reconstruction section.

Hi Julie

My nipples weren't made from transplanted skin but were made by basically "twisting" the existing skin into a nipple and then I had them tattooed later.  They look great and I am really happy that I had them done.  I wasn't out of pocket very much at all and the recovery wasn't anything like what you have read about!  Certainly no separation of the stitches etc.....it was a very easy and painless operation.  Talk to your plastic surgeon as this may be an option for you :)

Louise

Hi Julie, glad all my blather was useful, I will post after the next bit, I found when I began this whole thing I really wanted information but lots of people get through the journey and move on, so don't look back. I have another friend who has exactly the same issues as me but three months later so I can show her where things are headed. Everyone makes up their own mind and decisions are difficult but the more views you can get of things the easier I found it was to be comfortable with that final decision about what to do. Good luck with your next steps, it is really pretty amazing what doctors can do.

Hi Fiona

Thank you so much for your detailed account, it was, and will be, extremely useful. I made my hubby sit down and read it too! Prior to reading it I had made up my mind that I would only go for tattoo nipples, but you seemed to have survived the nipple recontruction OK despite it sounding really yuk! I'd have to take time off work, that first week sounds awful. But one of my boobs in particular is sitting very flat compared to the other and nipples may well help the look of it, as you say, just that glance out of the shower that would makes you think for a second that you had real ones!

First though, I have to do what I can to fix up my mismatched boobs, The PS said he could attempt to fix the bottom half by injecting fat into it from my stomach (all under local anaesthetic apparently) which I will probably go for. Then I will have to let it settle down before the tattoos. So a while away yet.

I can't wait til I'm at your stage - you are almost at the end of all your procedures! Do post once you've had your tattoos done.

Thanks and take care

Julie

Hi Julie

I posted on another thread about how I nearly didn't go ahead with the nipple reconstruction as I found out the cost and that my ps charges $1585 per nipple, some don't charge above the scheduled fee. After a lot of investigation with medicare I ended up out of pocket about $1500 as the extended medicare net kicks in at $1222 out of pocket (out of hospital out of pocket) and you get back 80% of your cost except on capped items - nipple reconstruction 45545 is one of those, also if you get them done at the same time you only get half of the full fee - ($620)  so $310 for the second nipple - it was really complicated.

 Anyway I talked with different people , and my husband and decided to go ahead, I did really consider :A keeping the Barbie Boobs and having no nipples - who really is going to be looking anyway?, B: 3D tattoo ......but then though heck I have done all the rest so just go with it.

I had the procedure done in the ps rooms and it took quite a while, I thought it might be simple but it is really quite delicate.(about and hour and my ps is fast) I found a website from another ps and there were diagrams of the cut etc, basically a horizontal line with a half circle in the middle, this half circle gets twisted around and sewn together to form the nipple.

I was warned that they would look enormous after surgery due to the swelling but they would shrink - up to 3 months later. I went home with two very thick square sponges with holes cut out around my nipples - out of all the surgeries this was the one where I couldn't disguise stuff and had to not go out for the week, no shower either.

Then the stitches came out and I just had one sponge and wore a loose bra to hold the sponge in place. The first morning I noticed I was coming apart and panicked - I found out later this is normal and I just needed to keep the scabs and wound moist with antibiotic cream. The main thing is not to put any pressure on the skin graft to keep blood flow to the new nipple and then keep everything moist so the scar heals and pulls together slowly.

Phew so I am now about 3 weeks down the track and as I mentioned in previous post above, feel that my fake boobs look more real, not that I go around flashing them but the quick glance when you get out of the shower has made all the difference to me. The new scars will mostly be hidden by the tattooing of the areola and the older horizontal scars don't seem to be the main focus anymore.

I have been really lucky not to have to work through this whole process as I had income protection, it would depend on your job if you felt okay about the whole Sponge Bob look after the initial week - although each ps has their own procedure - mine used to use little "Madonna" cups but has switched to the sponges and tape for the first week.

Everyone is different - about as different as types of boobs and types of breast cancer, but for me I am glad to went ahead, my fake boobs are still kind of flat across the front so the nipples make them more what I think of as a normal shape and this was the main reason I didnt go witht he 3D tattoo as I felt it would look stuck on the flat part and not realistic.

Cheers

Fiona