Surgery Complications

I love this question and I hope you do not mind a long answer.
After my mastectomy, I was very confused about the surgery itself. As a veterinarian, I wanted the gory details but really was not getting any. I did not understand where the expander was in relation to my muscle and chest wall and I also developed a large hard mass in my arm pit that my doctor did not seem to be able to explain. It was extremely uncomfortable and I had to keep my arm raised to minimize the discomfort. Communication was very poor with my surgeon and staff at this point. My drain was also pulled, to my surprise and I was given the pathology report on my way out the door. At a previous visit, my surgeon told me that he had gotten everything and the 3 sentinel nodes taken were clean. I read the report in tears on my way home. The report stated that the original mass (IDC) was nonviable scar tissue but it also reported another small mass, invasive lobular carcinoma, not previously detected, with 0 margin of clean tissue on the chest wall side of the tumor. Not good. It also reported that 11 nodes were taken, not just the 3 sentinel nodes. Fortunately, they were all clean. The real concern was the lack of clear margins. My understanding at that point was that radiation would be necessary but also not possible without removing the expander. I had no one to talk to and the weekend to survive until I could get more information. I was a mess. I saw my surgeon the following Monday and he allayed my concerns about the free margins (which were confirmed by my oncologist). The next day, however, I was in the ER with a 104 fever and an infection.

During my post surgical complications, I knew I could not continue healing at my best in my current state of mind. I was unhappy with the poor communication I was having with my surgeon and his staff and I just did not trust the conflicting information I had been getting. I was seriously considering changing surgeons/hospitals. I knew, at this point, that I could not change my surgeon and how he interacted with me nor could I change the culture of the hospital and staff. The only change I could create was in myself and how I chose to engage. With the help of author Caroline Myss, (Defy Gravity), I meditated and focused on reinventing my relationship with my surgeon (and my life). I surrendered to the situation and flipped my state of mind from one of fear and anger to love and trust. It required daily/hourly effort (or remembering) initially, but the benifits were so powerful and freeing, it literally had a momentum and staying power of its own. Simply put, a choice. I love this question and I hope you do not mind a long answer.
After my mastectomy, I was very confused about the surgery itself. As a veterinarian, I wanted the gory details but really was not getting any. I did not understand where the expander was in relation to my muscle and chest wall and I also developed a large hard mass in my arm pit that my doctor did not seem to be able to explain. It was extremely uncomfortable and I had to keep my arm raised to minimize the discomfort. Communication was very poor with my surgeon and staff at this point. My drain was also pulled, to my surprise and I was given the pathology report on my way out the door. At a previous visit, my surgeon told me that he had gotten everything and the 3 sentinel nodes taken were clean. I read the report in tears on my way home. The report stated that the original mass (IDC) was nonviable scar tissue but it also reported another small mass, invasive lobular carcinoma, not previously detected, with 0 margin of clean tissue on the chest wall side of the tumor. Not good. It also reported that 11 nodes were taken, not just the 3 sentinel nodes. Fortunately, they were all clean. The real concern was the lack of clear margins. My understanding at that point was that radiation would be necessary but also not possible without removing the expander. I had no one to talk to and the weekend to survive until I could get more information. I was a mess. I saw my surgeon the following Monday and he allayed my concerns about the free margins (which were confirmed by my oncologist). The next day, however, I was in the ER with a 104 fever and an infection.

During my post surgical complications, I knew I could not continue healing at my best in my current state of mind. I was unhappy with the poor communication I was having with my surgeon and his staff and I just did not trust the conflicting information I had been getting. I was seriously considering changing surgeons/hospitals. I knew, at this point, that I could not change my surgeon and how he interacted with me nor could I change the culture of the hospital and staff. The only change I could create was in myself and how I chose to engage. With the help of author Caroline Myss, (Defy Gravity), I meditated and focused on reinventing my relationship with my surgeon (and my life). I surrendered to the situation and flipped my state of mind from one of fear and anger to love and trust. It required daily/hourly effort (or remembering) initially, but the benifits were so powerful and freeing, it literally had a momentum and staying power of its own. Simply put, a choice.

Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.



Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.

Richard M. Kline Jr., M.D. Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.



Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.

Richard M. Kline Jr., M.D.