scar tissue

Donna H · 03-05-2015, 10:32 AM

I had a lumpectomy in early April. I have finished chemo and rads with only 5 more Herceptins to go. Here is my problem. I have significant scar tissue at lumpectomy site - the scar tissue lump is at least as large as what was removed and that was 5cm x 2.5cm. I am trying to decide if I should have the scar tissue removed. It is uncomfortable to lay on that side and sometimes it hurts. My GP thinks it should be removed. My onc doesn't seem to have an opinion. The positive side to having the scar tissue is that it is not as noticeable that I had part of my breast removed! The posts/threads on this site have been so helpful through this journey I thought who better to ask - what should I do? PS - if I remove scar tissue I will probably need (want) reconstruction and that is frightening.
Thanks
Donna

tricia keegan · 03-05-2015, 12:48 PM

Donna, I had scar tissue too although had my breast surgeon check it first to be sure in case I needed a biopsy. I didn't feel any soreness though and in your situation I think I'd see a breast surgeon to see what can be done to make this more comfortable for you.

Debbie L. · 03-05-2015, 01:57 PM

Donna, I would include your rads onc in the loop, as he/she may have an opinion on whether it might be better to wait longer, for the rads damage to resolve as much as possible, before contemplating more surgery. I think everyone is different in how rads affects the tissue. But rads definitely does, to some degree, affect how the tissue will heal.

Do you know if you tend to form excess scar tissue (keloids) in general? If so, again -- get the most expert opinions that you can, so that you don't end up with an extra surgery, but (again) still more scar tissue.

There is no rush to make this decision. Can you gather opinions from both oncology surgeon(s), plastic surgeon()s, and rads onc(s)? If you're not entirely satisfied at any point, this would be an excellent time for a second opinion.

Debbie Laxague

Shirley · 03-05-2015, 05:25 PM

Donna,

I had a DEIP recon last fall, followed by a revision surgery to smooth out the scars and even things up 3 weeks ago. The DIEP surgery was about 10 months after radiation. Depending on the plastic surgeon, they will have you wait 6-12 months for surgery following rads. I healed up fine after the DEIP, but this most recent revision has been a different story. My skin after the revision got really red and has started to peel (though not as bad as what happened during radiation--ugh), and my surgeon said it could take a month to heal and for the redness to improve due to the radiation. He put me on antibiotics for a week. But it was still worth it to me because he was able to dramatically reduce the scarring (both on the breast and on the tummy scar) so in the long run I think I’ll be happier with it.

I think there is an excellent chance that a plastic surgeon could do something about your scarring. Just know that it might take longer to heal than someone without radiated skin. I encourage you to check it out.

Shirley

europa · 03-05-2015, 08:18 PM

I had the same thing. I spoke to several plastic surgeons and my own grandmother who was a plastic surgeon.mthey all said the same thing....leave it alone. They said the body would re absorb the fluid that was built up in the scar. My scar was hard and huge for over a year. It's been three years since my surgery and I can still feel a grape size scar. You can try to massage the scar with a little coconut oil once a day to help break up the fluid but the body will eventually re absorb it

Shirley · 03-06-2015, 10:23 AM

Also, my PS recommended a scar reducing product called "Scar Fade" which Amazon sells. I haven't tried it yet, but plan to. I used an antioxidant facial cream on the original mastectomy scar and that scar looks great, but I can't say for sure it was due to the cream. The Scar Fade product is a silicone-based band aid sort of application.

Donna H · 03-06-2015, 01:30 PM

Hi Shirley-
Thanks to all for responding. Question for Shirley - what is DEIP recon?

Shirley · 03-06-2015, 02:23 PM

DIEP= Deep Inferior Epigastric Perforforators. It is a reconstruction method that transplants fat from the tummy to the breast, following mastectomy. It results in a natural looking breast using your own tissue. Not everyone is a candidate for this type of reconstruction--you have to have enough belly fat. My PS says he can do them even on skinny marathon runners, not sure how, but he works miracles.

You've had a lumpectomy so this wouldn't be for you. Maybe they could remove the scar you have and do some fat grafting....I'm not sure. Plastic surgeons can do so much these days for BC patients.

Shirley