Archives for posts with tag: tram flap

I had a very different afternoon on Friday.  I pencilled it into the diary as “bra ladies” because that is exactly what it was, an afternoon of trying on bras.  And not your usual lingerie … post breast cancer surgery bras … post lumpectomy, post mastectomy or post reconstruction.  Post any of the above.

On 27th June 2012 I received an email from the organiser of the Cancer Support Group I attend (Active Women Touched by Cancer, Celebrating Life) saying she’d received an email from a lady called Tina who had cancer treatment and a mastectomy and reconstruction while in her 30s. Tina found that since the reconstruction she couldn’t find pretty and most importantly comfortable bras so she set about designing her own!   She was looking for women willing to talk about their experiences with finding comfortable bras to find out exactly what they liked or didn’t like about what was available, what they wanted to see, where they would buy them from, costings and all the relevant details.  I emailed Tina and said I’d be happy to be involved in any way possible as I knew lots of my ladies struggled to find comfortable bras that didn’t look like they were designed for your great-grandma.

We’ve had numerous email exchanges over the last year and a half.  Tina received her first prototype but was utterly disappointed with it and had to start again.  Bear in mind, this is a personal project, she has no backing or funding at this stage, so a setback like having to start all over was huge.

Here’s what Tina has to say:

Finding a company to produce the bras was a challenge.  The ‘journey’ (that word again) took me virtually via emails and Skype to Europe.  The European company understood my brief and vision.  What I love about working with the company is the beautiful attention to detail, quality, the European touch, the pride in the workmanship.  They have been an absolute pleasure to work with.  I also felt that having the bras made in an European country gave them that extra touch that I was seeking that China was unable to provide.

My design brief was to design lingerie that was European, sexy and fashionable.  The lingerie also had to accommodate the breast form securely and be comfortable to wear.  The pocket had to be in cotton.  Why?  Because most breast cancer treatment (not all) places the woman in menopause.  This means the woman experiences hot flushes and sweats and makes wearing a breast form in a bra with pocket polyester lining uncomfortable.  Cotton lining just seemed logical and it has the properties to absorb moisture and keep the wearer cool.

Which brings us to Friday afternoon.  We had five ladies in my clinic who had been through cancer, plus me. Tina brought along some examples of what was already available on the market for comparison and six designs of her own from two different producers.

The first person to try on had had a lumpectomy and had a “chicken fillet” insert to help fill out the affected side so she popped into the loo and came out to show us how it looked with her insert in.  She loved how it felt, particularly the cotton lining next to her skin – her current bra has a different lining which sometimes makes her feel a bit sticky and sweaty, so cotton was a nice touch.

The next lady who tried on had a double mastectomy and tram flap reconstruction seven months ago and nipple reconstruction a few weeks ago.  She had some swelling still in one breast.  She came out and modelled a different bra but had the same comments on comfort and design.  Great.

The third lady recently had lat dorsi reconstruction about three weeks prior and was also still swollen.  She hadn’t worn a bra in about five years because she couldn’t find any comfortable ones out there.  She had absolutely no inhibitions and whipped her top off and tried the bras on right there – again – in heaven.  She tried them nearly all of them on and was happy each time.

There wasn’t the right size for the fourth lady to try on but by that stage everyone was showing off their scars and ooohing and ahhhing at how good things looked – “wow, you can barely see the scars; wow, you’ve got nipples; wow, look how well you’re moving after such a short time”.  Nothing like a shared experience to bring people together.  I’m sure the laughter was heard for blocks!

We discussed how much everyone would be willing to pay for them – oh, did I mention she’s going to design undies to go along with the bras so you can have a beautiful matching set?  And where you’d buy them from.

Here’s a photo of the three winners of the day:

Image

Red Fern Lingerie, tina@redfernlingerie.com.au

If you’d like any more information or would like to try on the bras and give your opinion, please contact Tina Doueihi at tina@redfernlingerie.com.au or on 0407 359 751.  Her website http://www.redfernlingerie.com.au will be up and running soon.

Advertisements

I don’t often get to see people before their surgery which is a shame, because a couple sessions of manual lymphatic drainage beforehand makes a huge difference on a number of levels …

  • the immune system is given a tune up
  • any lingering toxins are cleared out of the body
  • new pathways away from the site of the surgery can be created helping to reduce swelling or oedema more quickly once the surgery has taken place

I see R on a monthly basis to work on some swelling she has in her lower legs and feet.  She and other females in her family all suffer from this condition and while in her case it is not severe, it is enough to make buying shoes difficult, not to mention it’s just plain uncomfortable.

R was diagnosed with a DCIS (ductal carcinoma in situ) in her right breast in December.  She’s been having annual screening for over twenty years as she was considered high risk and after a couple months of deliberation she has decided to have a double mastectomy and a tram flap reconstruction at the same time.  This is a huge decision on many levels.  A DCIS is not usually considered an aggressive cancer and the recommendation is a lumpectomy, sometimes followed by radiation and one of the hormone inhibiting drugs if deemed necessary.  But R’s reasoning is that she has been screened for 20 years and she’d like to stop worrying.

The surgery is major but one of the main benefits is that there is only one (usually, of course there may be complications but hopefully not).   Muscle, fat and skin are taken from your abdomen to create a new breast using your own tissue.  The transverse rectus abdominus muscle is used to create a breast and later on, if you choose, there is another surgery to create a nipple and areola.  Or you can use a prosthesis nipple – a client told me today she bought one and wore it to bed the other day and woke up with a new nipple on her arm!  Probably best to take it off before going to bed.)

The surgery is long, eight hours or so.  As with any procedure there is a risk  with anaesthetic.  And the recovery is long and quite painful (think about it, you’re moving your stomach muscle up to your chest, ouch). 

The following excerpt is from About.com Breast Cancer, http://breastcancer.about.com/od/reconstructivesurgery/tp/tram_flap.htm

Moving Muscle and Skin

TRAM Transverse Rectus Abdominus Breast ReconstructionIllustration © National Cancer Institute
On the skin markings, your plastic surgeon will make an incision, and raise the skin and muscle flap. A tunnel will be created under your skin so that the flap can be relocated. This tissue flap will go through the tunnel to your mastectomy incision. Notice that this illustration shows a free flap — the skin, fat, blood vessels, and muscle have been cut.

Creating Your New Breast

TRAM Transverse Rectus Abdominus Breast ReconstructionIllustration © National Cancer Institute
The abdominal skin flap (still attached to muscle) will be positioned so that it fills in the skin that was lost during your mastectomy. If you’re having a pedicle flap, your plastic surgeon will close the skin incision to create a new breast. And if you’re having a free flap, your surgeon will use microsurgery to reconnect blood vessels first, and then close the skin incisions.
 

Post surgery there is hourly monitoring to make sure that the tissue is still functioning (there is a small chance of necrosis) and numerous drips which are gradually taken out over the next few days.  There are bandages for the breast and braces for the tummy.  The stomach will likely be sore for about six weeks.  But at the end of all that, there are beautiful breasts made from your own tissue.

After the surgery, as soon as she feels able, R will come in for some post-op lymphatic drainge to help her

  • eliminate toxins from the surgery
  • build her immune system back up
  • reduce the swelling around the surgery site

Extra care is taken and only superficial work is done in the abdomen, that is, if she’s able to tolerate any work at all.  With R I have to be mindful that her lymphatic system is compromised already but luckily she will not have nodes removed in the surgery so the main collections under her armpit should not be traumatised and I can direct fluid towards them as well as the nodes in her neck.

Surgery is next week, good luck R.