Getting Sensation Back After Your Mastectomy
I spent the summer in my hometown of Newport Beach, California. In between our back-to-back Breastie retreats, I made sure to sneak in some beach time because there is nothing I love more than the beach.
I will never forget this moment though… it was a Wednesday morning, it was a gorgeous day and I couldn’t wait to get to the beach and dive right into the ocean. The water felt amazing and I was having the time of my life body surfing and catching waves.
When I got out of the water, something felt off. It was as if EVERYONE on the beach was staring at me.
I mean, I definitely had on a cute bikini but it wasn’t THAT cute…
As I walked past a teenage boy, he bluntly said, “yo your boob is out.”
I was MORTIFIED. I couldn’t believe that my ENTIRE foob was out and I legit had no idea…
Don’t get me wrong, this wasn’t my first nip slip. I have had way too many since my double mastectomy in 2017. But this one was especially mortifying for some reason and for the rest of summer (and to this day) I feel like I am CONSTANTLY paranoid about nipslips.
I have become obsessive about making sure the girls are being properly concealed and I can’t help but wonder how different my life would be like if I still had sensation in my chest.
In case you didn’t know this - I had nooo clue before my surgery - after you undergo a mastectomy, you typically lose almost all of the sensation in your chest. What does that mean? You have no idea if your shirt pops open, if your bathing suit slips off, you can’t feel someone touching your foob, you can’t feel your pet or child breathing on you, if you spill something hot or cold you have no idea… the list goes on and on and it truly makes a huge impact on your life.
If I could go back in time, I wish someone would have told me that this didn’t have to be the case. I wish someone would have told me that there is this incredible technology called Resensation that actually reconnects your nerves so you can potentially regain sensation after your mastectomy. (more on this below)
Since I didn’t have all of the facts at the time of my mastectomy, I have made it my mission to do my best to bring all of the facts to y’all so you aren’t going into your surgeries as blind as I did.
I hope that if you are navigating your options, this information is empowering for you, and not overwhelming. If you are wondering if you are a candidate for ReSensation, I recently sat down with Dr. Suhail Kanchwala to get us some answers.
Dr. Kanchwala is super impressive, not only was he recognized by America's Top Doctors in 2017 but he was also recognized in Philadelphia Magazine's annual Top Docs issues for 2018 and 2019!! AKA he is kinda a big deal…
LETS START WITH THE BASICS, WHY DO WOMEN LOSE SENSATION IN THEIR CHEST FOLLOWING A MASTECTOMY?
During a mastectomy, all of breast tissue is removed. The breast tissue contains nerves that supply feeling to the breast and overlying skin. Those nerves must be cut during a mastectomy. As a result, most patients will experience numbness in a significant portion of their chest.
Numbness across the chest is significant to patients because they cannot feel a large part of their body. The only personal experience I have to relate to it is being numbed for a dental procedure. For a few hours part of your lip is numb, you’re drooling, and talking funny. It’s a very unsettling experience and that’s only about 0.1% of your total body surface area - and it’s temporary. Imagine your chest being numb, which is closer to 9% your body’s surface area, and you start to get a sense for the scale of this problem. If the nerves cut during the mastectomy are not reconnected during reconstruction, sensation will only partially and incompletely come back and it can take up to 2 years for that to happen.
SO HOW EXACTLY DOES RESENSATION WORK?
During a breast reconstruction using a patient’s own (autologous) tissue, we take skin and fat (most commonly from the abdomen) to create new breasts. I form the abdominal tissue into a flap and move it to the chest. Then I hook up the arteries and veins in the flap to allow the tissue to live in the new location. At the same time, we can actually reconnect the nerves, too.
The idea of reconnecting nerves during breast reconstruction isn’t necessarily new. The challenge previously was finding nerves in the abdominal flap long enough to reconnect to the nerves in the chest. Resensation works by bridging the gap between the nerve in the abdominal flap and the nerve in the chest using a nerve allograft. The nerve allograft acts as an extension cord, connecting the nerves in the newly constructed breast. The procedure only takes about 15 minutes and has a significant and positive impact both physically and emotionally on the patient.
You can find a doctor near you that performs Resensation using their surgeon locator HERE.
WHO IS A CANDIDATE?
Patients considering autologous (free flap) reconstruction or revising a previous implant reconstruction with a free flap surgery are candidates for Resensation. It’s important to express your desire to include sensation as part of your breast reconstruction with your surgical care team.
WHO IS NOT A CANDIDATE?
Currently, patients seeking autologous breast reconstruction are potential candidates for Resensation. It’s important to talk with your breast and plastic surgeon about the options that may work best for you.
HOW LONG AFTER THE INITIAL MASTECTOMY CAN THIS PROCEDURE BE DONE?
Resensation can be performed during autologous breast reconstruction whether you chose an immediate or delayed reconstruction.
CAN THIS BE DONE WITH IMPLANTS?
The Resensation technique works with autologous tissue breast reconstruction and requires connecting a nerve found in the flap tissue (typically the abdomen) with a nerve in the chest using a nerve allograft to bridge the gap between the two. There are some advances surgeons are working on to provide return of sensation in the case of implant based reconstruction. This is a vital area of new research and I hope we will be able to move in this direction clinically in the near future.
WHAT IS RECOVERY LIKE?
Resensation is performed at the time of the autologous breast reconstruction and does not impact the recovery process. Recovery times may vary from patient to patient, but the general recovery time for a DIEP reconstruction is 4-6 weeks.
HOW MUCH SENSATION IS EXPECTED TO COME BACK?
When you perform a nerve repair, there's always a lag period, return of sensation is not instantaneous. Nerves grow very slowly at a rate of about a millimeter a day. Because nerves regrow so slowly it takes time for sensation to return and continues gradually month after month. Between nine and twelve months, many patients are starting their sensory recovery, and that recovery is typically complete in 18 months. The level of sensation return can vary patient to patient, and we are currently studying outcomes and level of sensory recovery among treated patients.
HOW OFTEN DO YOU PERSONALLY PERFORM THESE SURGERIES?
I specialize in autologous breast reconstruction and perform these surgeries on a weekly basis.
WHAT DO YOU FIND THE IMPACT IS FOR THE PATIENT WHEN RESTORING THEIR SENSATION?
The impact is both a physical and emotional one.
Physically, mastectomy causes a significant deficit to patients because they can’t feel a large part of their body. This makes them more prone to injuries such as burns or frostbite from ice packs and heating pads, as well as sunburns with over exposure because they can’t feel the tissue being damaged.
But that's just one part of it. It's how a patient experiences their new body after mastectomy that is a critical part of their recovery. Their emotional recovery, including how comfortable they are with themselves, and how comfortable they are interacting with their partners and loved ones is a fundamental part of their lives.
You can directly hear from a Breastie how Resensation has affected her life, in this YOUTUBE video or you can read about her experience here.
WHAT DOES RESENSATION DO FOR WOMEN THAT TRADITIONAL RECONSTRUCTION OPTIONS MAY NOT?
My goal in performing any breast reconstruction surgery is to get the patient back to a state that they were in before they ever received a breast cancer diagnosis. Feeling normal isn’t just about the appearance of the reconstruction, it’s also about how it feels to them. Resensation plays a critical role because it allows patients to return to a sense of normalcy faster. We want the reconstruction to become part of the patient’s body image and a significant part of that has to do with regaining feeling in their chest. Regaining sensation helps patients experience their reconstruction in a much more normal way.
This information should be used as a tool to better understand what YOUR options are and to feel empowered when you talk to your doctor to ask the right questions, understand the procedures and the benefits and drawbacks. At the end of the day, it is YOUR body and it is YOUR choice. Knowledge is power and you should always feel empowered to take charge of your health and ask for what YOU want.
To discuss if this surgery may be helpful for you, please call Dr. Kanchwala at 800-789-7366 or check out the ReSensation Website at the link here.
IF YOU LOVED THIS INTERVIEW AND WANT TO SEE MORE LIKE THIS IN THE FUTURE, PLEASE LEAVE A COMMENT BELOW, SHARE THIS WITH YOUR FRIENDS, AND LET ME KNOW WHAT TOPIC I SHOULD COVER NEXT!! LOVE YOU ALL SO MUCH!! XO
This post was created in partnership with Resensation. All opinions my own.