I told her that I did not want porn star boobs. Repeatedly. Guess what I got?
Now, boys and girls, don’t get too excited…I am likely the only one who sees them that way. Ha! But arguably, I’m really the only one who matters when it comes to how I see them.
She, on the other hand, my plastic surgeon (PS), seemingly couldn’t care less what I wanted. I should have listened to my gut when she told me she didn’t need to see photos of what I might like to see in my future, bespoke boobs. On at least one occasion, she snidely mentioned “all my questions”, too. I mean, who was she seeing who didn’t have questions about a freakin’ mastectomy & the multitude of reconstruction options?!
Yup, my gut that told me she was not the one. I should have listened. My bad.
As I’ve mentioned (probably too many times!), I am not a fan of my new “girls” and I’m finally ready to make some revisions. Actually major revisions. So I’m looking for a new plastic surgeon. Egotistical, non-caring doctors (see above) need not apply.
Honestly, I’ve found it difficult to really understand and thus, express, how much I hate these uncomfortable foreign invaders. They’re chronically hard & heavy, still riding high (and they won’t settle anymore at this point), yet don’t move with me and I constantly feel like my chest skin is being pulled thistight. And there’s more, but that’s all I’m able to share right now.
I feel like at their core, they just don’t feel like a part of me. It’s hard to explain, but I almost feel completely disassociated w/ them, unconnected…which has caused me to never feel at home in my body these past two years. At the end of the day I know they (and I) will never be the same as pre-mastectomy, but I just want to literally feel more comfortable in my own skin.
Not only do they not feel good though (& guys they so, so don’t feel good), they have some structural issues that make wearing 42.6% of my wardrobe, shall we say, difficult. Anything sleeveless for the most part no longer works, including dresses. V-necks refuse to sit front and center and pull towards my right (your left). And don’t even get me started on wearing swimsuits and not just for the normal “lady reasons” of thinking every swimsuit designer hates women. And lord knows I don’t need any further wardrobe malfunctions.
If you’ve noticed my penchant for scarfs within the last two years, well, now you know why. It’s not just that I’m extremely fashionable.
But, I thought I was done. I thought I was done with the mack truck pain , the headache inducing meds,the laissez-faire dropping of the paper gown to show my chest to the next doctor on my consultation list like I was just showing them my tennis elbow. I thought I was done with not being to pick up Callie, gallon of milk, or vacuum. Wait…ummm…anyway, as I was saying…
It’s been almost two years(?!?) since my initial surgery and I was more than ready to move past this chapter and skip straight to the end of the story. But it appears this chapter isn’t quite yet finished. This was just the rough draft and re-writes are in order.
I knew revision surgery(s) are almost always needed after full mastectomies, but they aren’t nearly as tough. They’re outpatient the majority of the time and generally require only a week or two at most until you start feeling back to normal. Turns out, though, I’m not just looking at making a couple of minor tweaks.
So here I am, researching new plastic surgeons. Doctors appointments. Physical therapy. Surgery dates. And mentally readying myself for another serious recovery.
Serious, because I’m basically starting at zero again, unfortunately. Zero, because I want to remove these awful, uncomfortable, annoying water balloons (said implants) and having the surgery I originally wanted in the first place, but didn’t due to a variety of reasons – autologous reconstruction.
In case you haven’t heard of this type of reconstruction option, it’s basically reconstruction using one’s own tissue. In a tissue flap surgery, the doctor removes extra tissue from other parts of your body where you may have some spare fat & skin you’re not using – abdomen, thighs, butt and even your back. The most commonly performed procedure these days is a DIEP Flap (deep inferior epigastric perforator – say that three times fast!) where they take fat and skin from your tummy, but they don’t touch any muscle like the TRAM (transverse rectus abdominis muscle) Flaps did back in the olden days (ie. the 80’s when Morissey was still relevant). Abdomen is by far the most common flap surgery so doing one of the other tissue transfer types like thighs or butt would likely require travel outside of Colorado. Not ideal certainly.
The DIEP flap, considered the gold standard in tissue reconstruction, has a lot of what I see as benefits. They look and feel more like natural breasts and they behave accordingly like shrinking or enlarging with weight loss/gain. They also don’t need to be replaced down the road like implants do. Also, they should be warmer, so I can likely toss out the invention plans I had for that heated bra. The downsides though are why I initially went down the implant road and why so many women do.
The initial tissue flap surgery is a good bit longer (8-12 hours is what I’ve currently been quoted) and requires two surgeons because of the length and technical difficulty of “micro surgery”. My implant surgery was about 6 hours for reference. Recovery from that first micro surgery generally requires a 4-5 day hospital stay whereas the implant reconstruction I originally had, is often just overnight. (Although I ended up getting to hang out with the nurses for three days thanks to varying levels of intolerance to the pain medications). And of course, you’re left with two surgical sites that now need to heal. Imagine trying to get out of bed without using your arms or core muscles AT ALL. And no, trying to get out of bed w/ a wicked hangover is not the same, ya lush. I would know. There’s a small chance I’ll need to do expanders again, but given that I’ve had the implants stretching my skin now for over 2 years, we think that that is unlikely. Hopefully that will be the case. And thankfully since I haven’t had any radiation, my chest skin is not compromised, which is good because I already have pretty thin skin.
Two years ago, because the downsides outweighed the upsides at the time, I chose the “simpler” implant surgery. What I didn’t know at the time was that tissue actually could be an option for me IF I combined it with an implant. This hybrid tissue/implant surgery was definitely being done at the time, but has gained a good bit in popularity in just the past two years as more and more surgeons are performing them with great results.
More medical curriculum; your body’s tissue sits on top of the implants (in my case, a smaller and less “high profile” implant than I currently have) and since your own tissue and fat covers the implant, the final result looks and feels much more like natural breasts. The first and most difficult surgery will be the implant removal and stealing of some of my spare abdomen skin and fat and putting it in my chest cavity where they will mound said tissue into a breast shape. (Cool!) Then they have to then reattach all those tiny blood vessels (some only as wide as a strand of hair) in the flap to the tiny blood vessels in my chest under a serious microscope, hence “micro surgery”. (Gross!)
Also, gross, I’ll have to have drains again to prevent fluid buildup, but four this time instead of two. Um, yea me?! Two on either side of my chest and two on either side of my abdomen, but they’re a necessary part of healing. (Ah, remember the time I said I couldn’t imagine how some women could have four?? Yea, I don’t really either. Thanks narcotics!)
PS – If you’re already grossed out, I highly recommend NOT googling images of all these crazy terms unless you have a very strong stomach! Although if you’re the curious sort or geek out on the incredible science of these kind of procedures, this article from Very Well Health provides some good, not-too-gross-out information.
The second surgery will be adding the implant under the tissue once all of it has proven healthy, ie. the tissue flap hasn’t died, ie. failed, ie. g#!d$*@(*$#)!!!! Both the second and third surgeries (any revisions/fine tuning/fat grafting that needs to be done) should be on an outpatient basis with a much shorter recovery time, barring any complications.
(Oh, why, yes I do feel as though I should get an honorary medical degree. So kind of you to inquire. I assume it’s in the mail?)
Another downside to tissue flap reconstruction is more visible scars. Not ideal certainly, but all of this gory detail should help illustrate just how much I dislike what I currently have weighing heavily on my chest. And my heart.
Two years ago I was told by my original PS that I as NOT a good candidate for tissue because I was too thin. Yea, I know, I can hear the tiny violins from here. Never mind that I think I have plenty extra to donate, but I guess I’m not an actual MD for a reason. She being my actual MD though, didn’t think to mention that she didn’t actually perform tissue surgeries nor that her department colleague actually did, if I wanted to reach out to him for a second opinion. (I’ve learned most plastic surgeons only tell you what options you have based on what type of surgeries they do, so it’s up to us, as patients to do the research.)
As I’ve been researching “explanting”, my social’s began blowing up with a hashtag I hadn’t ever heard of – #BreastImplantIllness. While that term is not a medical diagnosis (it is widely used to explain a large variety of symptoms that may or may not be related to implants) as I research this topic further, I may have more to come on that.
Suffice it to say, whether or not 100K+ women are making these symptoms up (spoiler alert: unlikely) and linking them to their implants, doesn’t really matter. It just feels like another reason I didn’t even know I was looking for, to say “adios chica’s!”
For example, the FDA explains that the longer you have breast implants, the more likely it will be that you’ll need to have them removed. Their list of risks associated with this procedure is extensive and detailed, ranging from chest wall deformity to toxic shock syndrome.
In addition, there’s a “rare” type of non-Hodgkin’s lymphoma cancer that we’re now seeing in women with implants (generally the textured type, which I don’t have), but some reports are starting to indicate that the cancer has been found in women with non-textured implants and has caused at least 16 verified deaths as of early 2018. As of late 2018, textured implants are no longer on the market in Europe. ’Merica, it’s your turn.
To be clear, there is a higher risk of complications with tissue surgeries over implant surgeries. The pro’s & con’s of all the types of reconstruction is truly dizzying, though. I’ve spent hours researching them and still feel as though I’ve barely scratched the surface. If you, or a loved one is considering mastectomy surgery (with or without reconstruction), I highly recommend Kathy Steligo’s Breast Reconstruction Guidebook. The most recent update was in 2017, but it’s still one of the most comprehensive, non-judgy references out there that I’ve found.
But thankfully, I’m not overweight (oh, those violins sound so pretty), a smoker, over 60, nor have I had radiation therapy or chemotherapy. All factors that increase the likelihood of developing a complication with tissue flaps.
As you can imagine, I have not come to this decision lightly and am so, so thankful for my ever patient, incredibly supportive husband & family in all this. I hate that Bill, especially will once again need to perform the unforgiving job of caregiver for a while. But I’m very glad to also be in a much better place now than I was before and after my mastectomy. And as I told all the doctors on my consultation rounds, I’m hoping to have these babies for another 48 years so hell YES! Let’s do this.
Now if you’ll excuse me, I have some Salted Oreo ice-cream and Netflix to stockpile.