“Okay, let’s have a look,” the plastic surgeon says as she opens my robe. She grabs her tape measure and goes to town, taking all sorts of measurements. Determining the distances from my collar bone to the nipple and underneath of each breast, then across horizontally between the pair, just to mention a few. On one of the visits I remember smiling over at my husband afterwards and saying proudly, “My measurements were almost exactly the same for each side! At least they sag symmetrically!” My husband later told me that sitting there watching someone take measurements of my chest was one of the weirdest parts of the plastic surgeon ordeal. I agree, however, I also found it unnerving to be naked from the waist up and have to turn around and have the doctor analyze my chest, back and stomach to determine what type of reconstruction my body would be suitable for. For example, if I had decided to perform a surgery that entailed using my own fat from my stomach to form new breasts, I was told the newly constructed breasts would be smaller than what I am at now. Huh, I thought looking down at my belly…there seems to be more than enough fat in there to me. Consequently, my husband informed the doctor she was more than welcome to use some of his! How sweet! Ha! :)
A reconstruction decision provides a variety of options. I am going to do reconstruction utilizing expanders and implants, but as I also briefly mentioned above you can choose to reconstruct the breast from your own fat. Before reconstruction, a mastectomy is performed. This involves removal of the breast tissue which goes all the way up to the collarbone and over to the underarms. This is an extremely time consuming surgery because great care needs to be taken to remove as much of the breast tissue as possible. In addition to the breast tissue removal, you also must consider skin- and nipple-sparing surgeries. These involve keeping your chest skin and/or nipples intact, or conversely, full nipple reconstruction. Following mastectomy, if implant reconstruction is performed, a tissue expander will be placed under the chest muscle in order to slowly stretch it to make room for an implant. Saline is added to the expander every 1-2 weeks until it reaches the desired volume. A second surgery is needed, known as an exchange surgery, to replace the expander with either saline or silicone implants. This whole process lasts several months. Some of the other choices for surgery are known as flap surgeries. These utilize your own tissue from your tummy, back, thigh or buttocks to recreate the breast. These surgeries create very natural feeling breasts since it is your own fat/tissue, however the recovery is much longer than recovery from implant reconstruction because other parts of your body are involved.
One of the most important things is that you are fully confident and comfortable with your doctors. My husband and I met with three different plastic surgeons in order to make sure we knew all of our options and received several opinions. Dr. A is wonderful. She is great at answering our endless questions and describing specific aspects of the procedures.
If I’m being totally honest one of the comments that gets frustrating to hear is, “At least you’ll have perky boobs for the rest of your life!” I know it’s likely just a knee-jerk, reactive comment, and that people are just trying to be nice and look on the bright side, but in reality I would prefer to keep my own natural breasts. This is not a decision I am taking lightly or that I am excited about just because my chest may not sag (well sag more than it already does) in the years to come. I may joke about silicone or speak lightly of my gravity driven chest, but mostly it’s a defense mechanism to get through all of this. If I really felt I had a choice, I would not choose to cut off my natural boobs even if they’re trying really hard to reach the ground. See, there I go again! But, my boobs are plotting against me. My pre-emptive strike against them is less than three weeks away bringing me much closer to relief and freedom of fear.
By the way, I found The Breast Reconstruction Guidebook by Kathy Steligo one of many helpful sources of information.
Until next time, here’s to plastic surgeons, expanders and silicone!