A Breast Reconstruction Journey

Once I had decided on the double mastectomy and reconstruction it was a matter of just making it happen. My surgeon referred me to a plastic surgeon, who I loved! Having confidence and a good connection with your plastics doc is really important. While he was very to the point and matter of fact, his pictures of his work were great and he did take the time to listen to my fears and concerns and answer my questions. From beginning to end, he was great to work with and did an awesome job! When meeting with them remember this is what they do, day in and day out.

So we met and he talked about all my choices. I told him I had chosen the double mastectomy and he talked about the process and showed me pictures. I was quick with my decision, ready to have it made, but I think I made a good choice. We decided on starting the reconstruction process “immediately” aka right after the double mastectomy. But first I had to have chemo. So after months of chemo and a month after my last treatment I was ready for surgery.

I went in for the double mastectomy and the surgeon did his part then my plastics doctor came in right after my surgeon and did phase one of the reconstruction. Phase one was putting in expanders and a plastic medical mesh and sewing me back up. I woke up in a bra much like a cross between a training bra and a sports bra that fastened in the front. There wasn’t much there but there was something! Which is better than flat or nothing in my opinion, I think it would be really hard emotionally to deal with not having anything. To those of you who experienced that, my hats off to you for enduring and being so brave!

I also want to mention that I did have drains in for the first week after surgery which I went to my plastic doctor’s office for removal. I did not realize that when I went in for this one week follow up after surgery that they would take those out then. Take someone with you would be my suggestion, you won’t feel like driving. And plan to take some pain killers. Its not a fun feeling when those tubes are pulled out. But as I’ve said all along, I would recommend having someone with you if possible for every appointment. You might not remember everything that is said and the moral support is so important. I had someone with me every time except for radiation treatment days and my final plastic appointments.

I had a few weeks of healing from that when we started the actual expanding process, or phase two. This involved going to his office and he would fill my expanders up with saline. It didn’t hurt really, but was uncomfortable and sore. For those of you wondering, you pretty much lose all feeling and the expanders are rock hard; they have to be to stretch the muscle and skin to the size you want to be. Your plastics doc will discuss with you before surgery what size you want to be and what size is safe and realistic. I had gained some weight over the years and with chemo so I was looking for a full C or D. I had enough issue left over from the mastectomy to make this possible.

I healed very well from the incisions before he started the expanding. There was one complication where a spot didn’t want to heal and close all the way but it finally did. I had the expanders filled a few times before we got to the size we agreed on. Keep in mind it is important to wear that training bra 24/7 during everything except when in the shower. If you don’t the expanders could move or fall. I didn’t experience this but know it could happen. Also, trust what your plastic guy says about sizing. My radiologist said she has seen where some people went way too big and they split open and the implant fell out. So listen to your doctor. I’m not worried about that happening but just be safe and smart.

When I got expanded to where I needed to be it was time for radiation. I went the numerous treatments of that and was told that my radiated side could become firmer and slightly smaller than the non-radiated side. This would have been due the skin scarring and healing. But actually, much to my happiness and surprise of my plastics guy, that didn’t happen. They are literally as perfect as man can make them. I really have no complaints about my doctor, the process or the outcome. Prayer works and I know I am extremely blessed and I am very grateful for it!

After my skin healed from radiation I had phase three which involved taking out the expanders and putting in the implants. I had two choices of implants: memory silicone gel or saline. Both have pros and cons but I chose the silicone for a more “real feel”. Saline is technically safer and for women who just get implants it would be a good choice, but since there is NO BREAST TISSUE LEFT the silicone gives a nicer feel. I also think it’s quieter (as in you can hear the bag rippling), with saline I think it’s louder but I sometimes hear the silicone when I’m working out and such. They’ll let you feel samples ahead of time.

That surgery was pretty quick and they cut underneath on the bra line, just like with normal implants but the incisions maybe slightly larger. That is where the expanders come out and the implants go in. They will not or at least should not reopen your mastectomy scars. Luckily I had no drains with that process and was sent home the same day! The first surgery I stayed a few nights at the surgical center but that was mostly due to a medication issue and finding out I’m allergic to morphine. Let’s just say throwing up after that surgery multiple times was not fun. So let’s hope you know everything you’re allergic to before surgery!

I had a two week recovery period after the final surgery but really started feeling much better after just a couple days. You still have to wear your training bra for a while and go in for checkups but the implants are so much more comfortable than the expanders. After that you wait about two to three months before you can start wearing regular bras or bras with underwire. Just check with your plastics doctor before making the switch from your “training bra”. After about three months was when I got serious about getting my body in better shape and exercising.

I chose not to have a process called “nipple forming” done. Apparently they pinch some of the skin and tie it off and let it stay a while. After a certain amount of time they “unwrap” or “untie” the skin and the shape of a nipple is formed. From women I talked to, this process was not pleasant or worth it. Eventually the skin relaxes back down and you no longer have the raised area for a nipple. I also chose to not have my plastic surgeons office do my nipple tattoos. They are not usually trained on the 3D effect tattooing. These are all options you can have done. For those who want to try the nipple forming, I say go for it! And if you cannot afford professional tattooing then have your plastics office do it because insurance will pay for it that way; you can always have more tattooing done later.

After going through everything I decided to wait a while on getting my nipple tattoos. I almost wish I hadn’t. To not have feeling in my “Breast mounds” (the technical term for them) it sure as hell hurt! Felt just like any other tattoo except for the pain was spread all over, probably due to the nerves being moved all around from the stretching and surgeries. I had dealt with some pain during the expansion process and after surgeries for a few months. I was told it was muscle spasms and was given a muscle relaxer to take, which did help. But tattoo pain is a thing I didn’t care for. Some people handle it better than others I guess.

I went to a professional cosmetic tattoo artist. Other than the pain, she did amazing! She also had some numbing jelly she put on my skin that helped. It felt like she was chiseling away at my breast bone, I guess it was just due to the location and not having any real tissue to help absorb the shock. But I do believe it was totally worth it. I had to go back after about two weeks to have touch ups done. You can discuss size, color and location with your tattoo artist. We mixed up a color I preferred since I didn’t like the standard color choices. I also had her make them a little larger when I had my touch up done. You can also have the scars tattooed a skin color to blend them in and away, but I did not.

The final product of my reconstruction process is simply beautiful and amazing. The tattoos were a closer on the whole process for me. I feel whole and complete. I feel beautiful and amazing and I love my body. I love my body even more since getting in shape and taking care of my body. I eat healthy and exercise. Since starting the whole cancer ordeal I have now lost 22 pounds, which doesn’t sound like a lot but I’ve gained muscle mass and I think I look great! I hope knowing what to expect and what the outcome can be will help you through your journey. Through the pain and tears and struggles I can now say I love my body and I love life. Feel free to comment or ask questions. Blessed Be!


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