Déjà vu

WARNING: NSFW / graphic content below.I can't even

A month after my last surgery, during which we swapped the tissue expander on left and adjusted pocket on right, I am again uniboobin‘ it. Déjà vu? Twilight Zone? Groundhog Year?

Yes, that is right, I have lost another implant. This time it is the right one. Everybody together now: WTF?!? DARN IT! I am really feeling dejected. I literally can’t even … (not me~>)

So what happened this time?

This was different than last year, but the outcome is the same, unfortunately. Sunday during my typical post-shower wound inspection, I noticed that there was a tiny inflamed spot on my right breast on old, already healed incision. It got a bit bigger by end of day. Monday morning I went in to see Dr. M. Both him and one of the nurses suspected it was an internal stitch trying to make its way out.

That’s not so bad, right? Just a little stitch. Dr. M advised me to do a warm compress three times per day and keep a very close eye on it. A couple of days later the area started bulging out and I could see yellow puss inside. Thursday morning I sent an email to Dr. M, with an update but I knew he was in surgery. Early afternoon I did the compress, which made the abscess open. After all the goo drained and the stitch knot came out, I was left with another hole. I knew what was coming :(. Went to see the nurse right away. She took cultures and started making calls to coordinate my surgery for the next day, during which I had the right implant removed, pocket cleaned out, and closed back up without inserting another implant.

So … here I am with one breast again AND I got another drain. Fun fun! I go in for follow up on Monday to find out what is next. This is like a rerun nobody wants to watch. Especially not me. Last year I had exchange 9/3, implant taken out 10/15, expander placed 4/10, exchange surgery 9/11, and this implant out 10/10. At this pace, it will take another year.

Enjoy the visual (kind of gross):

Abscess

Ovarian Cancer Awareness Month

They say that Ovarian Cancer whispers. It is a silent killer. The symptoms are often attributed to GI issues (bloating, abdominal pain, difficulty eating, going to the bathroom often), there is no reliable screening method, and it is hard to find in its early curable stages.

My mom experienced these types of symptoms. By the time doctors took a closer look, they discovered ovarian cancer in advanced stages. She lived for a little over a year. Not a day goes by that I don’t think about and miss her.

Ladies, please educate yourselves about the symptoms and risk factors associated with ovarian cancer. Has anyone in your family been diagnosed with ovarian cancer? How about breast cancer under the age of 50? Male breast cancer? Two members on the same side of the family with any of these cancers: breast, ovarian or fallopian, prostate, pancreatic, or melanoma? These signs may point to hereditary cancer. If you suspect the cancer in your family may be hereditary, it is important to consult with a genetics expert. Find one here.

Ovarian Cancer Fact Sheet

Bra shopping

WARNING: NSFW / graphic content below.

My exchange surgery was on September 11. We swapped out the tissue expander on my left and made a pocket revision to correct the implant bottoming out on the right. The follow up appointment was two weeks later. Everything feels and looks relatively good. Some twinges of pain here and there, but that is to be expected. As far as my results: small issue, but it’s still early as things will change and settle for a while. My next follow up is at six weeks.

Compression braI have been wearing this sexy little hospital-issued number almost 24/7 and was hoping to hear that I could ditch it. Well, I can burn that one, but I do need to continue wearing something. It should be wire-free, but have a tight band. I set out bra shopping this weekend and quickly became frustrated! The first two stores didn’t even carry a 32. I ended at Victoria’s Secret, where I should have started, but that was tiring too. It seems that out of the 23049814 bras VS carries, only a few are wire-free.

First tried on the Perfect Comfort Demi Push-Up in 32DD. Too much padding, I’m still spilling out (no DDD), and the VS girl didn’t know her shit – it has an underwire. I went home with two of the Sexy Tee Wireless Bra in 32D. It truly is wire-free and has no extra padding.

VS bras

photoUpdate: I also went to Nordstrom Monday. My location does not work with United Healthcare, but they offered to provide the paperwork and I can file it myself for UHC to review and decide on.

I didn’t mention this option originally, but should have. As Joyce wrote in the post comments, Nordstrom has fitters and works with most insurance companies for post-mastectomy bra needs. They will find the right bra and file paperwork for the insurance company to cover the expense. Appointment required.

I bought How Perfect by Wacoal in 32D. It is super soft! Love it.

The results

As I mentioned things are looking pretty good, but I do see a small issue: asymmetry. Prior to this surgery my right implant had bottomed out and was lower than the left. Now I am seeing the opposite, although not as much of a difference. I also have a sneaking suspicion that my right side is getting tighter, which may be a sign of capsular contracture, but I don’t want to panic just yet and continue to massage like Dr. M advised.

It is still early and things will continue changing. This may be a non-issue in a few months or it may be worse .. we shall see. In any case, I am just pointing out what I see now. I have not lost sight of the big picture and reason for all of this: I said NOPE to breast cancer! In the words of the wise Casey Eischen: “Prevention, not perfection.” :) <3

These things really don’t look like a D naked, but you know bras are like jeans: there are multiple ways to measure and it seems like every brand does it their own way. The bras I bought will serve for the next month. After that I hope I can go bra-free.

Reminder: Mentor round, smooth, high profile silicone implants in 450ccs.

2014_9_27 front

 

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Fin!

WARNING: NSFW / graphic content below.

Alright boys and girls .. I think we did it! I think we’ve finally arrived at the end. My exchange surgery was on Thursday, September 11. I had pocket revision on my right side and a swap from tissue expander to implant on my left.

SunriseWe arrived at the hospital at 6:30am for the 8:30am procedure. It was a beautiful morning! The surgery lasted three and a half hours – longer than we expected. I woke up bundled up in a tight compression bra and ACE bandage wrapped about my chest. The biggest and most wonderful surprise: NO DRAINS!!! I couldn’t believe it. Spent a bit in the recovery room and then hightailed it home to my comfy bed.

On Friday, we drove out to Dr. M’s office for my follow up appointment, which is when I got to see them for the first time after surgery. Things are looking good! I do have some swelling, which is to be expected, but aside from that they look to be the same size, are even on my chest wall, and my nipples line up. Woo hoo! I know it’s early, as it takes up to a year for things to settle, but I am just ecstatic!

Post exchange

Dr. M explained what he found while he was in there. It appears that at some point since my last surgery in April I ripped apart the pocket revision he did then and this is why the right side was bottoming out again. This could’ve happened as I bumped into something or fell or had some other physical strain or trauma. Hub pointed out that it may have something to do with me painting. Yes, I admit, I did more than I should have. I’m an idiot. This time around I am doing N O T H I N G. Absolutely nothing. For at least a month. And no excuses!

On my left side, Dr. M made the incision underneath the nipple, where the original was, rather than going in through my armpit again. He had to do some work on that side to make sure symmetry was achieved, hence a bit more swelling there. He did not do any fat grafting, which made me happy and I did stay with the same implant size and projection I had previously: Mentor round, smooth, high profile, silicone in 450ccs.

I am feeling amazing! I think the girls look great and physically I am not in too much pain. I am to wear this compression bra for two weeks straight, with the exception of showering. This will ensure everything heals in place as it should. Next appointment: September 25.

Fitness

I can’t wait for this surgery to be behind me! Only a few days left. At 1½ years, this process has taken much longer than I expected and I’m so ready for it to be a distant memory.

One of the things that I have stayed away from during this adventure has been my regular workout routine. I miss it and am eagerly awaiting to be cleared by my plastic surgeon to get back to it. After my last exchange in September ’13, I got that clearance a month out. About the same time I began using the silicone scar-reducing gel and we all know what came next. Ever since then I have been scared to overdo it, so I just haven’t done anything.

I’m not planning on seeing my good ol’ buddy Tony Horton the day after surgery, but I do plan on seeing Casey! Casey Eischen is a fitness expert and nutrition coach that is certified in training women who are recovering from breast cancer related treatment or surgery. She created a great post-mastectomy exercise program that I did after each one of my surgeries (see below). Casey also founded Foobie Fitness as a guide to help women not only prepare and recover from treatment or surgery, but also to educate us on how we can all make small improvements to help live a cancer-free lifestyle. Today I got my Foobie Fitness tank. I am ready!

Foobie Fitness tank


As with starting any diet or exercise program, always consult with your doctor.

Projection waffles

waffleI am such a waffler! Why is this so hard? I already decided that I am not swapping the implant I have for something else! Yet here I am, still thinking about it. I remember this .. this is how the whole “should I keep my nipples” thing went. Remember how that turned out? I think I made the wrong decision then. I want to make the right one now.

At my pre-op appointment last week I signed consent forms*, gave blood, got prescriptions for Norco and Cipro, and played around with some implants. Here are two silicone implants that are both 400ccs. The left implant is high profile, the right one is ultra high profile. The ultra high profile version is narrower at the base, and has more projection.

implant profiles

So last time: do I keep my Mentor round, smooth, high profile, 450cc silicone implant and match it on the other side or do I go for an ultra high profile version? As I said in my last post, I am not disappointed with what I have, but we could improve on projection. Here are some more answers that helped me come to the FINAL final decision:

  • QuestionWill replacing the existing implant increase risk of capsular contracture? Even if we choose to keep the current implant, it will be removed to resolve the issue causing bottoming out. Either way, it is coming out and then something is going back in. Risk unchanged. (I didn’t realize this. I thought we’d fix it without taking the implant out.)
  • Current implant has zero rippling (woo hoo!). Will a higher profile create that issue? It is impossible to predict this. Many factors come into play. Unknown.
  • Will any pocket revision be needed? Goal would be to choose a UHP implant size with the base width close to current implant, so that no pocket tightening is needed.
  • So how much difference in projection can we achieve with a swap? Depends on what size implant we choose. We went to the Mentor product guide to check dimensions.

This is what I have in now:

HP 450 dimensions

The UHP implant with the closest base width is 590ccs! That is just not going to happen. I don’t want the “done” look. My tissue expander is at 550ccs and it is already too much for my taste. I wouldn’t mind a little more projection, but that will come with overall increase in volume = bigger foobs. I am not comfortable with that idea. The options are:

UHP dimensions

We could do a 480cc or 535cc UHP implant, but the increase in projection is minimal (1cm at most, which is about the length of a finger nail) and I like my size now. So while yes, we’re going in there and the implant is coming out anyway, I love the fact that I have no ripples and that I know what I will look like on the other side. Let’s do only what we really have to and hope for the best! Fingers crossed surgery #5 will be a huge success and I will be DONE!


*Carefully read your consent forms before you sign them. You do have the option to strike out or refuse some of the things you may not agree with. I do not consent to medical students/residents, fellows, or visiting surgeons performing any part of my procedures. I understand the need for teaching opportunities, but my plastic surgeon is the only one I want touching me (with the exception of his regular surgical assistants and OR staff).

Last expansion of round 2

WARNING: NSFW / graphic content below.

For the second time now, I am excited to declare that I am done with expansions! Yes, I’m celebrating just like I did last year when I finished the process then. We added 50ccs to the expander on my left (right in pic below), for a total of 550ccs. I now wait until September 11 for my exchange surgery. Time to bring back the calendar countdown thingie!

During my appointment, I had an opportunity to discuss the upcoming procedure with my plastic surgeon. I wanted him to eyeball things, make sure everything is OK, and confirm that all we are doing is taking out a tissue expander and placing the Mentor round, smooth, high profile, silicone implant in 450ccs.

Well, it looks like the implant on my right is making the trek south again – bottoming out. This means that during the exchange surgery, Dr. M will have to go in on my right side and close up the pocket from the bottom. This is what he did in April, so I’m concerned about whether or not this will hold. He explained that this time he will do the vest-over-pants (overlapping) closure, which should hold tight. I sure hope so, because I’m counting down to surgery #5 and now at 1.5+ years into this thing. I do not want any more surgeries!

We also discussed the current implant and whether I am happy with its size and the shape. I’m not unhappy, let’s just say that, but I did ask about the difference between high and ultra high profiles. Dr. M will look into the specific measurements and we will discuss when he returns from vacay. If there was something to improve on, projection would be it, but after discussing with the hub I am thinking that I don’t even want to go there. He agrees.

This is a 450cc silicone implant on the left of pic and a 550cc tissue expander on the right.

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