Tag Archives: breast reconstruction

Happy ending?

WARNING: NSFW / graphic content below.

One week after exchange surgery, during which my right tissue expander was replaced with an implant, I am feeling fantastic! My recovery has been going very well and I like what I see. The surgery took a few hours; I was home by 2pm. I left the hospital in a bra and with a drain exiting my right armpit. I suspected I would have one, so while still a big bummer, it was not a surprise. The pain level was low overall (maybe a 3). The following days were uneventful. I spent the weekend home alone, mostly reading and sleeping.

Pain Scale

Drain tubeAlthough my level of activity was low, drain output was 80mL for the first couple of days, so it had to stay in a bit longer. During my second follow up appointment, on Monday, the drain was removed. About a foot of tubing, which was placed in the pocket around the implant, was pulled out (see pic on right: from the black stitch just under the hand, all the way down!). This is usually not painful, just weird. Good riddance! Feeling so much better with that thing out of me. Dr. M declared that things were looking good and ordered a follow up a week later.

So, how are things looking? You tell me!

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Mentor round, smooth, high profile, silicone in 450ccs. Left in pic: 1 week, right: 10 months.

IMG_3901I am still swollen and bruised (Arnica helped), but the result is pretty darn good, considering the circumstances. I’m hesitant to celebrate, however. With my history, I have a few more weeks to go until I can breathe a little easier. The issues I experienced after my last two exchange surgeries (see: Houston, we have a problem and Déjà vu) both happened about a month out. So, fingers crossed that this is my happy ending! I can’t wait to move on with my life.

T-minus

WARNING: NSFW / graphic content below.

The final countdown has begun. T minus seven days until my exchange surgery! That’s right, just one week left. This will be surgery #8 in the mastectomy and breast reconstruction process, which started January 22, 2013. The goal is to replace the tissue expander on my right with a squishy implant. On one hand, I am very excited about this surgery, as it should be my last one. However, I am also incredibly anxious. This process was supposed to take about eight months and two surgeries. Here we are 2.5 years later with #8 on the horizon. I’ve experienced a few complications that have drawn it out and caused me a lot of grief. In any case, this time next week I will be home and it will be behind me. I can focus on healing and moving on with my life!

Surgery prep

As I prepare for next week, I think about what supplies I need to gather. I’m dusting off the good ol’ Checklist that has helped me get my stuff together each time. I’ll be using the abbreviated version from my Box o’ recovery crap post, which lists the things I keep on the night stand:

  • MedicationsRecovery aids
  • Lanyard (I will very likely have a drain)
  • Measuring cup
  • Rubber gloves
  • Alcohol swabs
  • Scissors
  • Tape
  • Digital thermometer
  • Back scratcher
  • Tiara (of course!)
  • Tissues
  • Chap stick
  • Cough drops
  • Water
  • Snacks
  • Hand sanitizer
  • Lotion
  • Note pad and pen (to track meds and temperature)
  • Camera
  • Kindle
  • Phone and charger

That should do it.

Status update

Yoda fucksI haven’t posted a photo since the tissue expander placement, six months ago. Slacker! My expansions went OK. That side is a different shape and size than my implant, of course, but not too bad. We stopped expansions at 450ccs, which is the volume of the implant on my left. There are a few things off at this point, like my nipples not being “level” and some weird divot in my cleavage, but honestly, at this point, I’m almost all out of fucks to give about these details.

So here I am, On the left in photo I am sporting a tissue expander in 450ccs. On the right I have a Mentor round, smooth, high profile, silicone implant in 450ccs (10 months after exchange).

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A few months after surgery I’ll evaluate the state of things and decide how much the details are bothering me and if there is anything else to be done. Maybe that divot will fill out (it’s OK in a bra) and the nipple-level thing won’t be as bad. Things will be different with an implant and maybe they’ll be symmetrical and just right.

One thing I know will definitely follow is a tattoo by Amy Black. I still haven’t decided if it will be just a 3D nipple fill or something artsy fartsy and covering more of my chest wall. We shall see!

Tissue expansion

And we’re off! We have begun round three of tissue expansions. I initially got 100ccs during the expander placement surgery to which we just added 50ccs for a total of 150ccs. We are going all the way up to 550ccs, so this is going to take a while. Started off slow with only 50ccs to see how I would tolerate it this time around. So far, so good. I’ll be asking for more next time.

What is tissue expansion?

Reconstructing the breasts after a mastectomy can be achieved in a few different ways, including using tissue from other areas of the body or breast implants. In some scenarios chest skin and muscle are first expanded (stretched) before the breasts are reconstructed. A post from a couple of years ago further explains how this works:

Tissue expanderTissue expanders, which are like “pre-implants” (pictured on left), are inserted underneath the pectoralis major muscle. They are similar in shape and size, but are more rigid, unnatural, and uncomfortable. A round magnetic port in the top half allows for insertion of a needle, without compromising the expander. The tissue expanders are slowly filled with saline to stretch said muscle and the skin that covers them, until the desired volume is reached.

Breast Reconstruction Guidebook Figure 7.1

The process of filling the tissue expanders is pretty quick and uneventful. First the nurse uses a little plastic contraption with a metal pin at the end to find the magnetic port in the tissue expander. Once the center of the port is identified, the nurse sanitizes the area and injects the needle attached to a syringe holding the saline. She then slowly pushes the plunger until all fluid has been injected into the expander. This takes less than one minute. After completing the fill, she places a little round band-aid over the injection site. The end. This procedure itself is painless.

The hours or days after a fill, however, can be uncomfortable and this will vary from one fill to the next and from one woman to another. Some women have no pain at all, some experience a gradual increase in pressure and pain, and some are surprised going from one completely painless fill to another one that knocks them off their feet. During round one I was fine until about fill 6, which was not fun. Days after 7 were so uncomfortable, that I split fill 8 in two. Some women take muscle relaxers or pain meds before their appointments.

Here are a couple of great videos explaining the process:

Source of Figure 7.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.

Nipple tattoos

WARNING: NSFW / graphic content below.

I recently attended a local FORCE support group meeting. As always, it was fantastic! Our group meets quarterly, varies in size from five to 20, in age from 20 to 60ish, and is comprised of mostly previvors (in various stages: just found mutation to done with surgeries), but also women currently undergoing treatment, as well as survivors. There’s something for everyone facing hereditary breast and ovarian cancer to relate to. I highly recommend you find a group near you and attend at least one meeting. You may find that it’s not for you, but it’s worth a try. Find a FORCE group near you by visiting the local support page. Other organizations also have in-person support group meetings, so check with your doctor or do some googling.

Sometimes we have guest speakers come to share their research, work, products, or information relevant to our community. Our most recent guest was tattoo artist Amy Black of Amy Black Tattoos and Pink Ink Fund. Since 2011 Amy has been specializing in nipple and areola repigmentation as part of the breast reconstruction process for patients post-mastectomy due to breast cancer or as a prophylactic measure. Her 3D nipple tattoos look like the real thing! See for yourself below. Pink Ink FundAmy also founded the Pink Ink Fund shortly after beginning nipple and areola tattooing in response to seeing clients concerned about costs and having no health insurance. Amy’s work both in restorative tattooing and supporting the community is amazing! I plan on paying her a visit once I am done with my reconstruction. In addition to 3D nips, she also does touch ups, repigmentation, and artistic designs.

Here are some examples of her work:

1 5 4 6 3 2

Amy is located in Richmond, VA. If you are interested in contacting Amy, click here.

Healing well

WARNING: NSFW / graphic content below.

Elephant on chestSo far, so good. Things are looking good and healing well after my latest surgery two weeks ago when a tissue expander was placed on my right side. I am not loving the discomfort I have. Feeling no pain, but the tightness is definitely there! It is that elephant-on-your-chest feeling. Not as bad as after original mastectomy, but still very uncomfortable.

I have not been doing my stretching and range of motion exercises on a regular basis, so time to get back to those at least once per day. No lazy days! I am a fan of the Coach Casey Eischen post-mastectomy exercise program. She designed it specifically for women recovering from breast cancer related surgeries after she had her own PBM and noticed a void in this area. Check out FoobieFitness.com for exercise tips, videos, and nutritional information. Here is the video with level 1 & 2 exercises. These helped me a lot after my original surgery two years ago and each one after that.

And here’s my progress pic: two weeks after tissue expander placement on my right side (left in pic).

First expansion: March 4. Exchange surgery: July 23, 2015.

Long road of expansions ahead

WARNING: NSFW / graphic content below.

The follow up appointment after tissue expander placement surgery was Friday. The drain output was not high, but too close to Dr. M’s threshold for removal (50mL), so we decided to leave it in until Monday. I Had an opportunity to see how the incision is healing. So far everything looks goodt. I have been arnica montana and have very little bruising.

Low healthOverall feeling OK .. as long as I stay on my med schedule. Slowly trying to ween off of it, but not in a big hurry. Last night I didn’t set an alarm to wake up and take meds at night. Well, my body woke me up at 6 with a not-so-gentle reminder that I just had surgery. That was not pleasant at all.

The prune juice, Smooth Move tea, water, pears, and other fruit worked their magic. I went #2 on second day of recovery, but still have a bit of bloating and discomfort. TMI? If you’ve ever had general anesthesia surgery, then you understand how important this is. If you haven’t, then I hope you never do! Pain meds, no food/drink after midnight, inactivity, and anesthesia cause constipation. 

At the appointment Dr. M removed my dressings, which means I can now take a shower. I’m excited to do that today. Reviewing an old post (Shower time) and gathering supplies while I wait for hub to get home and help. This time around I didn’t get any tape or glue on my incision. If you recall, it was a suture knot that caused my last complication and the removal of the implant. To avoid that scenario, Dr. M used a single-filament type of suture (vs. braided) and only placed sutures and knots where absolutely necessary.

I also found out that my tissue expander is filled with 100ccs. We are filling all the way up to 550ccs, so that’s a long way to go. I start the expansion process six weeks post-op and will be getting fills every other week. In the past I have done 50ccs per fill, but may be doing a bit more this round to speed things up a little bit. Looks like July 23 may be just right after all.

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