Tag Archives: breast reconstruction

Yup, tissue expander

Tard on drainsDarn it! Yes, it’s a tissue expander. There was too much scar tissue in there, so we are playing it safe. I’m OK with that … I like safe. Also, yes, I do have a drain and yes, I still hate them!

On my right side, we were able to go up to 450ccs and alter the pocket. From what I can see so far, things are looking OK. I will take photos tomorrow after my dressings are off and this pesky drain is out.

Tiddy BearThe procedure took about four hours and I only stuck around for a little bit after. The Tiddy Bear came in handy for the ride home. I ❤ these things! My throat is sore and my chest does hurt, especially on the left side where I have the tissue expander. No surprise there. No showering until tomorrow after I see Dr. M for my follow up. Until then I look as if I was choked by an Oompa Loompa, because of the pre-surgery scrub on my neck :).

Thank you all for the massive amount of positive energy and prayers sent my way. ❤ ❤ ❤

Hubby has been taking really great care of me. I just took delivery of a green smoothie to drink with my Norco. He keeps reminding me to stay on my ass and take it easy. We don’t want a repeat of last year. Nope! My two kitties have not left my side since we got home. You can’t see the other one, because she is under the blanket, spooning my leg. LOL

Recovery buddy

Box o’ recovery crap

Counting down the hours! My surgery is scheduled for 8:30am on Thursday and should last about three hours. We are doing reconstruction on my left/flat side and pocket revision plus implant swap on the right side. I’m excited to finally get here after the six-month wait, but I’m also very nervous. Not knowing what is waiting for me is uncomfortable.

My bedside box o’ recovery crap is ready! I used my PBM checklist to gather the essentials:

  • Recovery aidsWater
  • Back scratcher
  • Tissues
  • Tiara (of course!)
  • Digital thermometer
  • Scissors
  • Tape
  • Measuring cup
  • Alcohol swabs
  • Chap stick
  • Phone and charger
  • Rubber gloves
  • Snacks
  • Medications
  • Camera
  • Lanyard (I will very likely have a drain or two)
  • Hand sanitizer
  • Lotion
  • Cough drops
  • Note pad and pen
  • Kindle

I think I’ve got it covered. Don’t you? Now I just need to pack my hospital bag. I expect to be home in the afternoon, so this should be quick. Wish me luck! Talk to you later ‘gaters.

Fighter

No whining

WhambulanceIt looks like it will be a tissue expander after all. Waaah! Not what I wanted to hear. Somebody call the whaaambulance, STAT!

Dr. M and I discussed this yesterday during my pre-op appointment and unfortunately, he will likely be inserting an expander rather than an implant. There is a chance that one will not be needed, but as I mentioned, that is unknown until he goes in there, so planning on an expander. What a disappointment! I am hoping this won’t happen, but definitely not counting on it. Major bummer.

kikDeflated = this is how I felt when I left Dr. M’s office. It means surgery #5 is in my future and probably not until some time in August. Another summer with a tissue expander, more appointments, many more uncomfortable moments :(. BUT I got over it after reading the text my husband sent me in reply to my rant. I took a deep breath and exhaled all those thoughts out of my system. Expander fills suck and can be very uncomfortable, BUT chemotherapy side effects are much more uncomfortable. Doing this, all of this, is worth it.

So NO MORE WHINING! It is what it is and I trust Dr. M will make the best decision after assessing the state of my tissue and skin. And yes, it will be over before I know it. What I know I don’t want is more complications as a result of trying to rush things.

In addition to talking about this, we discussed the low pocket and implant size. During the procedure the pocket will be closed up a bit and I will get a larger implant on my right side – we are shooting for 450ccs. There’s a chance of fat grafting around the implant. Not sure where the donor site will be, but I know this means lots of bruising and more pain.

Less than two weeks to go! I leave you with a short video of me playing with a busted cohesive silicone gel implant while waiting for my appointment. Even if ruptured, the gel stays within the silicone capsule, unless pressure is applied. It returns to the capsule when released:

Here we go again

Got the pre-registration call from the hospital today. Here we go again. I am two weeks away from going under the knife for the fourth (and hopefully last) surgery in this process. Almost six months have passed since I had the last surgery during which one of my implants was removed due to an infection (see: Houston, we have a problem).

Pre-op

My pre-op appointment is on Monday, March 31. I’ll be doing standard lab work and discussing the plan for my upcoming surgery, including:

  • QuestionNipple symmetry – the left nipple became necrotic and I lost just the tip when the scabs came off. I want to snip the tip of the right one to match. What’s worse than two erect, awkward nipples? ONE!
  • Pocket closure – the pocket on my right side is too low, so during this procedure I’d like it surgically closed up a bit at the bottom.
  • Increase in size – since we are going in there on both sides anyway, I’d like to achieve what I originally declared as the right size for me, which is 450ccs (350ccs now).
  • An implant, not a tissue expander – this! More than anything, I just want to be done.

I have my fingers and toes crossed that I will wake up with an implant and not another expander! Obviously, I don’t want any more issues, so if an expander it is, I’ll suck it up and just deal with it. I’m pretty sure I will have at least one drain. <sarcasm>Yipeee.</sarcasm>. Time to whip out the good ol’ checklist and start getting ready.

Breast Prosthesis

thisguyGuess who has two thumbs and the same number of foobs? This .. gal. No, I haven’t had my reconstruction surgery yet, but I did acquire a new breast prosthesis to compensate for the flatness on my left side. I recently said that if somebody is uncomfortable with my lack of bosom, that’s their problem. Well, my thoughts on that haven’t changed, BUT I did realize that I would soon be in a situation where I’d prefer to avoid having these conversations altogether.

Vacay

Hubby and I are going to visit his family in the Caribbean. It’ll be up-close-and-personal and about 85° Fahrenheit, which means my state will be unavoidable and questioned. If I spoke fluent Spanish, I’d say bring it on, but I don’t, so that leaves all the conversating and explaining to my hubby. I just don’t feel it necessary to do this to him. I’m very much looking forward to spending time with his family and enjoying getting away from everything.

How to acquire a foob

So, where do you even start? I remembered that the awesome Miss Casey Eischen – who is a rock star fitness expert, nutrition guru, and herself had a mastectomy with some complications – recently shared that she had a breast prosthesis in need of a home. I reached out and got the package just a couple of days later. I was excited and couldn’t wait to get it opened! Unfortunately, it wasn’t meant to be: the size and shape just weren’t right.

ProsthesisBraI dug up the name and number a friend shared with me shortly after my removal surgery for a local boutique that specializes in the needs of breast cancer survivors and individuals in need of image consulting. We scheduled a fitting and I obtained the necessary referral from my plastic surgeon. It took a couple of visits and an overnight shipment for us to get the piece just right, but we did it. Here it is, my new friend. Can you tell? The prosthesis is on the right side of the photo. It looks great in the pocketed bra and even better in clothing! I won’t fool the TSA agent reading the images produced by that airport body scanner thing, but I’m confident that I won’t be fielding and attempting to answer uniboob-related questions in Spanish. Yo no hablo mucho español.

I got the prosthesis and two bras. All of the pieces are covered by insurance, but standard deductibles and out-of-pocket maximums apply. Since my insurance plan year just restarted on January 1st, I have not yet met my deductible, so had to cover the total myself. Not a huge issue, as I will have additional expenses with the April surgery and will have to exhaust my deductible and out-of-pocket maximum then anyway. The damage? Around $400. Not too bad. Breast prosthesis: $300, two new bras: $98, consultation fee: $20, not having to answer awkward questions from distant in-laws about your missing boob: priceless.

ProsthesisSideProsthesisFront

Just some “fluffing”

WARNING: NSFW / graphic content below.

Well, it has been a month since I posted my last status update, because there really isn’t anything terribly exciting going on. I do have a photo for you to show you some “fluffing” I’ve noticed in my right implant, though.

I saw Dr. M for another follow up visit a couple of days ago and we agreed that the infection is no more. I have been redness-free for over a month, so I seem to be in the clear. My next appointment with him is at the end of March, which will be my pre-op visit, with the surgery to follow on April 10, 2014. TESSADuring that procedure my PS will attempt to replace the implant via a small incision in my armpit, using the TESSA technique (right). If he observes that too much scar tissue has accumulated in that space, he will have to place a tissue expander instead. We won’t know until he gets in there. It’s a log way away, but it’s not too early to start crossing fingers and banking those positive thoughts. Get on it! 🙂

As of today, it has been over three months since my exchange surgery and two months since the infection claimed my left implant (see: Houston we have a problem). The implant on my right does seem to be “fluffling,” meaning there has been a slight change in the perceived shape and size of the implant. What is actually happening is my body is changing around the implant forcing it into a different configuration, thus making it seem like the implant itself is actually changing. It is a gradual redistribution of the volume from top to bottom of the implant. The completion of this process may take from three months to a year. Here is the difference in just one month:  left = November 13; right = December 13.

Fluffing

The waiting game

WARNING: NSFW / graphic content below.

It has been over ten weeks since my exchange surgery and a month since the infection that lead to removal of my left implant. I originally thought that I may have the next surgery just three months after the deconstruction, however some issues linger.

2013_11_7 rednessWhile I was across the pond, spending time with family after my mother’s passing, I experienced a lot of redness on the left side. I emailed photos to Dr. M and was told that the combination of stress, emotional and physical exhaustion, as well as a possible infection were the very likely cause of the inflammation. He instructed me to finish the antibiotic I proactively picked up on my way to the airport. After a few days, the redness went down and hasn’t resurfaced since. This Wednesday I saw Dr. M for a follow up. He did an ultrasound and discovered a couple of small fluid-filled cavities. I am to finish the antibiotic and keep a very close eye on the area, while the serous fluid is reabsorbed and addressed by my body. If the redness returns, the fluid will be aspirated for a culture and a decision on following treatment. I’m 48 hours drug-free and things are looking good.

In any case, my next surgery is scheduled for April 10, 2014. At this point, it is unknown whether a tissue expander will be needed. Nothing to do now, but sit and wait. This is what things look like now. I am not wearing a prosthesis or going out of my way to camouflage my lack of bosom. I’ve come to the conclusion that other people’s discomfort is their problem.

2013_11_13 Front

Attitude is everything

Attitude

Yes, THIS. I have hit a  pretty huge speed bump on my road to being finished. A major setback that’ll add at least three more months to this process. When I had my prophylactic bilateral mastectomy in January, I expected to be finished by mid-summer. HA! It’s almost January again! Yes, I’m devastated and angry, but there really isn’t anything I can do about it now except focus on recovery and what’s ahead of me.

Attitude really is everything. While you cannot always control what happens to you or around you, you have complete control over your reaction to it. I have chosen to continue to be positive, because the alternative won’t help anyone or improve my situation.

Good news x 3

I saw Dr. M for a follow up on Friday.

  1. The Lone Drainger is out! Whoop whoop! I was producing less than 15 mL/day.
  2. Culture results are good and show no signs of infection. This doesn’t mean I didn’t have one, it means that the antibiotics I have been on since Monday are working.
  3. TESSAI might not have to have a tissue expander!!! Dr. M thinks the tissue won’t retract so much that I would have to start all over. If all looks good in a few months, he will place the implant via a small hole in my armpit using the TESSA technique (Transaxillary Endoscopic Subpectoral Smooth Augmentation). This was the best news! It also means that we will NOT have to mess with the incision/scar again.

Houston, we have a problem

WARNING: NSFW / graphic content below.

Before I tell you about what has been happening for the last few days, I just want to say to those that are considering this procedure, preparing for one, or have already started the process: women who undergo a mastectomy, whether prophylactic or not, don’t always experience complications. Actually, I’d say that most do not, based on my involvement in a few online support groups and interaction with women in my local community. Everybody’s experience is different, because of different doctors, hospitals, body condition, other health issues, activities during recovery, nutrition, etc. There are many factors. Each person should consider their scenario and discuss concerns they may have with their surgical team.

Another thing to keep in mind is that usually the people that have problems are the ones that speak up. You know – the squeaky wheel thing. There are so many women out there that have had a completely complication-free experience and have beautiful results! You can’t tell that they’ve gone through this journey unless they tell you! Those women usually don’t linger in the support groups, stop blogging about it, move on, and just leave it all behind them. They are DONE and don’t have to think about it again.

Okay, Houston, we’ve had a problem here

Unfortunately, I’m not one of them. Upon my return from vacation, I started working out again (cardio) and I also began using Kelocote on my hypertrophic scars, as I mentioned in a recent post. Both of these activities began on Sunday. The following Wednesday I saw Dr. M and things looked good. The next day I noticed a bit of redness around the incision on my left breast. By Saturday there was a small area in the center of the scar tissue from my bout with necrosis that had turned blue. I emailed Dr. M and got this response:

Yes, this is a significant problem. Need to see you tomorrow.

HoleBy Monday afternoon, I had a hole. By early evening I had chills, sweats, and a fever of 101.7. Panicked, I called the after-hours service to page Dr. M and he called back immediately. The plan was to continue on the antibiotics, take a couple Tylenol, and sit tight unless the temperature spiked past 103, at which point I’d hightail it to the ER. Within two hours the temperature dropped below 100, but I knew what was coming: the implant had to go.

My surgery was at 5pm on Tuesday, October 15. Dr. M cleaned up the incision and removed the implant. I am left with one breast and another drain! I really REALLY don’t like drains, but who does? What’s next? We have to let everything heal for at least three months before we being talking about restarting reconstruction on that side. I’m am so bummed by this humongous setback!

Why did this happen?

A combination of things may have caused this, but it’s hard to say exactly which was the straw. In Dr. M’s experience, implants are usually (but rarely) lost due to complications from three major things: radiation, smoking, and/or trauma. I fall into the third category. The necrosis I experienced in January produced a lot of scar tissue, which has poor circulation. My use of Kelocote on that scar tissue introduced chemicals into the equation. On top of that, I started working out again. My body protested against the combination of old and new trauma. So here I am, uniboobin’ it for at least three more months! Good thing it’ll be during winter and I can camouflage things a bit. I present a foob and a drain:

2013_10_16 closeup

One month post-exchange

WARNING: NSFW / graphic content below.

It has been a month since my exchange surgery and over eight months since my prophylactic bilateral mastectomy. I went from about 184ccs of breast tissue pre-PBM, to 550ccs of saline in overfilled tissue expanders, to 350ccs of silicone gel in my Mentor round, smooth, high profile implants.

2013_10_5 FrontNot much has changed in the last month. I was hoping that the pocket on righty would close up a bit on the bottom, but that has not happened. This means I will most likely have a revision procedure this year to do that surgically. The new girls look fine in clothing, but I am not 100% happy when looking in the mirror. In addition to pocket revision, I am still planning on addressing the nipple asymmetry by removing the tip of the right nipple. I hope to wrap this all up by the end of this calendar year.

My scars are not pretty, but I already know I develop “two year” hypertrophic scars, so I am not surprised. I just started using Kelocote on the incision spots; hopefully this will help speed up their softening.

In other news, I just returned from a two week Europe vacation visiting Venice and my family; I’m excited to be participating in the local 2013 Race for the Cure on October 12th as part of Team FORCE (Facing Our Risk of Cancer Empowered – www.FacingOurRisk.org); and I was also recently featured in another article in the Fall 2013 edition of a local cancer magazine. Here’s my excerpt (changing names, because I want to continue to keep this blog anonymous):

“Mogatos says she never thought much about cancer until about ten years ago, when her 28-year old sister was diagnosed with breast cancer. In the intervening years, she’s had a great deal of time to think about it: she lost her sister to the disease, her mother was diagnosed with ovarian cancer, and another sister is undergoing breast biopsy.

Mogatos began having alternating ultrasounds and mammograms every six months to monitor her own breast health. She also had the BRCA test, which was negative. Once in a while she’d have an MRI, just to make sure everything was OK. Her doctor explained some women with breast cancer in their families choose to have a mastectomy, so she knew that was an option. But she was only in her early 20s, and “I was going along the lines of if it ain’t broke, don’t fix it,” she says.

In March of 2012, the time came to fix it. Mogatos picks up the story: “An ultrasound spotted some issues. Three separate masses were present. They had developed in the six months since the last mammogram. The oncologist recommended an MRI screening. Waiting for test results was hell, but when they eventually arrived, they were good – no cancer.

“In June, I felt something unusual during one of my monthly self-exams. The lump was in one of the three spots where the ultrasound found issues.” Another ultrasound confirmed that two of the three spots had increased in size and were now palpable. Mogatos had biopsies done, and again endured the terrible wait for results. There were some abnormal cells but no frank cancer. She was told to continue her self-exams and keep regular screening appointments. “The inconsistency of the messages I was getting was very hard psychologically,” she says. “I didn’t want to go through this again, having to wait for test results, feeling anxiety, then being relieved, and then ‘oops, maybe we made a mistake.’ I just couldn’t go through that again.” She began considering preventive mastectomy.

She was referred to Dr. M. “When I met him, we really clicked,” Mogatos says. “He brought up things no other surgeon mentioned. I talked to some of his other patients. I felt he’d be a great partner to get me through it.”

When the time came for surgery, she was ready. “I’d researched, I’d read, and I knew what to expect.” She was too lean for the DIEP procedure, so Dr. M placed tissue expanders, and a recent surgery replaced those with Cohesive Gel implants. “I’m ready to be done with the reconstruction,” she says. “It’s been sometimes painful, sometimes frustrating, but I’m so happy I did it. When I look at the big picture, the possibility of getting breast cancer and not making it through, like my sister, I have no regrets. It’s totally worth it. I never have to think about breast cancer again.”