Tag Archives: health

The reveal

WARNING: NSFW / graphic content below.

Saw the PS this afternoon for my exchange surgery follow-up. Some great news and some not so awesome. First, the good news: the hemovac/pancake drains have been removed. Woo hoo!!! Buh buy, I hope I never see you again!

In other news: during this appointment I got to see the girls in their full glory for the first time. They are smaller than what I was expecting, even with my over-compensation when declaring what the perfect size would be. We discussed doing 400-450ccs and over-filled to 550ccs to accommodate this volume. The implants I have are Mentor round, smooth, high profile silicones in 350ccs. I was very adamant that I did not want to be able to rest a drink on my bosom. Well, I definitely got the natural slope I wanted. No “shelving” in sight!

And the not so awesome news: righty sits lower than lefty. When I had the expanders, it was the other way around: lefty sat lower than righty. The PS had to open up the pocket to make things even. I don’t know if too much tissue was separated or if it is just swelling or if that’s the void from the drain tube that will eventually close down a bit. This is pretty obvious when I put on a tank top. I didn’t really get a good look and notice this until I was at home, so haven’t yet discussed it with Dr. M.

Aside from the asymmetry and being smaller than I anticipated, I think they actually look pretty good. I like the shape, the amount of cleavage, and the natural slope.

From the other side

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Thank you to everyone who sent their love, support, and best wishes for today! The exchange surgery was a piece of cake! Nom nom. 🙂

We started just after 9am and I was on my way home by 2pm. Dr. M removed my tissue expanders and replaced them with silicone implants. I didn’t see him post-op, so don’t know yet what projection and volume I ended up with. They are definitely smaller than the expanders and are not all the way up to my collar bones. Woo hoo! I haven’t messed much with the dressings and plan on leaving this up to Dr. M.

On the pain scale, I’m at about 2. Really feeling good. I took Norco, stinky antibiotics, and some Arnica Montana to help fight inflammation and bruising as soon as I got home and ate something. This time around the nurse gave me an anti-nausea, behind-the-ear patch. I do have terrible dry mouth, though, so I’m drinking lots of water and eating cough drops like candy. This also means frequent trips to the potty.

I am sporting a sexy hospital-issue bra and an ACE bandage as you can see above and dealing with two drains. Yes, this happened. The tubes exit my armpits causing me more discomfort than the chest pains! Once again they are the giant hemovac type reservoirs. I have a follow up appointment Wednesday afternoon, during which the drains are supposed to be removed. Less than 24 hours to go!

Squishy time

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Well, the day is almost here. Exchange surgery is less than 12 hours away! I’m so happy to finally be here. All that’s left is a good night’s sleep. I feel like Mario when he finally reaches those stairs at the end of the level. 😀

Following the handy-dandy checklist I put together for my prophylactic mastectomy back in January, I have gotten everything ready. Based on all the feedback from the Ladies that have gone through the exchange surgery before me, I expect this to be a breeze. The exchange surgery will only take about two hours and will be an outpatient procedure. I should be home by about 4pm.

Prep for surgery

I didn’t borrow a recliner this time, so I built myself a pillow-fort-kind-of-thing on the bed. I prepped a basket of essentials to keep by my bedside. It will travel with me between the bed upstairs and the couch, as needed. The hospital bag is packed with a few essentials like the tablet, hand wipes, chapstick, cough drops, lanyard (for those stinkin’ drains), medications, and my awesome My Destiny Foundation tiara.

I have been downing prune juice for the past couple of days to get ahead of the constipation. Also bought some snacks and food items that will be easy to prep while I’m home alone this week. I took the rest of the week off and expect to be doing absolutely nothing.

Later gaters. Write to ya from the other side!

Headlights

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WARNING: NSFW / graphic content below.

So this little trick popped up in the Facebook groups. Did you know that if you hold a flashlight to a boob with an expander or an implant, it will glow? Yes, yes I did try this myself. Gives a new meaning to HEADLIGHTS! The left is the image from i-am-bored.com circulating the groups; the right is my version. You can see the shade of the expander port in the top of the image. Creepy!

Show me the goods!

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Only two weeks to go until my exchange surgery! I am so excited. Can’t wait to be on the other side of this thing. I’m looking forward to being finished. I report to the hospital at 7:30am, for a 9:30am surgery, on Tuesday, September 3rd.

Pre-op appointment

Met with Dr. M this afternoon for my pre-op appointment. Discussed a few more details, got my pictures taken, signed the familiar consent forms, got the don’t-take-these-meds sheet, had my blood drawn, and peed in a cup.

Here are a few of my final questions:

Will I be required to wear any type of bra (compressions or underwire) after the exchange surgery? Should I purchase something? No. If any type of compression is needed it will be via ace bandage and dressings or a mastectomy bra that will be issued by the hospital.
I have hypertrophic-ish spots on my incision scars from the mastectomy, should I use something special after the exchange to prevent this from happening? The lumpy scar tissue will be removed during the exchange surgery. Since the pockets are already created/expanded, there won’t be as much stress on the incisions going forward. Silicone sheets? That’s an option that will apply pressure to the incisions to keep them flat. We will revisit once they close.
What about this ugly, scarred tissue from the area that was necrotic? Depending on how much skin is loose/available after the implants are placed, we may be able to remove the chunk now. Otherwise, a skin graft from the hip area is an option, but that would need to happen at a later time.
And the most important question: will I have drains again? Yes. That wiped the smile off my face. Noooooooooooo! I was hoping I would never see a surgical drain again.

For my photo session today, I removed everything except my underpants. This is the third set of full body pics we’ve taken, but it was still weird. While standing on a pedestal I was thinking of this XKCD strip Lannis shared a little while ago and giggling. Where are my beads? I earned them!

Source: xkcd.com

Choosing implants

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Saline versus silicone? Teardrop or round? Will high profile give enough projection? Choosing implants has been a popular topic in the Prophylactic Mastectomy Facebook group this week. While reviewing feedback of some of the other Ladies, I found myself questioning the choices I’ve made. After looking over my little list yet again, I reaffirmed that I have made the best decision for me. Here are the winners and the losers .

Disclaimer: Each person may give different levels of importance to the factors I list below and should discuss their options with their plastic surgeon. It is not my intention to convey that choosing anything different than what I chose is wrong. I am just presenting my logic. Right, wrong, or just plain stupid. 🙂 As always, I welcome your feedback!

Implant type

Factor	Saline	Silicone
Durability
Incision size
Chance of rippling
Natural feel
Sloshing
Leak detection

All the hoopla about the link between silicone implants and connective tissue disease, breast cancer, or reproductive issues is just that .. hoopla and unproven. It still caused the moratorium on use of silicone implants in the US in 1992, though. Because of this, breast implants are the most tested medical device out there. The moratorium was lifted in 2006. See FDA’s Update on the Safety of Silicone Gel-Filled Breast Implants for more details.

In any case, both types of implants are encased in a silicone shell. The one encasing the silicone implant is solid, but the saline one has a port (salines are inserted deflated and filled with fluid; silicones are pre-filled). Also, salines are more prone to ripple, causing folds in the shell. These two vulnerabilities are the causes of higher failure rates of saline implants. Although they come out on the bottom here, problems with silicone implants are more difficult to detect. Regular MRI screenings for “silent ruptures” are recommended for patients with these types of implants.

On the aesthetic side of the equation, the incisions needed for salines are smaller, but they are firmer and have been reported to produce a “sloshing” noise.

Implant shape

Factor	Round	Anatomical
Natural appearance
Natural feel/motion
Higher projection
Complication due to turning

From the various photos I have seen, I am not convinced that there is much difference in the aesthetic outcome, but in my head it makes more sense that anatomical (teardrop) implants have a more natural shape, so I gave them the . While both shapes are filled with cohesive gel, the degree of viscosity varies between the round and teardrop versions. Teardrops may look better, but they are firmer due to the gel being more form-stable (read: solid). This consistency is what gives the implants the “gummy bear” moniker.

Whether saline or silicone, implants come not only in different shapes, but also either smooth or textured surfaces, as well as different projections. Due to the distribution of the gel within the implant shell, the same volume of silicone produces a higher projection in a round implant versus a teardrop one. The higher the projection, the narrower the base. With a 29″ rib cage, I need narrow implants and the round version offers the highest projection: ultra high.

And lastly, the fact that corrective surgery is required if the implant turns is a big one for me. When a round implant turns, you can’t tell, but if a teardrop is loose within its pocket, it is obvious. With the current state of my expanders (one sits higher than the other), I am nervous about this possible issue and want to avoid it.

So there you have it: I chose round silicone implants.

Check out this awesome video showing the difference between regular round silicone implants and their anatomical counterparts.

This is a video of me playing with a round implant that has been ruptured. You can see that this type of implant is also cohesive enough to not leak outside of the shell. It retracts just as the anatomical implant in the above video.

Source of Table 6.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.

So what size are you?

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It’s strange how often I have heard this question. Yes, I had a prophylactic bilateral mastectomy, and yes, my boobs seem to be growing right before your eyes, but this question is not appropriate for watercooler chat. We’re not that chummy! How would you like it if I asked your wife her bra size? Kind of weird, no? Apparently not. If I had a Dollar …

The times I actually did answer this question, the only measurement I had was the volume in ccs. Unless you’re one of “us,” this don’t mean jack, so after yet another time I fielded this question, I decided to go on a quest and figure out exactly what the magic number was.

How I measured my cup size

A lot of women make an appointment for a fitting by someone who knows what they’re doing (usually Nordstrom lingerie department). I have not yet taken this step, because I’m not completely finished. Off to Google and the FaceBook groups I went. There seem to be a few different ways to do this. One of the ladies in a FB group, who is familiar with the topic, was happy to assist.

Source: Jason Lee, RealSimple.com

Without a top, I first measured the underbust, which is the lower yellow line in the graphic = 29″.

Traditional sizing says to add 4″ if even number or 5″ if odd number. Modern sizing rounds up to the next even number. We went with modern sizing, so that brought me to 30.

Then I measured at the top yellow line, which is the widest part of the bust = 36″.

The math: subtract the underbust from the bust. The difference is what determines size, with each inch representing one cup size. 1 = A, 2 = B, 3 = C, etc.

Ladies and gentlemen, we have our verdict: 30 DDD. Yes, that’s right D D D. I was shocked when we came to this conclusion. I still am. I was not expecting this at all. Having been wearing an A cup bra pre-op, triple Ds just seem ridiculous to me. I never had a number or letter in mind when thinking about reconstruction. I was of the mindset that I would keep expanding until things seemed just right. I hit that point at about 400ccs. Having read a lot of feedback of women feeling that they should’ve gone bigger, I told my plastic surgeon that the sweet spot was 450ccs. Since I’m getting round implants, we overfilled by 100 for a total of 550ccs. It’s at the overfill point that I measure a DDD, so this isn’t the final FINAL verdict. I will get a professional fitting a couple of months after my exchange, once things settle down. Stay tuned!

Here’s an interesting graphic related to cup size. A 30F on me is a 38C on someone with a larger ribcage/underbust. It’s all about body size and proportion.

Cup size and proportion

Done, DONE, D O N E – ninth expansion

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WARNING: NSFW / graphic content below.

I am officially finished with the expansions! YES! We added the final 25ccs to each expander, for a total of 550ccs/side. I am so ecstatic to have reached this milestone. I was really hoping to be completely done late Spring/early Summer, but my rebel nipple Dusky and his pal necrosis had other plans. Six months after my prophylactic bilateral mastectomy on January 22, 2013, I am finally done with fills! This is what I’m doing right now:

What’s next?

7/31: follow up to make sure I haven’t decided that I want to go bigger
8/19: pre-op appointment
9/03: the long-awaited exchange surgery!!!

That’s a lot of fills!

100 + 50 +75 +75 + 50 + 50 + 50 + 50 + 25 + 25 = 550ccs

Eighth expansion

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WARNING: NSFW / graphic content below.

I can almost smell it: the end of the expansion process. This was supposed to be my final expansion, however I wimped out and we only added 25ccs to each expander, for a total of 525ccs/side. The goal is 550ccs, so I have another appointment for the final FINAL expansion in one week.

Gravity The reason for halving the volume is pain. The last expansion brought on a lot of pain. Not that I thought it was going to get more pleasant, but it was pretty bad. As usual, the worst of it come early in the morning. I’ve never dreaded getting out of bed so much. As soon as I sat up, gravity would work its magic. Talk about grumpy mornings.

The pressure was intense and I was on ibuprofen for about three days after. It didn’t help that we spent that weekend camping, so I was not sleeping in my own comfy bed. I really thought if someone poked me, a foob would pop. I even had a dream that my cat sat on my chest and the thing just blew up under her. Not like a slow deflation, but a violent explosion! I woke up in a sweat and immediately groped my chest to make sure everything was still there. Whew!

Enjoy the pics. It’s getting crowded down there!

100 + 50 +75 +75 + 50 + 50 + 50 + 50 + 25 = 525ccs

Extra! Extra! Seventh expansion

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WARNING: NSFW / graphic content below.

The story I mentioned in my last post, has been published in Sunday’s edition of The Virginian-Pilot. “At-risk local women take the fight to breast cancer” features stories of the two local FORCE coordinators and mentions this very blog. Check it out.

In other news, I am definitely over the hill with the expansions. I reached the size I’d like to be after the exchange surgery with my last expansion that brought me to 450ccs and am now in the overfilling stage. My seventh expansion added 50ccs to each expander, for a total of 500ccs/side. There is one more 50cc fill left. I don’t know how that’s going to go. I feel like any minute now, these foobs are going to pop!

No surprise that this was the most painful expansion thus far. After previous fills I usually had a shitty Saturday morning, but did not really think about it by Sunday afternoon. Today is Monday and I did not have a pleasant morning. I slept fine, but I was feeling pain as soon as I sat up in bed after waking up. Gravity … I hate your face right now! I am both looking forward to and dreading the final expansion in three weeks.

100 + 50 +75 +75 + 50 + 50 + 50 + 50 = 500ccs