Tag Archives: Prophylactic mastectomy

Prosthesis v2

WARNING: NSFW / graphic content below.

After I lost an implant the first time, my husband and I were planning a trip to visit his family in the Caribbean. Prior to going on that trip, I got a breast prosthesis, so that we could avoid awkward conversations about my health with distant relatives; in Spanish, nonetheless.

no pantsWell, as you already know, I’ve lost another implant. On an average day when I’m running errands or meeting friends for lunch, I go as I am and don’t even think about it. Also, I work from home. No boob? No pants? No problem! 🙂 However, I will again be traveling in the near future, but this time it will be a trip to corporate HQ to show face and meet some new team members. So I got another prosthesis. Don’t get me wrong, I’m not shy about sharing my story (hello, blogosphere) and I am not embarrassed when uniboobin’ it, but in some close-encounter situations I don’t want to be focusing on and explaining my lack of mammary.

I made an appointment for a fitting at a local boutique that specializes in “image consulting.” Since I have gone up in size by 100ccs from the last time I needed one, it wasn’t as easy as just ordering another one. After a couple of tries, we found the right form to complement my current breast. It’s not perfect, but it’s pretty darn close. I also picked out three new bras. My insurance provider covers the prosthesis as well as bras. In fact, they cover up to six bras per year (this varies, so check with your provider). Most boutiques and stores like Nordstrom work with insurance and even submit the paperwork for you.

Here it is. It is lightweight and comfortable. Looks good under clothing too.

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By the way, this is working from home with cats (not my vid, but accurate):

Yep, looking good

WARNING: NSFW / graphic content below.

Yesterday was my one-month follow up after the removal of my right implant. It was also two weeks since the seroma was drained and small stitched pulled. Yep, looking good. The seroma is no more and the post-stitch hole has healed.

The only thing that’s wonky is the scar on the left side. It is sunken in as if stuck to something inside. I have not seen this before and asked Dr. M if I could massage this issue away, to which he responded that I could sure try. Worst case, he can fix it later. I had same reaction to that as my hub did when I told him: nope, not doing that. No more procedures unless absolutely, without question necessary to finish reconstruction.

My objective for this appointment was to get a thumbs up for surgery sooner than April. Right now I’m on the schedule for April 9th, which is six months after the removal. During this procedure we are going to be placing a tissue expander on the flat side. I got what I wanted and can do it sooner. Mandatory wait of only three months (January), BUT Dr. M is booked solid, so there goes that. I’ll check in with scheduling monthly for openings. Fingers crossed!

Later this week I have an appointment to pick up my prosthesis. Hopefully it will fit well. I’ll update once I have it. Until then, photos of my current state and the wonky scar:

2014_11_11  scar

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.” 🙂 ❤

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.

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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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Nippies

After my prophylactic bilateral mastectomy in January ’13, the left breast became necrotic from the incision up to my nipple. The scab that formed as the area healed eventually fell off taking my left nipple tip with it. Just the tip. It never grew back so I have one full nipple on the right and just the areola on the left. This makes for some awkward headlight moments.

What’s more awkward than two hard nipples?

Well, ONE! Although the remaining nip isn’t 100%, meaning I don’t have full sensation as I did pre-PBM, it still responds to stimuli. Every time I drive, for example, the seat belt rubs in just the right spot, so when I get out of the car, the right nipple is always “on.” If I was wearing bras, this wouldn’t be an issue, but I’m not, so I am usually sporting one headlight. I know .. it’s not that obvious and not everybody will notice, but I know it’s there!

One headlight

In an old post I went through the options that I face if I want to do something about the nip:

  1. Do nothing
  2. Get a 3D tattoo
  3. Reconstruct the lost nipple via skin graft or skate flap
  4. Remove the other nipple

I want to do something and it looks like it’ll be #4. My plastic surgeon can to this during an in-office procedure, but we will wait until I am healed from my next and hopefully last surgery in September. I am aiming to be finished by end of 2014.

In the meantime, he recommended I try Bristol Six Nippies. I have seen other women recommend this product on the various message boards and now I am recommending it too. These things are awesome! They are silicone nipple pasties that can be either inserted into a bra or cami or worn directly on the skin. I have the latter version, which is coated with an adhesive and sticks right where you put it, for many hours. Nippies Skin are seamless rounds that come in light, medium, and dark tones that blend into the skin. The medium version is pictured below.  The also come in other colors and designs, including tassels!

Bristol Six Nippies Skin

This is what they look like under the shirt. Yes, jerk cat IS judging you.

Bristol Six Nippies Skin

Updates galore

WARNING: NSFW / graphic content below.

Mother’s Day sucked

This was the first US Mother’s Day without my mom, who had ovarian cancer and died in November. Last week was rough. May 8th was World Ovarian Cancer Day and May 11th US Mother’s Day. Seeing everyone posting photos of celebrations with mom was really difficult. I know many of you reading this understand, because you have also lost your mom.

nope2BC is a success!

I spent the weekend doing my best to occupy myself with other things, such as painting, moving furniture, and shopping. I finally did something with the spare room that has been empty since we moved into this house seven years ago: it is now my crafting room.

Etsy logoDid I tell you the FORCE jewelry fundraiser lead me to start my own business? Yup .. nope2BC – Saying NOPE to Breast Cancer. Come see and Like on Facebook. I am making and selling cancer awareness themed jewelry and donating all proceeds to FORCE. I opened an Etsy shop and have also participated in a few local craft fairs and art expos. Over $1,000 has already been raised, which is way more than I expected to make in such a short period of time. I am ecstatic that it has done so well! I have another event tonight and many more coming later this year. I have lost count!

Recap of my reconstruction journey

Moving on to an update of where I am in the breast reconstruction process. First, I’d like to recap my journey for those of you who recently started reading this blog:

  • 01/2013 – Prophylactic bilateral mastectomy with tissue expander placement
    100ccs @ PBM, necrosis on left breast, hyperbaric oxygen therapy, fills delayed for two months, lost left nipple tip, expanded up to 550ccs
  • 09/2013 – Exchange surgery
    550cc expanders > 350cc Mentor round, smooth, high profile, silicone implants
  • 10/2013 – Infection and left implant removal
    Necrosis scar tissue broke down, hole developed, infection followed, implant had to go
  • 04/2014 – Revision surgery
    300cc tissue expander on left, swap to 450cc implant on right
  • 08/2014 – Planned exchange surgery

Expansions are a go

Five weeks after my most recent surgery I finally had my first expansion. We added 50ccs to the expander on my left, for a total of 350ccs. Our goal is 550ccs, so four more expansions to go. My exchange surgery is scheduled for August 19. We are going to be cutting it close with only about four weeks between last expansion and exchange. If I wuss out again and need to lower the expansion volume, I will have to push the surgery into September. Just two days after the fill, I am sore, but it is no surprise. Next expansion: May 30.

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