Tag Archives: surgery

Scar and surgery photos

WARNING: NSFW / graphic content below.

Had another follow up appointment on Friday. Dr. M refreshed the tape that’s holding up my right foob. We are going to keep doing this for a few more weeks in hopes that it will be enough for the scar tissue to form at the bottom of the pocket and close it up, BUT I may need another surgery anyway. We compared the two sides size-wise and found that we may need to swap out my right implant for a larger one. Plus, I still need to do something about this missing nipple, so yes, more OR time in my future.

He removed the strips covering my incisions, so I can now inspect them closely. They look 3049813476 times better than after the PBM. No necrosis in sight! I have a spot that looks a little bit like the start of a stitch abscess, so I will be watching it. Here’s what my scars looked like pre-exchange and what they look like now, 12 days post-op. Different lighting, but you can see that at the bottom that they are no longer angry red and keloid-ish.

Scars on righty   Scars on lefty

I also got a copy of my surgery pictures! It is really cool to see the changes from this angle. From left: 1. 184 g/ccs removed during PBM surgery (1/22/2013), 2. Expanders at exchange (9/3/2013), 3. One out, one to go, 4. Mentor round, smooth, high profile silicones in 350ccs.

PBM  Exchange 2 expanders  Exchange 1 expander  Exchange implants

So I think this is why my right foob seems smaller than the left one, even though the implant size is the same at 350ccs: I am concave/the hole in my chest is deeper on this side, so the implant sinks into the cavity more. We can’t do anything about it right this moment, though.

Concave front view   Concave side view

Done, DONE, D O N E – ninth expansion

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!

2013_7_19 fills

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

They’re growing – first expansion

WARNING: NSFW / graphic content below.

Goodbye ugly scab, hello first fill!

The scab that has been living on my left boob has finally fallen off! Can I get a “woo hoo”? It has been two full months since my prophylactic mastectomy on January 22 and the start of my adventure with resulting skin/nipple necrosis. Today I had my first fill. 50ccs of saline were injected into each tissue expander, bringing the total to 150ccs/side.

Tissue expanderWhat are tissue expanders, you ask? The type of breast reconstruction I chose is two-staged: tissue expanders first, followed by silicone breast implants. The tissue expanders, which were implanted underneath my pectoralis major muscle during the mastectomy, get filled with saline on a regular basis to stretch said muscle and the skin that covers it, until the desired volume is reached. They are like “pre-implants.” Similar shape, but more rigid, unnatural, and uncomfortable. They have a round magnetic port in the top half, which allows for insertion of a needle, without compromising the expander.

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 50ccs of fluid have 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. Same story on the other side.

This procedure is overall painless (based on just the first fill). The only sensation was a brief sting as the needle was inserted into the port through the skin.Three hours later, I feel a little bit of that now-familiar pressure on the muscle and skin stretched over the expanders. As soon as I got home, I popped an ibuprofen, did some stretches, and smeared my chest with Palmer’s cocoa butter oil.

As I look down at my chest, I can see that my foobs are bigger. It is a small difference, but it’s there. It will be interesting to watch these things grow. I can already tell that it won’t be pretty. The expanders didn’t settle exactly the same way: one sits higher and the other one is a bit twisted. The asymmetry seems to be normal based on my plastic surgeon’s feedback and the photos other women have shared. Enjoy the visual!

Fills 2013_3_29

100 + 50 = 150ccs

The fills will continue every two weeks at 50ccs/side. At this point, I have not yet decided how big I want to go (one of my friends joked: “go big or go home!”). However, I did find out that my breast surgeon removed 184 grams of breast tissue/side, which translates to roughly 184ccs, so one more fill and I will be back to pre-op size. Next appointment: April 12.

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.

Hyperbaric oxygen therapy

WARNING: NSFW / graphic content below.

Tissue or skin necrosis is one of the risks associated with a mastectomy (or any surgery), which is typically a result of loss/interruption of blood vessels feeding the tissue. Read more about it in my previous post: Tissue necrosis.

Hyperbaric oxygen therapy, most commonly known to treat decompression sickness related to deep diving, is sometimes used for treatment of wounds or necrosis. I was not familiar with this type of treatment before entering this community and even now, being completely engrossed in it, I don’t see it mentioned often.

In a nutshell

Hyperbaric chamberHyperbaric oxygen therapy (HBOT) involves the breathing of pure oxygen while in a sealed chamber that has been pressurized at 1-1/2 to 3 times normal atmospheric pressure. – American Cancer Society

What that means is: you get into a clear plastic tube that is sealed, the air pressure is raised (while your ears constantly “pop”), pure oxygen is pumped into the tube, and you get to watch two hours of TV while the oxygen works its magic. I renewed my Netflix subscription just for the occasion!

Why do it?

The main benefit to hyperbaric oxygen therapy for wounds is esentially faster healing. Here are some key points from WoldWideWounds.com:

  • Oxygen used under pressure can assist wound healing
  • It can be used successfully in wounds such as failing flaps and necrotising soft tissue
  • HBO therapy provides oxygen needed to stimulate and support wound healing where there may be insufficient supply
  • It combats clinical infection
  • It is a relatively safe non-invasive therapy

Does it work?

I had 14 treatments total and can definitely see changes in the necrotic area. I am unsure, however, how much of it can be attributed to the hyperbaric oxygen therapy versus regular rate of healing, diet, exercise, etc. Both my plastic surgeon and the wound care doctor agree that I will still have scarring and “discoloration” of the tissue underneath the necrotic skin, but will not need any skin grafting or other forms of treatment. My breast surgeon thinks that HBOT saved my nipple. So discoloration I can deal with, as long as I can avoid additional surgery and get to keep Dusky, the rebel left nipple!

These are earlier pics of changes in the wound over the first two weeks post-op, pre-HBOT:

Necrosis progress

This is what Dusky looked like after ten HBO treatments and four weeks post prophylactic bilateral mastectomy:

Necrosis four weeks

This is after the scab fell off two months post-op. Unfortunately, I did lose the tip of my nipple. Yup, just the tip. It took another couple of months for the pigment to return.

2013_7_12 Pigment

Recovery photos

I have finally added some photos! Check out the MY PHOTOS page.

CameraA couple of days before my prophylactic nipple-sparing bilateral mastectomy I took a “before” photo of the girls. Since then, I have been taking daily pictures to document my journey. Take a peek to see how I’ve been doing during my recovery thus far. The pics are of my nude torso, so NSFW/graphic.