Tag Archives: Tissue expander

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.

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

Headlights

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!

Headlights

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

Eighth expansion

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.

GravityThe 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!

2013_7_12 Fills

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

Extra! Extra! Seventh expansion

WARNING: NSFW / graphic content below.

The Virginian-PilotThe 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/sideThere 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.

2013_6_21 Fills

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

Fifth expansion

WARNING: NSFW / graphic content below.

In other news: I had my fifth expansion. 50ccs have been added to each expander, for a total of 400ccs/side. We’re getting there.

184ccs vs. 400ccs

184ccs (pre-op) vs. 400ccs

I am very happy with how these things are looking so far. Compared to how expanders usually look on women, mine have a pretty natural shape. A bit lop-sided, with righty higher up than lefty, because of how the internal pockets healed post-op. The right pocket closed up a little bit on the bottom, so the expander sits higher in my chest, but it’s not too bad. This will be fixed during the exchange surgery in September.

I have a few more decisions to make before September. Mainly: will I get silicone or saline implants, what shape will they be, and what am I going to do about my nipples. If you’ve been following me for a bit (or can tell from the photos), you know that I lost one of my nipples to necrosis. I need to figure out what I’m going to do about it. The options are:

  • Nothing
  • Reconstruct the lost nipple via skin graft or skate flap
  • Get a 3D tattoo
  • Remove the other nipple

I can’t decide what is best. On one hand, I went through all this trouble, so why give up now, but on the other, I just don’t think I’m going to like the aesthetic result if I do nothing or reconstruct/tattoo just one. What’s more awkward than two hard nipples? ONE! I like symmetry. I think I’m going to remove the other one and maybe reconstruct them both. Not 100% on that though. We shall see.

Here are the pics. Big difference between what 100ccs looked like after my mastectomy in January and the 400ccs I have today.

2013_5_24 fills

100 + 50 +75 +75 + 50 + 50 = 400ccs

Fourth expansion

WARNING: NSFW / graphic content below.

Another fill behind me. We took it back down a notch from 75 and added 50ccs to each expander, for a total of 350ccs/side. I’m not sure that you can see much of the difference in the photo, whic is at the bottom of this post.

I must say that I feel better after this fill than I did after the previous three. Typically I wake up on Saturday and it takes me a while to get going. This morning I didn’t feel much pain at all – no ibuprofen needed. I went food shopping and cleaned the whole house. I hope I don’t regret this tomorrow! Fingers crossed that this continues for the next four fills.

To celebrate my over-the-hump expansion (four down, four to go), I present to you: t-rex. In a previous post (see: Shower time) I joked that I had t-rex arms because of my limited range of motion right after the mastectomy. I could barely scratch my head (or butt) for a few days. I got this shirt shortly after. Enjoy!

Ask me about my t-rex

2013_5_10 fills

100 + 50 +75 +75 + 50 = 350ccs

One month later

It has been one month since my prophylactic nipple-sparing bilateral mastectomy. How am I doing? Here’s an update:

  • Mario kartI am now driving and no longer need a chauffeur.
  • Sneezing still hurts.
  • Got clearance to resume aerobic exercise, but no running or jumping.
  • Planning on going back to work in less than two weeks. Eek!
  • I am not a fan of these expanders. They are hard as rocks.
  • Still no expansions/fills. We are waiting for the necrotic area to heal. The large scab is slowly lifting at the edges. I trim it so it doesn’t get caught on clothes.
  • Had the 14th and last hyperbaric treatment today. Not sure how much of the healing can be attributed to the treatments, though. The wound has definitely gotten better, not worse, so it didn’t hurt. My breast surgeon believes that it saved Dusky!
  • Some bruising has developed on my right side, right over the fill port, so I stopped massaging the skin and expanders. Still using the cocoa butter oil with vitamin E.
  • Making progress in getting back full range of motion. I am happy to report a small victory – I can now bring my arms all the way to the floor during the floor/towel exercise at 13:10 in this post-op exercise video. Big accomplishment!Coins
  • Haven’t gotten any bills yet, but I know they’ll be pouring in soon.

Overall my recovery has been going great! The complications I’ve had are relatively minor and I am happy that it has not been worse.