This may be my most personal and emotional post to date. I apologize in advance if I ramble with my thoughts throughout. I still can’t fully wrap my mind around what all is happening, I know that it’s what I have to do, but I will be honest I don’t want to! I want to start with the emphasis that a mastectomy is not a boob job. When I started telling everyone the decision that I had made I received the endearing comment “at least you get new perky boobs” I understand that people try to find the positive in every situation and try to use that to comfort, but it didn’t. Nothing helped and no fault to anyone. Just until about a month ago I did not understand a mastectomy procedure fully. All your breast tissue is removed down to the chest cavity, sometimes lymph nodes will need to be removed, this is usually decided during surgery. This is why it’s called breast reconstruction, you literally are starting from ground zero to reconstruct everything including the breast mound and the breast.
When Dr.Frame told me that we could start reconstruction immediately I thought “Ok so I will go to sleep with breasts and wake up with breasts” not so bad right? It doesn’t work like that always. Everything depends on your health, your skin condition, your skins elasticity, your body frame, how big/small you currently are, etc.. so this is a complicated procedure. I had approx 7 weeks until I seen the plastic surgeon to decide what route we will take. This was so overwhelming, there are so many different ways to reconstruct, again I don’t handle big decisions well let alone a lot of choices. For the next 7 weeks I researched and decided that I would do DTI (direct) this is the less painful of the methods and I want a short recovery if possible and would have fat grafting to fill in around the implant to make round and so you wouldn’t see the outline of the implant). Did not want tissue expanders…NO WAY
I met my plastic surgeon on Nov.15th,2016. Let me tell you how long of a wait that was! i was so nervous all day and my appointment wasn’t until 3:00pm. I had made up my mind on wanting DTI so I was mentally prepared to pick out what type of implants I wanted (teardrop,gummy bear,saline,silicone,high profile,med profile,low profile..) again overwhelming! When I got called back the nurse said to sit on the bench and the Dr. would be in to discuss and then I would do the dreaded undressing and exam my breasts. We waited for about 20 minutes, I didn’t know how to take him. I think he was nice. He asked me how I found out about the BRCA and again asked about my family history, surgeries, problems with anesthesia, what size bra I currently am and if I wanted to stay that way. He wrote all this down and told me to change and that he would be back and we would discuss options… Ok, well I am doing DTI… He came back and opened the cape and immediately started measuring, lifting and pulling.. kinda rough.. Ok, now i am embarrassed. I look over at Nick and he mouths “Are you ok?” I don’t even know if I am ok..I don’t know what I feel. His nurse writes all the measurements down and then she takes pictures of my breasts, this is great.. I feel so ashamed. I get dressed and he comes back to discuss options with me.
He comes back in and says “Ok we can do this, this is scary and I understand” His bedside manner is a little better and I think he senses my anxiety. He starts talking and I hear the words “tissue expanders” wait..hold up.. you lost me.. I said I want DTI he said that’s not an option for my body type, and I would defiantly be smaller and he doesn’t perform that procedure. I am fighting back my tears, my ears are red, my skin is splotchy. I kept asking “why” “Why don’t I get options? I don’t want tissue expanders” He said “Kathy you do get options. You get the option of no chemo and no radiation and you get the option to live.”He explained the process, he would place the expanders (looks like an empty implant) under my pectoral muscle to expand my tissue to make room for an implant, and he said “it’s going to hurt like hell” I would get saline fills every week or two and we would stop when my skin has had enough, this is when the skins elasticity comes into play. I am beside myself, I can’t really comprehend what is happening. These are like bricks on your chest and the doctor said he cant explain how tight my chest will be and will hurt worse with the fills as I get bigger. He also said there will be 3 steps, the second surgery will be the implant swap, this will be outpatient but will be a recovery for 2 weeks and will have drains again. Approx 3-4 months after the mastectomy. He said there will be nips and tucks and they will not be perfect, he can tell I am not ok at this time. He said “this is not cosmetic this is reconstruction.” I asked if I can keep my nipples and his exact words “umm no they are to far stretched out from having kids and breastfeeding” Wow..Ok didn’t think they were that bad! Then I asked him what size I would be and he couldn’t answer. He said “maybe a B cup” Ummm no…. I am far from a B cup and want a full C, this was the 3rd slap in the face of reality this visit. No DTI,No nipples, and maybe a B cup. Reality has hit. The 3rd step in this process would be nipple reconstruction or tattoo, this is done about 3 months after the exchange surgery. So this is a long recovery and drawn out one. i am worried about my mental health, keep in mind that I will have a complete hysterectomy at the same time.
The reason for tissue expanders is that you can monitor your size, based on how well your tissue and skin will stretch. Sometimes your body will reject the implants if they are done immediately and that poses even more problems, and the reason you usually end up smaller with DTI is that implants aren’t made that big, the reason you see big boobs after a boob job is because they are using the existing tissue and adding to it. Again we are starting at ground zero. As he put it “slow and steady wins the race” I looked at pictures of his work and they all looked good. I am not a candidate for DIEP because although I do have extra tissue and fat around my belly, not enough to reconstruct 2 breasts at a C cup. I am having a hysterectomy and cant have this done at the same time, and i honestly don’t like the side effects from this procedure. We filled out all the paperwork, got the prescriptions, he gave me a prescription for Valium and told me to take the night before.
I got in the elevator and lost it emotionally, I cried hard once I got in the car, I couldn’t drive. I cried all that night and even the next morning as I was getting ready for work.Nick said that he had never seen me this beside myself. I have a great support system, a great husband,great friends,great boss, a great job, a great team of ladies at work, a great church family and of course my family that will get me through this. I have a hard time living my faith but I have been and will continue and strength in the power of prayer. December 5,2016 7:00 am is my surgery day, a long recovery ahead but I am ready for this to be all a memory. Things could always be worse. This may teach me how to ask for help, lord knows I will need it. Ready for all this to be a memory..