Bionic Boobs

Yesterday I had a third surgery on my boobs.  A year ago December, I had a double mastectomy, which was clearly the most traumatic physically and emotionally.  At that time, my plastic surgeon, Dr. W, started phase one of my reconstruction, which involved placing tissue expanders behind my chest muscles.  Over a period of weeks, those were injected with saline solution and expanded to keep the skin that remained after my mastectomy from contracting, making reconstruction more difficult later.

I loved my expanders.  Most people hate them.  I loved them.

In considering reconstruction, I kicked around the idea of autonomous replacement (tram flap surgery) where the surgeon uses abdominal fat and muscle and a tunnel to recreate a breast or two.  However, it's a highly invasive procedure that involves several days in the hospital, many hours under general anesthesia (and I have issues with that), and there's still no guarantee that the flap will take (I know one person whose flap died).  Other women with flap reconstructions have abdominal issues.  There's one in my exercise class who can't do many abdominal exercises because of her missing abdominal muscles.  To make a long story short, I opted to NOT do flap surgery.  Maybe some day, when my kids are older, when the procedure has been perfected more, when it doesn't involve removing abdominal muscle.  But for now, I'm happy with my decision to have the relatively simply reconstruction of saline implants.

You know, super model boobs.  Only, mine aren't super model size.

Women get breast implants all the time.  It's a pretty basic, easily accomplished procedure.  However, when done strictly for cosmetic reasons, there is still surrounding breast tissue and the implants supplement what is already there.  With reconstruction after mastectomy, there is no breast tissue and the implants are placed under the chest wall.  Placing them there serves two purposes.  Most importantly, in placing the implant under the chest wall, it's easier to detect any new tumors in the breast area...there is always some small amount of tissue left.  Of secondary importance is that since there isn't breast fat and tissue left, if implants were placed on top of the chest muscle, it would look like balloons under skin.

So, I have my two moderately sized implants under my pectoral muscle, and I can flex them like a body builder. 

One advantage for me in having had a mastectomy before my implants were planted is that I have very few nerve endings in my chest area.  So, there was very little discomfort.  The biggest discomfort was in restricting my movement.  If I took my pain meds on schedule, I had very little discomfort.

And then one day I noticed that my right breast was significantly lower then my left breast.  I'd read about implants slipping.  I'd feared it.  I was certain that is what had happened.  However, after revisiting Dr. W, she determined that my right side had done what it should have done, settled into a more natural position.  The left side, however, was brutalized by 6 weeks of radiation last spring.  Radiation is nasty stuff.  It changes the skin and muscle.  What that means for me is that I've lost some flexibility on that side.  My skin and muscles, especially the muscles, are tighter.  That's also the side I had lymph nodes removed, which damaged other muscles.  Therefore, the right side implant didn't settle.  There are other negative and permanent side effects of radiation therapy, most notably heart and lung damage, but no one can really see that.

So, while most women, especially after having babies (which I did 5 times) have asymmetrical breasts, because of a lack of breast tissue and being placed under my  muscle, my asymmetrical breasts looked really odd.  They looked like a very unskillful job of bra stuffing. 

To fix it, not much can be done to the left side.  Radiation has done its damage.  So Dr. W suggested raising the right breast.  This, however, involved stitching the implant to my rib, or rather the living tissue, the periosteum, that surrounds the rib.  And that is what she did to me yesterday.  She also removed some extra skin on both breasts.

I still don't have many nerve endings, and I'm rather glad I don't, because this is painful.  I don't remember why I felt like I'd been kicked in the sternum after my mastectomy, but I did.  This evening, I feel like a donkey kicked me in the rib.  Even with a maximum dosage of Percocet, whenever I move my right arm in a reaching motion, I feel a stabbing yet bruising sensation in my rib. 

But my boobs are even. 

Now to decide what to do.  Percs make me itch.  Not taking them makes me hurt.  I can take them with benedryl to cut down on the itching, and that combo knocks me out.  But I don't like the way that makes me feel.

In my next life, I won't have any reconstruction done.  It's not worth it, I don't think.

Adios, Portia!

Tomorrow, the "final" step on this whole sucky journey takes place....I'm having my reconstruction surgery. Even more exciting, my port will be removed at the same time. I am more excited about having my port removed than I am about getting my squishy boobs. I'm pretty much over breasts. If I had a different body type, I'm now certain I'd have not opted for any reconstruction. If I had this body type, I'd be quite comfortable without breasts. Alas, no matter how much I run, no matter how much I work out, that particular body type will never belong to me. I'm rather happy with my rock hard, totally unnatural "breast mounds" caused by the tissue expanders I have in right now. For those of you who don't know about tissue expanders, they are HARD. No movement, what's so ever. The rest of my body jiggles. Not my boobs. This makes lying on my stomach somewhat of a challenge, but it's still manageable. I could live with these for the rest of my life. Really, I could.



But this port....the port squicks me out, big time. The surgeons and doctors all say that it's one of the "best" they've seen, but it's nasty. There's this button right under my skin, about 2" below my collar bone. And then there's this tubing that runs under my skin, up toward my collar bone and disappears into my heart. Gross. Gross. Gross.



To top it off, I have some keloidal scarring along the tube, so there's a maroon line going up my chest. I care less about how it looks...by this point, most of my friends have some sort of scarring. But I simply can NOT stand how it feels. I know the word is over used, but it really is GROSS.



However, by tomorrow night, Portia the port will be gone. She has served me well, allowing 10 relatively pain free chemo infusions and 17 herceptin infusions. However, she shall not be missed.



And I'll have new boobs. Everyone assures me that I will be able to continue to live brassiere free after my surgery heals, and that had better be the reality I face. I do not miss wearing bras. Not. At. All.



And if I don't like these boobs, I can always get rid of them.