Bye, Bye, Boobie, Boobie, Bye, Bye!
This morning I met with the breast surgeon to discuss the mastectomy. I think she was surprised when I told her why I was there, but said she completely supports my decision and my thinking and will do the surgery. Mom went with me for an extra set of ears.
Dr. C talked us through the various types of mastectomy and reconstruction. She would do the mastectomy portion of the surgery, and I will need to decide on a plastic surgeon to do the reconstruction. They would begin the reconstruction at the same time. I'll spare you all of the details of the different ways you can get rid of boobs, and the different ways they can make new ones, and just tell you what I'm going to do. And if that's too much for you, well, stop here.
I'm going to have a fairly traditional simple mastectomy, with the exception of the incision. Most surgeons place their incision either straight across the breast or diagonally and it is a couple of inches across. Dr C uses a circular incision which removes the nipple complex. It's closed using a "purse string" suture which pulls the skin back together and makes a much smaller scar. They will remove all of the tissue between the skin and the pectoral muscle. A tissue expander, which is basically an empty implant, will be placed behind the pectoral muscle during surgery and inflated a little bit. The expander will be filled maybe once every two or three weeks until the muscle stretches to the appropriate size to accommodate the permanent implant. It will likely take longer for my cancer side to stretch because of the radiation damage, so that will determine how long the process takes. Once we get to the right size, they will swap the expander for an implant in a much easier, outpatient surgery.
There are reconstruction types which use your own body tissue to create the new breast. Basically they take the fat from your stomach and make new boobs. So you get a tummy tuck. Most people don't have enough tissue to do this for two breasts. I'm glad she didn't look at me and say "Oh, you've got plenty of fat. You should consider this!"
As far as recovery, I'll spend one or two nights in the hospital. I'll have drains for about a week, and I already know I'm going to hate that. She said I'd need to be out of work for three weeks. My immediate question was completely out? or working from home out? She said I'd be able to work from home as long as I was managing the pain ok. Since they'll be cutting my pec muscles, it will take a few weeks before I'll feel able to drive and do anything else that involves a lot of arm movement.
Right now the next step is to pick a reconstructive surgeon. Dr. C took the action to check which doctors she has worked with and recommends takes my insurance. Once I get that information, I'll start checking out their work and trying to make a decision. She thinks it will take a couple of weeks to get this on the calendar (scheduling two surgeons simultaneously and coordinating an OR for several hours) but doesn't think it will be a problem to do the surgery this spring (March/April).
I also need to have a mammogram before surgery as a precaution. It would really stink to go through this and get the pathology back and find some cancer. She didn't feel anything in the exam, so there is no specific concern. But the good news is that this will be my last ever mammogram! On the slim chance that I have a recurrence down the road, it would be easier to detect since the muscle will be pushing that tissue against the skin and I should be able to feel anything with my hand.
Dr. C talked us through the various types of mastectomy and reconstruction. She would do the mastectomy portion of the surgery, and I will need to decide on a plastic surgeon to do the reconstruction. They would begin the reconstruction at the same time. I'll spare you all of the details of the different ways you can get rid of boobs, and the different ways they can make new ones, and just tell you what I'm going to do. And if that's too much for you, well, stop here.
I'm going to have a fairly traditional simple mastectomy, with the exception of the incision. Most surgeons place their incision either straight across the breast or diagonally and it is a couple of inches across. Dr C uses a circular incision which removes the nipple complex. It's closed using a "purse string" suture which pulls the skin back together and makes a much smaller scar. They will remove all of the tissue between the skin and the pectoral muscle. A tissue expander, which is basically an empty implant, will be placed behind the pectoral muscle during surgery and inflated a little bit. The expander will be filled maybe once every two or three weeks until the muscle stretches to the appropriate size to accommodate the permanent implant. It will likely take longer for my cancer side to stretch because of the radiation damage, so that will determine how long the process takes. Once we get to the right size, they will swap the expander for an implant in a much easier, outpatient surgery.
There are reconstruction types which use your own body tissue to create the new breast. Basically they take the fat from your stomach and make new boobs. So you get a tummy tuck. Most people don't have enough tissue to do this for two breasts. I'm glad she didn't look at me and say "Oh, you've got plenty of fat. You should consider this!"
As far as recovery, I'll spend one or two nights in the hospital. I'll have drains for about a week, and I already know I'm going to hate that. She said I'd need to be out of work for three weeks. My immediate question was completely out? or working from home out? She said I'd be able to work from home as long as I was managing the pain ok. Since they'll be cutting my pec muscles, it will take a few weeks before I'll feel able to drive and do anything else that involves a lot of arm movement.
Right now the next step is to pick a reconstructive surgeon. Dr. C took the action to check which doctors she has worked with and recommends takes my insurance. Once I get that information, I'll start checking out their work and trying to make a decision. She thinks it will take a couple of weeks to get this on the calendar (scheduling two surgeons simultaneously and coordinating an OR for several hours) but doesn't think it will be a problem to do the surgery this spring (March/April).
I also need to have a mammogram before surgery as a precaution. It would really stink to go through this and get the pathology back and find some cancer. She didn't feel anything in the exam, so there is no specific concern. But the good news is that this will be my last ever mammogram! On the slim chance that I have a recurrence down the road, it would be easier to detect since the muscle will be pushing that tissue against the skin and I should be able to feel anything with my hand.
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