Will that be one scoop or two?

Yesterday's appointment was with the plastic surgeon to discuss reconstruction options and endure more waiting, waiting, waiting and more waiting at the VA.  

Not that the VA usually smells all clean and fresh, but yesterday not only did it smell like something had died but I was starting to think one gentleman would "expire" prior to being seen by the doctor.  I was glad to see him be moved into a room (hopefully they didn't forget about him). 

With that being said, I was finally called by the nurse, only an hour after my appointment time.  After a little more waiting (and beating Darin at Words with Friends by 235 points), the surgeon came and introduced himself.  I couldn't even say his name, let alone try and spell it, but he was very nice.  I got to wear the very flattering extra-extra large hospital gown, except, for these appointments, the opening is in the front, so no tushy shots.  After a little discussion (basically, he wanted to know how much I had been researching online...no worries…I played it cool),  he proceeded to explain the procedure while emphasizing the point that my breasts will never look like a natural breasts again.  One thing I will never forget was his way of explaining the tissue removal process.  Basically an incision will be made across the nipple and then tissue will be "scooped" out of that opening.  I don't think I will ever be able to look at an ice cream scoop the same way again.  He made a few diagrams on a paper towel (saves the VA money, I’d rather him cut cost here than in surgery) that aided in my visual understanding, he wasn't that bad of an artist.  He then measured various parts of my breast...from my collar bone to my nipple, the width of each breast, etc.  I thought he would be measuring me like they do when you have a bra fitted...back size and cup size, but I guess that all changes after the "scooping".  After all the discussion here are my two one options...

Muscle flap reconstruction using my own body’s tissue from either my stomach or back to rebuild the contour of the breast.  As he drew on the napkin I have to say I was getting excited about the idea of getting a tummy tuck out of this ordeal.  But then as he examined me by pinching and grabbing my tummy, I thought should I be sucking it in or letting it out.  He said this is the one time I shouldn't be sucking it all in.  As a woman who has perfected the art of "tummy sucking", I tried to let it go.  But he said, I didn't have enough fat in my abdomen to rebuild me past “perhaps a small B”.  I wanted to argue that point, feeling quite chubby lately given after my last appointment I inhaled chocolate as I drove home stressing.  However, it was nice to hear that I didn't have enough fat.

Second option is breast implants, either done at the same time of the mastectomy or by placing an expander beneath the skin and chest muscle before inserting implants to replace the breast.  Aside from having to come back for a second surgery to remove the expander and place the implants, this option is interesting because each week I would go in for a "fill-up" until I reached the desired cup size. The next thing to ponder was whether to use saline or silicone implants?  I felt like I was at the grocery store where they ask you paper or plastic.

Saline Pros:  more natural for the body to absorb if/when it leaks or breaks; no need for biannual MRI’s to detect leakage (if they leak, you deflate and it is very noticeable); less likely to cause future problems than silicone implants.

Saline Cons:  more likely to ripple or wrinkle; looks and feels less natural if you are thin or have minimal breast tissue (cons are largely aesthetic).

Silicone Pros:  feels and looks more natural, especially for thin women or those with minimal breast tissue.

Silicone Cons:  difficult to detect leakage; MRI’s mandatory after three years, then every two years after that; studies suggest there may be a link to silicon leaks and autoimmune diseases, cancers and other diseases, though not enough long term studies have proven this.  The doctor said, with the improvements in silicone, chances of serious problems are now literally one in a million.

I haven’t made a final decision...

By the end of the appointment, we had decided on immediate reconstruction with breast implants done at the same time as the mastectomy with the understanding that, if the doctor doesn’t feel comfortable doing it at the time (if the skin isn’t reacting well to the surgery), I will be getting the expanders.
   
I listened to reality yesterday.  I tried to remember everything the plastic surgeon had to say.  But the part that sunk in the most is my breasts will never look like a natural breasts again.  I have high hopes that they will look as good or even better than the hundreds of reconstruction photos I have looked at over the last month, and let me tell you some are awesome.  But others?  Painfully bad.  I am living in la-la land thinking that somehow I will be special and end up with a set of those awesome looking ones that doctors will want to put on their websites to show how good of a job they’ve done.

But, the reality is I won’t know how mine will turn out until all is said and done, which could be a year after surgery.  All I can do is hope that they don’t look like frankenboobs.


I have spent the last two months looking at boobies online.  I have bookmarks and folders saved with photos of boobs.  All different types of reconstruction techniques and their end results.  Good, bad, horribly disfigured, and some so awesome I couldn't tell anything had been done and they looked better than the originals.

I hope I never lose my laptop or the person who finds it will wonder what kind of fetish kink I am into!  Lol!

My next appointment is August 4th to sign all the release forms and answer any questions I might have.  I did ask the plastic surgeon if they had one of those before and after books...unfortunately they did not, so I will taking my laptop to the next appointment.