This is the post where I explain my specific beast reconstruction process. The mastectomy and reconstruction were very difficult for me, and for many women I’ve spoken to, so this is hard to write about, but important for anyone else going through the process.
Once I knew I was going to proceed with a full bilateral mastectomy, I had to determine if I was also going to have reconstruction done. Some women don’t; they simply have the mastectomy and then use a prosthesis to try and recreate their original body. Some women decide to not even do that and simply elect to be flat chested afterward. In retrospect I kind of wish I was bold and courageous enough to have taken that route as I’ve seen images of women who have and it’s a brave and powerful statement, but not one I was willing to make at that time.
After talking to my plastic surgeon and researching options online, I decided to have immediate implant reconstruction which is a surgical procedure with 2 surgeons in the operating room at the same time. One was my breast surgeon who did the mastectomy and the other was my plastic surgeon who immediately afterward, put in an expander so that I could eventually be fitted with implants.
The procedure is tough, as are most reconstruction stories I’ve heard about and I was pretty miserable throughout the entire process. When I first heard all my reconstructive options from the plastic surgeon, I elected to go the expander and implant route because it seemed like the easiest route to take, but I found the expanders, and the expansion process, to be very uncomfortable.
It felt like I was wearing an iron vest for the three months I had them in. The entire process is really daunting. They put in the expander, and ultimately the implants, behind your chest muscle, in order to position it in place. The expander is a hardish type plastic and not very comfortable in your body. It has an opening at the top which allows the plastic surgeon to insert a needle filled with saline into the expander which expands the skin and muscle in increments of about 50 cc’s of saline each time.
Each expansion that I had was very uncomfortable. I would recommend anyone going through it take 2 Motrin or Tylenol prior to the expansion so that you can deal with the tightness that comes with the increased saline after each expansion. I was surprised by how much pain I had in my back, vs my chest. I think it’s because the expansion pulls all your muscles tight and draws your back forward. It’s hard to explain, but I just know that I would experience terrible aching in my back for the first few days after each expansion.
Every time I would discuss the process of expansion with my (male) plastic surgeon, I would tell him that I wanted to look the way I did prior to breast cancer, a small B cup. Originally he said, “OK, that will probably be about 300-325 cc’s” (this is the lingo they use for size of implants). But once the implants were in, every time we’d discuss this, he’d say things like, “Well, when we get to about 350 cc’s” and then at one point after about 4 expansions he said, “When we are at about 400 cc’s,” at which point I practically fell over, because I had been very clear all along that I didn’t want to have large implants and was just trying to look similar to how I looked prior to the mastectomy. And, clearly, he (being a man) thought I would prefer to have larger breasts, which I found to be insulting and sexist.
The good news is that when I asked my husband if he had a size preference (I actually said, “This is your only chance, Buddy, if you want ’em bigger, let me know now”) he said, “Do whatever you want, I’m cool.” Thank goodness. Because to be perfectly honest, in addition to the fact that I didn’t really want big breasts, the expansion process is really uncomfortable and the smaller I decided to go, the less expansion I would have to deal with.
After each expansion, I would wait another week or two for the next. I only had 50 cc’s of saline inserted each time. I had read online that some women try to have as much as possible inserted each expansion, but that anything over 50 cc’s would cause even more discomfort, and given my own level of discomfort with just 50 cc’s, I concur. So, if you’re considering going the expansion route, plan on doing 50 cc’s each expansion, take 2 Motrin or Tylenol’s before each expansion and know that you’ll have a good bit of discomfort after each.
After about 3 months, once I hit the date when I was ready to swap my expander for the softer, long-term implants, I was so relieved. Of course, it entails another surgery but mine was outpatient and at this point, I felt like outpatient surgery was a piece of cake. Since I was so relieved to get the hard expanders out, I was actually looking forward to it.
The surgery went uneventfully (I had it on February 14th, Valentine’s Day – what a way to celebrate, right?) and I went home that night feeling quite relieved to have the entire reconstruction process behind me. I had no additional drains and the recovery was pretty easy compared to the mastectomy.
Now I’m several years out from reconstruction and there are still pros and cons to how I feel. I don’t know many women who are really thrilled with their results. I still have discomfort. Mine are still a bit tight and I have weird side effects from the implants such as numbness in my hands when I sleep on my side.
I do know that there are great strides being made in reconstructive surgery each year. Do your research if you have to have a mastectomy as there are new procedures such as DIEP flap surgery which are very promising and appear to offer wonderful and more natural results. My fellow advocate, Terri Coutee has a site called DiepCjourney, with lots of support and information regarding Diep flap reconstruction. Research your plastic surgeon and find the best in your area, one who focuses on reconstruction, as it’s a fine art.
I hope you never have to go through this. But if you do, research your options by reading online, getting multiple opinions and asking other survivors for their insights.