Sunday, June 3, 2012

Yes, They're Fake...My Real Ones Tried to Kill Me.

I've spent a lifetime lamenting that - how can I say this delicately - my cup doth not exactly runneth over in the lingerie department.  So, I would be lying if I said I wasn't looking forward to meeting with my plastic surgeon to discuss reconstruction.  

The breast reconstruction process itself is complex.  After the general surgeon performs the mastectomy where the breast tissue and involved lymph nodes are removed, the plastic surgeon takes over.  The pect muscles are dissected along all the borders except the sternal border.  A plastic expander is put into place beneath the pect muscle and then secured using cadaver tissue because my tissue will be gone.  In 4-6 weeks, after I heal from that surgery and around the same time I start chemo, the plastic surgeon will begin injecting saline into the expanders at about 50-100cc at a time.  This process stretches the skin gradually until over time I reach the size I want to be.  At that point, we schedule a second surgery to place the implants.  After recovery from that, a third surgery occurs to form nipples and then they are tattooed to appear realistic.  Heavy, right?  Keep in mind I didn't know any of this when we first met with our plastic surgeon. 

Here's how I pictured the consult would go down:  A soft porn version of Willy Wonka and the Chocolate Factory with a room full of boob options lined up like eye glasses at the optometrist.  "What do you think of this model honey?" I would ask, as my supportive husband picked out something from the "C" shelf.

Here's what happened:  My very competent and wise plastic surgeon discussed all the risks of implants (they can leak, pop, poison you and at the very best must be replaced every 10 years) the surgery (blood clots, impaired healing, blood loss, death) as well as possible complications of the reconstruction itself (the implants may not settle correctly, be lopsided or worst case scenario form what I affectionately deemed "the uniboob"). He discussed that complications occur in about 1 in 20 cases (to his credit he used the phrase "driven hard and put away wet" when he discussed women that are more likely to suffer complications such as smokers, obese, have diabetes and not healthy.  I respect a clinician who can use that term and somehow still remain professional.) it would be about a year before the process would be complete and that when it's said and done most women are very happy with their silhouette while wearing clothing. 

It was at this point that I burst into tears and demanded to see an album of my nipple options. 

This was not my best moment.  It turns out that everyone has their breaking point.  I could handle the cancer diagnosis, seemingly endless diagnostic tests and planning for chemotherapy.  But nipples sent me over the edge.  So, I sat and cried in that exam room while my (now slightly panicked appearing) plastic surgeon searched for an elusive nipple gallery.  

And all the while my supportive husband handed me tissue, held me and told me it was going to be ok.  The funny thing is...I believed him (but that could have been due to the xanax he slipped me).  Even though we didn't have the "brown chicken, brown cow" moment I thought we would, somehow it didn't matter.  We were going to get through this - together. 

By the time my now defeated surgeon reappeared to admit he could not find the gallery which was somewhere in his vacationing partners office, I was ready to move forward.  

Thanks to the wonders of Google I've now spent an unreasonable amount of time searching reconstructed breasts and various nipple options (it's a wonder our computer doesn't have a virus at this point) and so long as I don't end up with the dreaded "uniboob" I think everything will be just fine.