Reconstruction Q &A
I sat there as the paper shook in her hand and I held that hand and said I will help you through this……
It is these moments that I know I am here for a reason. This is the most meaningful part of me and hope I continue to use it. I always look at what I bring and how it can change people everyday. To guide terrified patients through tests, surgery, chemo or radiation and explain what to expect, hold their hands and sit on a bed and look them in the eye, knowing I have felt their pain , crosses barriers and humbles me.
I explained to a nurse what the patient’s pain felt like so that she could understand what they felt.
My mastectomies for bilateral cancer tumors, needed skin resection with the tumors, making full implant reconstruction with allograft challenging and stretching the skin to it’s max. It felt like nerve pain beyond anything conceivable. My whole chest and armpits felt like weeping blisters of burn. And before it had healed, more surgery as it the left axilla came out too. Some nights, I would lean over my knees in some form of relief despite medication to do something with the nerve pain . But…. 6 week s later, as my cards always say, it settled. Yes, I would do it all again. Done in one go, I was able to move through treatment knowing that the main surgery was behind me.
Seeing patients go through reconstruction in any form – there was a new level of understanding between all of us – knowing that I had been there, inspired that I am back with purpose.
People ask me :
Why do reconstruction?
I understand those who do not feel they need it. I would be quite fine if I was told it was not possible but I remember the day I spoke with the plastic surgeon and she told me that she would make me look great and showed me the new gel substitutes that she would attempt to insert. She cautioned that due to loss of skin tissue, especially on the left side, I may need a tissue expander, and along with all the benefits came surgical risks. The expander is a temporary saline bag that is inflated to gently stretch the pectoral muscle and overlying skin to make room over time for the eventual full implant. It is common to insert this at the time of mastectomy; less common to accommodate a full implant immediately. If there is a certainty of a large amount of radiation, a full implant would be delayed since it can be affected by the radiation.
Reconstruction is commonly done after all treatment too. The plastic surgeon has to assess the condition of the skin if radiation has been done. There is the size of the other breast too to take into consideration.
In the end, I am so proud to wear clothes and be able to play tennis, swim, exercise with no second thought. Finishing the reconstruction with tattoos is an option I explored. It is absolutely remarkable. The quality of artistry is so incredible, that it is hard to tell it is 2D from a short distance. I am suddenly comfortable changing after the gym and feel like I fit in. I am very comfortable with all my scars while enjoying a sense of normality.
Flap vs implant?
There are rotational flaps and free flaps. The Diep free flap is taken from the lower abdomen like a tummy tuck and its blood vessels reconnected with microvascular precision to the chest to provide skin and fat to form a breast shape. It is very effective but you must be a healthy wt and maintain it to keep breast shape. Other rotational flaps like the latissimus and TRAM flaps, sacrifice some muscle and have complicaitons related to this. The other breast is often matched with a lift at the same time. Each person is assessed individually for their suitability to flap vs implant.
So there you have it – reconstruction Q & A
Looking Good does make you feel better and reconstruction can take that to the next step of self confidence too.
Ask me if it is worth it? Absolutely, I hope to help spread comfort and awareness around this topic for lots of women.