Plastic Surgeon Update

Kevan and I met with my plastic surgeon on Tuesday.  It was her first day back from maternity leave/bed rest.  So, it was the first time I have seen her since my surgery on 5/8.   I am happy to finally have my final reconstruction surgery date.  My surgery will be December 5th.  This surgery is for my "exchange" of tissue expanders (aka "rocks") to implants.  I am looking forward to my surgery, but at the same time I am dreading it a little.  I hate "going under" and I also hate waking up in pain.  I've been reading a lot online about the recovery and it sounds like the first 5 days are similar to the mastectomy surgery (can't sleep flat, can't get myself up by myself, pain meds around the clock, drains, etc).  But, after that most women are able to resume their normal schedule.  Except for lifting restrictions.  Of course, I will be posting about my experience so I can help other women know what they may experience if they have to go through it too.

Size
The PS looked at how well I'm doing and thought the tissue expanders looked great.  Her nurse, "L", really did a great job while she was out.  We finally talked about "size" and "implant type".  Kevan and I talked a little about what we were thinking size-wise.  Then, she talked to us about my frame-size and torso-size and what she recommended.  She said that if women small like me go too big the implant/breast will protrude out the side of the chest because my frame is so small.  She doesn't recommend going too big because I will hate doing anything (farm chores, sports, etc) where I use arm movement because my arm will constantly be running into my implant/breast on the side.  I totally trust her opinion.  We are going to go a little bigger than what I had before cancer, but not too big.  I have never wanted to look like Dolly or wanted my chest to be noticed when I walk into a room.  So, I think that will be just fine.  I just want to feel girlie.  She said that they will bring several implants into the surgery of different sizes.  They will fit them into my chest "pockets" that have been formed by the tissue expanders, raise me up (while I'm under anesthesia), check to see how they fit and choose the best size for my frame...while keeping in mind what Kevan and I would like me to end up with.  I think that is fair.

Implants
We talked over the good/bad about each implant (silicone, saline, silicone/gel) in regards to my body.  She really likes the plain round silicone implants because they are easy to place and if they end up turning it doesn't matter since they are round.  But, she feels this implant may "ripple" since I do not have much flesh left after the mastectomy and my skin is so thin.  If we did choose these they would try to fill as much of the area that may ripple with fat (from somewhere else on my body...think liposuction), but it may not hold (it can be rejected by the body).  So, it would require another surgery to try to inject the fat again.  Also, the plain silicone implant would sit up higher and be more round and more fake.  I want to look more natural and I don't want to have to have an additional surgery due to rippling.  So, we decided on the 410 "Gummy Bear" silicone implants.  She said if she was me this is what she would choose.  It is less likely to ripple, it's textured (to help it stay in place) and is shaped like a tear drop to look more natural.  Due to this my PS can't do my surgery because they are still in clinical trials.  Her partner will be doing my surgery.  I meet with him on 10/29.  Also, with 410 implants, because they are gel they cannot leak into the body.

Fat injection/Liposuction
Before the surgery my surgeon will ask me what areas of my body I'm unhappy with due to excess fat.  This, is just one of the blessings of the surgery.  lol!  Then, with a blue pen the surgeon will circle different areas that I choose so that during surgery he can remove fat from those areas (liposuction) to use in the breast reconstruction.  I have to say...I'm a little excited about getting my excess fat removed.  lol!  I know it won't all be removed, but hey....even a little is good...that is a few less crunches or lunges.  Right?  I also read that it is pretty painful so I'm not looking forward to that aspect of it. 

Reflection
When I think back to when I first saw myself after my bilateral mastectomy 5 months ago it is an awful memory.  I was flat chested and things turned black due to lack of blood flow.  Kevan was my cheerleader though and kept reassuring me that things were going to get better...that this wasn't the final result.  I think God gave Kevan some special grace because I don't know how he looked at me then and thought so positively.  Thank you Lord for him and for all your prayers during that time.  But, if you have to go through this...remember....there is hope!  Kevan was right....after each PS visit (and fill) I started to look more normal.  The bruising and black areas faded and now everything looks "normal".  I have to say that if I had to look the way I do today and couldn't have the surgery I would probably be pretty okay with the results.  I mean, I've had cancer.  I look pretty good and the technology they use today is pretty awesome.  I hate these tissue expanders, but they provided a huge purpose in how I look today and it was worth going through it.  If I had cancer 50 years ago I would look similar to that first day minus the bruising.  I wouldn't have been able to save my N's.  So, I am already blessed so much.  My PS told me that based on how I look today she thinks I will look really good when I come out of surgery.  The sunk-in places of flesh that are missing (where the oncological surgeon had to get clear margins) will be filled in my fat injection.  My scars will fade over time and hopefully it will be hard to tell what I've gone through.  God is so awesome.  He has walked with me through this whole journey and continues to bless me so much.

Fractured Rib
Funny/painful story.  I was laying in bed on Monday, 5 days ago ,and I decided to flip over on my side.  When, I did...I heard a POP.  Well, I think my tissue expander fractured my rib.  I have been in so much pain whenever I move or lift something.  I talked with the PS about it.  She thinks it might have been scar banding that popped and the nurse said it may have been a suture that tore where my expanders are sutured in.  In both cases it should've been better by today.  It's not.  Which leads me to think it is a fractured rib.  I've been taking Advil for the pain, but it doesn't help that much.  I wanted an x-ray, but the PS said there isn't anything they can do for a fractured rib anyway.  So, I will just have to wait it out.

Nails
I had mentioned in previous chemo updates that I was keeping my nails short so that I didn't lose any.  I had heard that a lot of women lose their nails or that they tore if they let them get long.  My nails made it through chemo great.  A couple weeks after the last chemo I let them start growing.  Then, about 1 weeks ago I woke up one morning and EVERY nail was ripped close to the skin.  So, please keep in mind if you go through chemo that it is still affecting my nails weeks after treatment.  I'm still having to keep them short.  The nail is just not strong enough yet.  So, I will be waiting another month or so before I try to grow them out again.  It would probably help to have polish on them...but I'm not crazy about nail polish.

Thanks again for reading my posts, for your prayers and thoughts.  I appreciate every one of you.  Even those I don't even know are reading my blog.