Another Revision

Standard

Following the poor healing of my last procedure to transfer fat from my belly to my chest, and the prior placement of 700mL implants, instead of the promised 800mL that we had stretched for, I was left with loose, over-stretched skin, wrinkly indented breasts and visible impressions above the implants.

 

I went in yesterday to have the proper implants placed, and additional fat-grafting to smooth the edges.  Fingers-crossed that this did the trick and no more surgeries will be necessary.  I’ll post more pictures as I am able to remove the new dressing.

Autologous Fat Transfer a.k.a. fat grafting

Standard
IMG_20150909_132719059

Post-op, Comforted by Stabby the Unicorn

It’s been a while since I posted.  My last procedure was in September 2015, fat was transferred to fill the indentations around my implants, and to try to create a natural slope above the implants.

IMG_20150831_201300910

Example of one of the indentations to fill.

The fat grafting was painful, surprising and disappointing.  It was a fairly simple procedure. While you are under general anesthesia, the surgeon makes a couple incisions in your abdomen and inserts a cannula to suck out fat (liposuction).  The cannula is moved around and a few cups of fat are harvested.  The fat is centrifuged to separate out the blood and whatever else got in there, so that they can inject just the fat back into you.  Using a large gauge needle, the surgeon injects the fat back around the implants, in the hopes that approximately 80% or more is retained by the body.

IMG_20150908_144615165

Day of surgery

IMG_20150908_173327522

Day of surgery

Bruising and injection sites, day of surgery.  Every day after surgery, the bruising and swelling continued to progress, despite wearing a medical girdle to compress the area.  What they don’t tell you, is that blood will pool, down, to your lady business, and even thighs.  Ouch.  Ew.

IMG_20150911_224116150

Blood pooling after liposuction.

This procedure was far more painful than placing the implants.  And disappointing.  Most of the fat that was transferred seemed like it was going to take, but over time, it’s been sinking down as my body has been burning it off.  I am now scheduled for an implant exchange and more fat transfer to try to make my boobs, boob-shaped, as they should be.

 

Reconstructive Surgery

Standard

I had to resist posting too soon after the implant surgery, because all I wanted to do was scream, ‘what in the fuck have I done to myself?!?!?’  I woke up with pancake-flat implants, no fat grafting, no more big boobs.  I spent these last two weeks freaking out about the end product, waiting for my post-op visit, and knowing that things are healing and I have to wait for things to ‘settle.’

5 Days post implant reconstructive surgery

5 Days post implant reconstructive surgery

At my post-op visit today, the surgeon explained that they put in a smaller implant, because the next size bigger was ‘bulgy.’  They didn’t do fat grafting, because they had to do extra work in my left side, in order to lower the fold and even out the implants, and they had to cut away a lot of scar tissue on the left side.  He said he figured we would discuss a revision surgery anyway, in case I changed my mind and wanted nipples, which we rediscussed and still decided no on.

5 days post-op implant reconstruction

5 days post-op implant reconstruction

I will now wait a month and heal and continue to let things settle.  In a month, I can decide if I want to have a revision surgery to have fat grafting to fill in the large impressions above each implant.  I anticipate wanting fat grafting to fill in those indentations.

Two weeks post-op implant placement.

Two weeks post-op implant placement.

Indentation above implant.

Indentation above implant.

Count down to surgery #2

Standard

In about 12 hours I’ll be heading to the hospital to check in for my implant surgery and fat grafting procedure.  As you can see from the picture below, the expanders are crooked and boxy.  It feels like there are baseballs under my skin, that’s how hard they are in some places.

Last day of expanders

Last day of expanders

Here is a close up to see why fat grafting is necessary.

Expander up close.

Expander up close.

The fat will help create a slope, and hide my bones.  It’s unnatural to see half your ribs when you aren’t flat chested!  And there is a pretty big divot on the right side below my collar-bone.

Finally, I’ve said it before and I’ll say it again.  This is not a cosmetic procedure.  It is reconstruction to try to create a natural looking breast, not an enhanced breast.  My chest now consists of two gigantic scars, so anyone who thinks I’m getting a free boob job can seriously just piss off after looking at this picture below.

Scar up close.

Scar up close.

Final Fill, six month cancer check, Surgery Scheduled!

Standard

A couple of weeks ago I had my final fill.  The surgeon over-fills the expanders, so that the final implants can lay properly and are not projecting like rockets from your chest.  The final fill was uneventful, and I’ve experienced some soreness and ill-fitting clothing ever since.  I’ve also been ridiculously tired, but I’m been tired since I came out of the first surgeries.  We schedule my implant surgery and possible fat-grafting for the end of May.

A week ago, I met with my cancer prevention nurse for my six month check.  I had my hour long internal and external pelvic ultrasound, CA-125 blood test and talked about the last six months with the nurse.  The results of my ultrasound were normal and my CA-125 was within range.  The nurse also went over the new guidelines with me.  I now will have a full body exam by a dermatologist to check for melanoma, annually.  The last thing we discussed was oophorectomy.  I still plan on surgery, but closer to age 40, so long as all of my tests continue to be normal.  New research suggests that the origin of ovarian cancer is actually the distal end of the fallopian tubes, so some surgeons are beginning to perform salpingectomies around age 35, or at the end of child-bearing, followed by oophorectomy at or after menopause.  I think this is a good option for me, but just not quite yet.

A couple of days ago I went in for my pre-op physical.  This was the same as the previous pre-op physical.  Blood draw revealed my hemoglobin to be at 8.7, which explains my extreme fatigue.  I need to get my iron up for surgery, so I have to take iron and another blood test in two weeks.  I really hope I can get the level up in time for surgery!  The doctor was quite concerned that we don’t know why I’m anemic, and after I get through surgery we will have to investigate that further.  *sigh*

First Fill

Standard

Today was my first expander fill.  The surgeon used a tiny magnet to locate the center of the port under my skin, that made a tiny x on my skin when he pressed down.

20 gauge needle

20 gauge needle

He then stabbed a 20 gauge needle into the port and used a caulking gun to inject somewhere around 100mL of saline into each side.

IMAG0504

Expander-filling caulking gun

I didn’t feel the needle going in at all, and all I really felt was pressure as the expanders filled.  He said I should expect more pain tonight, and offered up meds, which I rejected.  I can take some of my leftover Valium or Oxy if need be, but so far I just feel mildly sore a few hours later.  They also feel heavier than before, and are visibly bigger.  Good, now I don’t have to look like a little boy.

The next fill will be in two weeks.  Once I decide on the ideal implant size, I will get one additional fill to expand to make sure there’s enough space for corrections and the fat to soften the edges.  I haven’t decided if this is the ideal size.  I will take the next two weeks to try on some clothes and bras to see how it looks and feels.

Post Fill

Post Fill

What does it all feel like?

Standard

Basically everything I read prior to surgery about the pain and recovery was a big damn lie.  About the closest thing I read was one woman’s account of it feeling like being hit repeatedly in the chest with a baseball bat.  I know that everyone is different and therefore their experiences will be different, so here is mine.

Waking up in the hospital I was groggy and confused, heavy and sore.  I kept telling the nurses I was in pain and they kept telling me that I wasn’t pushing the morphine button enough.  Meanwhile, I was up all day and night staring at the machine because I could only push the button every 10 minutes.  The night nurse was surprised to find me awake every time he came in, and he upped the dose.  Nothing.  Eventually, I was switched to oral medications, and switched multiple times, because those were not making a difference either.  Finally, on discharge day, one of the residents said that I needed Valium to control the muscle spasms, and assured me that my pain would finally improve.

At discharge, I was sent to the pharmacy to pick up drugs, and then wheeled out the door.  My pain was not under control by any means, and every pothole felt like we were going over a landmine.  I sobbed in pain the majority of the ride home and could barely make it into the house.

After the marcaine ran out, I realized that I was actually experiencing some level of relief from it and that it was now gone.  The marcaine had been numbing some of my chest, but not all of it.  Every time my muscles moved after that, they would twitch and spasm, become sore, ache and cause pain and discomfort.  My chest was still feeling a ton of pressure until the drain tubes were removed, and a bit more space was created in my chest.

At the end of my three weeks off from work, I contacted my boss to tell her I was still in a lot of pain and having a lot of pressure, and at that point I was still draining, so I took a fourth week off from work.  Every little task required resting.  Everything from getting up and eating to brushing my teeth, tidying up.  Naps were and still are essential to my functioning.

I’m at the end of my second week back to work, working part-time.  Every day I can do a little bit more, but every night I am in pain and still need the Valium to control the muscle spasms.  The Valium and rest have been the only things to help my pain.

Physically, it feels like there are rocks in my chest.  I can feel the metal ports of the expanders under my skin.  I can push the plastic material around and move portions of the rigid material under my skin.  There are hard parts jabbing my rib cage, especially below my arm pits.  If I get cold, and start to shiver, my muscles twitch uncontrollably, moving part of the expanders.  If I overuse my muscles at work, again, my muscles twitch uncontrollably and move part of the expander.

Psychologically, it’s painful to look in the mirror, because I can’t imagine the end result.  Everything is scarred and deformed.  I’m not afraid of the scars, but I definitely am not adjusting to lumps that are not shaped like boobs.  It is difficult to imagine my body looking the same in bras and corsets, as the expanders lack any flexibility whatsoever, so I’m stuck wearing nursing sleep bras at the moment.

I haven’t had any fills yet, and my last meeting with the surgeon made it sound like I wouldn’t need any.  He tapped my boob and said he could fit a larger implant in.  I plan to discuss this further at my next appointment in March, because I was told I was only at 3/4 of my final size and I can’t imagine fitting an implant in that’s much larger than what’s in there now.

While I’ve come a long way to controlling my level of pain, and my body has done a reasonable job at healing, I’m still in pain every day.  I don’t think I was adequately prepared for the level of pain, discomfort and emotional distress that this whole process would cause.  In the end it will all be worth it.