In my last blog post, Making Lifelong Friendships, I discussed the amazing support group I joined at UCSF. As I previously mentioned I was initially very hesitant to join a support group and wanted to maintain focused on my own journey. However, after talking with my amazing medical oncologist she suggested I look into a program she created especially for young women (women under 45) with breast cancer. In every meeting I felt seen, and related to each member in the group. I left the group wanting to reach through the screen and hug every warrior.
Breast Reconstruction Planning
When I had radiation treatment, I unfortunately developed an infection and my oncology team felt that it was important for me to wait at least 6 months after completing radiation before I should have reconstructive surgery.
After further conversations, my team also wanted me to complete the Kadcya (chemo) infusions before surgery. They shared that they had seen a few people with complications when they preformed surgery before completion of Kadcyla and they wanted to be extra cautious given my infection history. Anytime you are receiving chemotherapy, you are immunocompromised, which means you are also at a higher risk for developing complications and infections.
After a year of having the Tupperware Tata’s (tissue expanders), I was finally able to get a surgical date on the calendar for February 16, 2023. I was VERY excited and ready for surgery.
Prior to surgery, I asked to have a video call with my plastic surgeon to discuss my surgical plan and what the healing/recovery period would look like. From what I had learned, the surgery is fairly straightforward. My plastic surgeon basically swapped the tissue expanders with breast implants. Some patients believe this surgery is easier than the initial bi-lateral mastectomy. It is typically done as a same-day outpatient surgery.
Surgical Plan
Technically, there were three parts to my surgery.
- The first and main part is replacing the tissue expanders or Tupperware Tatas with the implants.
- I also asked my surgeon to do fat grafting to help the contours of my body look more natural. She felt that using the fat from my inner thighs was the best option for me.
- Lastly, they removed my port, which was in my upper chest for more than one year to access my system for infusions, chemotherapy, etc. I really wanted to keep it as a souvenir as it has been a lifeline for me. Unfortunately, they no longer allow that due to changes in procedure.
Fat Grafting
With a bi-lateral (double) mastectomy, all of the breast tissue is removed. You may not realize it, but breast tissue goes up to your collar bone and extends into your arm pit area.
The goal of fat grafting was to take fat from another area of the body and add it to the desired location, for me the outer arm pit and chest area. This would help make the reconstructive surgery look more natural. Given my history of significant infections, I was not sure that my surgeon would agree to add fat grafting in this surgery, but after much discussion, my surgeon agreed to do the fat grafting for me.
Surgical Outcome
My surgery lasted about 3 hours. I was in post-op for more than an hour before going home.
My thighs were VERY bruised and started to look better about a week post-op. People often say that area for the grafting is more uncomfortable than the chest area. I have such a high pain tolerance that neither really bothered me; less discomfort, more annoying. I have to wear lovely Spanx (compression) garments around my thighs for the 2 weeks following surgery for 23 hours a day. I had to live in those things and can only hope that they will be worth it.
I am happy to report that overall, the healing process is going well without any issues. I saw my plastics Nurse Practitioner (NP) a week post-op and they are thrilled with how everything looks. Post-op, I learned I developed a new allergy to the surgical glue that was used for all the surgical sites. I became VERY itchy and my skin was very red and obviously very irritated. There was nothing they could do when we realized I was allergic, as the dissolvable stitches and glue were used. We have noted the new allergy in my medical chart. (I apparently like to keep things spicy in my life. 😉
The hardest part for me throughout the initial healing process was sleeping on my back, just as I had to do following previous surgeries. About a week after surgery, I finally was given the okay to sleep on my side (based on my own comfort) and was able to get good rest.
A few differences in the healing process for reconstruction that has been different from post bi-lateral mastectomy surgery. One key difference is I was able to go home the same day as surgery. I also did not have any drains, which is always something to appreciate. Lastly, I am able to move my arms as I want. The only restriction I have is that I cannot lift 10lbs over my head. The team suggests to only do walking for exercise for the initial 8 weeks post-op.
First Look
I was able to remove the surgical bandages three days post op, and took a first look at the new girls. Initially, I was not happy and felt like they were much larger than I wanted. After much discussion with others who have had this procedure and my team, I learned that I need to allow more time to heal and allow the swelling to decrease.
Giving your own body grace through healing is a continual learning process for me. I spoke with the NP and she shared that if I am unhappy at all, Dr. Piper can always do a revision. The goal is for me to feel happy and become confident in my own body. I am taking it one day at time at this point. We will better be able to assess the results at the six week mark if not a bit after that. The next step will be for me to meet with Dr. Piper (my plastic surgeon) six weeks post-op.
Thank you for continuing to follow along on this journey with me. I hope to continue to provide helpful information that will provide insight into breast cancer treatment for others, particularly young women.
