Adventures of Breast Reconstruction
Breast Reconstruction is a very common part of this crazy breast cancer ride so many of us have been thrown upon. I had no idea what it would entail, and I certainly never imagined I would have breast implants. I always had larger breasts and never felt the need to make them any bigger than they already were. But when I was diagnosed, surgery was a hot topic.
I knew a mastectomy was in my future, and it seemed so unreal. I couldn't even imagine it happening. What I didn't realize is that surgery isn't as easy as remove breasts, replace them, and done. It is so much more complicated than that! And no one seems to have the same surgical story. Here's mine.
On August 28, 2013, I had a radical mastectomy of my right breast. "Radical" means everything was removed and I was left with a flat place where my breast once was. My left breast was left untouched. The reasoning for this was I had just finished chemo only a month before, which increases my risk of blood clot. So I was going to have my reconstruction done in multiple steps.
I lived with only one breast for almost a year.
In July 2014, I had a skin/nipple sparing mastectomy on my left breast. This means all of my breast tissue on the inside was removed. I also had a LAT Flap surgery on my right side. This means that a part of my latissimus dorsi muscle was detached, tunneled under my arm, and attached to my chest. There was also a piece of skin from my back moved to the front as well. This left space for the doctors to eventually place an implant. But before we could do implants, I had to have tissue expanders placed. These are like empty plastic implants that are placed where the implants will go, and then they are slowly filled with saline every couple of weeks until the size I wanted was achieved.
The tissue expanders were so uncomfortable and hard, and getting them filled wasn't really pleasant either. You don't realize how much you actually use your chest muscles until they are really sore from something like this!
I had my expanders until December of that year. They were finally replaced with implants! I was thrilled, except I wasn't done. In July of 2015, I had a revision surgery. My left breast looked much larger than my right. The implants were the same size, but because I had radiation on the right, the skin and tissue is much tighter. So my surgeon replaced my right implant with a larger one and did some fat grafting. This is where the surgeon took fat from my abdomen through liposuction and relocated it in my right breast. This helped my size difference quite a bit!
But I still wasn't done.
In April of 2018, I had my left nipple removed for no other reason except that I started experiencing pain. It felt like someone constantly had me by the nipple and it was awful! My surgeon assumed it was from nerves trying to grow back and recommended removing it. I didn't even hesitate. Off with the nipple!
And now, here we are. It's November of 2019 and I just got a breast MRI to check my implants for leaks or rupture. This is normal and will happen every other year for as long as I have implants. They will eventually leak (possibly rupture) and will have to be replaced just about every 10 years, give or take. Which means more surgery....
And that brings us to my current decision. To keep my implants or not?
You might be wondering why in the world I would want to remove them! Removing them would mean I would be completely flat. Nothing there. But removing them would also mean no more surgery. It would also mean more comfort. These implants are not comfortable. I've just gotten used to them. It always feels like there is a tight band around my chest. They're heavy. And if they get cold, I'm freezing for the rest of the day. Not to mention, the implant is under muscle. So anytime I use my chest muscles, or my lat muscles, my implants get squeezed. It doesn't really hurt, but it is uncomfortable and sometimes super obvious when it happens. And then there's the boob cramps! Oh the boob cramp. My lat muscle on my right side cramps sometimes, and holy cow does it hurt! And there's nothing I can do, but wait it out!
And then there's a risk of cancer. Yup. There's evidence that breast implants are causing a specific type of lymphoma (BIA-ALCL). F that. Right now, it appears it's only textured implants, which I do not have, but this discovery is in its infancy. Research is still being done, and I've already done the cancer thing. I really, really don't want to do it again. Especially if it happens from something I can control.
But let's say that I don't have to worry about the cancer risk right now or possibly ever. What about Breast Implant Illness? BII is not an official diagnosis, yet. Women are coming forward every day claiming that their breast implants are causing a myriad of symptoms ranging from fatigue, to autoimmune disorders, to skin issues. The symptoms run the gamut and, from what I understand, is hard to pin to implants, which might be why it's taken so long to gain some traction. Either way, despite the fact that it is an unofficial diagnosis, women are suffering every dang day. For boobs. Not that I have an issue with boobs nor do I feel like anyone should be shamed for their choice to reconstruct or augment. But I think this needs to be taken seriously.
BII came on to my radar a long time ago. And I ignored it because I didn't want to have to think about making that kind of choice! I already did all that, and I didn't want to revisit it. But I can't seem to keep ignoring it. It just keeps coming up and every time I see something about it, it is more and more intense. Like the Universe is trying to tell me something (which I totally believe this happens). I have some of the symptoms that fall under BII, but like I said before, they run the gamut, and even women who have never had implants can still have these symptoms. Plus, given my background, my symptoms could be longterm effects from chemo... so the only real way to know for sure if my symptoms would improve is to remove the implants and see what happens.
So I tried to start a conversation with my current plastic surgeon about this, and she was pretty dismissive. It's fine though. It's completely what I expected. So I have found another doctor in my area that is very open to explant. I just need to schedule an appointment with her, but I'm hesitating because it's scary. But I am leaning toward doing this. I just need more info, and seeing a doctor that will be supportive of my decision will really help.
If you want more info on going flat after mastectomy and explants, I'll link some resources at the bottom of the page :)