Not Another Boob Job

20170614_160608It’s been a whirlwind since my last post. I have been meeting doctors,setting up fallow ups, preop testing,researching bras and other aftercare items that I might need. I wanted to go a little more indepth about the double mastectomy surgery process, especially for those of you who are considering the procedure.

THE SURGEONS:
First, I  had to find both of my surgeons, which was a big decision obviously. I want to find the best reconstructive and oncological surgeons that took my insurance. And it was equaly important that the two top doctor’s I found beable to work together, because this type of procedure requires they working on me simultaneously. I had both my consultant appointment scheduled for May 30th, 2017 at the University of Pennsylvania. Dr. David Anderson will be my surgical oncologist proforming the masectomy portion of my surgery and Dr. Joseph Serletti who is the chief of plastic surgery will be handling the reconstruction. Both doctor’s were great explaining the different procedure that could be done and would work best for my body type.

THE OPTIONS:
There are so many fine details that go along with this type of procedure. Which procedure should I choose? How do I want my breasts to be reconstructed? Should I keep my nipples? These decisions are by no means easy. I’m not planning on entering any wet t-shirt contests but, I am attached to my breasts. They have literally been with me for 15 something year’s. As much as I don’t want breast cancer and feel strongly that having a double masectomy is in my best interest it doesn’t mean I am will to sacrifice my desire to have the best reconstructive outcome.

There are basically three major options when it comes to undergoing a profolatic masectomy:
1. Autologous flap Surgery: This is when skin,fat, tissue, and sometimes muscle is removed from an area of your body such as tummy and or buttocks to reconstructed breasts. There are various kinds of (flap) reconstruction options.
2. Direct to implant: This consists of placing the final breast implant at the time of the mastectomy in a single operation.

3. Tissue Expander-Implant: This is a two step procedure. During the first surgery the breast tissue is removed a temporary implant or (expander) is placed on the chest wall and will be expanded over several weeks to stretch the skin. During the second surgery the expanders are exchanged for the final desired implant size.

My final decission is to undergo a prophylactic bilateral double mastectomy with nipple and skin sparing with expanders.

FIRST SURGERY:
My first surgery is scheduled for December 18th a week before Christmas. During the first surgery the surgical oncologist will make an incision along the bottom section of the areola and extending in a curvilinear fashion toward the axilla. He will then remove every bit of breast tissue down to the dermis. Next the reconstructive surgeon will place the temporary tissue expander under the skin on top of the chest wall. These inflatable breast implant are designed to stretch the skin and muscle in order to make room for the permanent implants. Once the expander are placed the reconstructive surgeon will then sew in between 2-4 surgical JP drains. The drains consist of a small plastic reservoir bulb connected to about 4 feet of flexible tubing. Their purpose is to remove fluid buildup from the surgical wound through mild suction. From what I’ve read and have been told the drains are the most annoying part of the recovery process. The drainage fluid collection bulbs will need to be measured,cleaned, and recorded several times a day until I hit a certain number required for them to be removed. This could take any where from 2-4 weeks.

The entire surgery will take around 3-4 hours. After I will be taking to recovery until I am stable then moved to a room and I will be in the hospital for 1-2 nights under observation.

More posts to come so stay following for updates!

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2 thoughts on “Not Another Boob Job

  1. Hi – best of luck to you! I wanted to pass along a pro-tip. I had a double mastectomy & reconstruction in 2014. The tip is to schedule your surgery for early January, not the end of December. There are a bunch of reasons. First is financial, unless you have already hit your insurance deductible & out of pocket max for this year (making it basically free). When do you do it in January, it’s the start of your deductible year, and you’ll hit that deductible & max (whatever it is) with that surgery. I had several follow up surgeries after the first one, and it’s a relief to know it’s all free after the first one 🙂 Since you know you’re going to have at least 1 more surgery (best case) to swap out the expanders, don’t pay the deductible & out of pocket twice if you don’t have to!
    The 2nd reason is that really lots of people go on vacation at the holidays and you want your team around. My dad had a surgery on 12/30 and had a crisis and his main doc. . .was on the golf course in Hawaii. I needed my docs in the first month after my surgery. I was going to have my biopsy in late December 2013 and even the scheduler at the hospital said waiting until after winter vacation was better because the radiologists would be away. Get your A team!
    Feel free to reach out for other tips. I left a little trail here: http://fellowsfriends.blogspot.com/ but haven’t updated it since my last recon in 2015. Again best of luck to you!

    1. Hey Cheryl,
      Thanks so much for posting. It’s a crazy whirlwind of tests,phone calls, preop appointment and my surgery isn’t even happening till mid December. Im a type A planner so im stressing my self out trying to get all my ducks in a row to make things as smooth as i can. Any advice is greatly appreciated as I don’t know where to even start looking sometimes about short term disability, recovery process, bras, exchange surgery.

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