Monday, April 12, 2010

New surgical plan: a smaller boob and nips delayed

This afternoon I met with Dr.C (aka Dr.McHotty) to take a look at my post-radiation construction site (aka my boobs) and figure out what we are doing on May 18th, my next surgery date (besides the hysterectomy by Dr.H, of course). The original plan was that I'd be getting a couple little minor fixes to achieve better symmetry and have nipples created. My left breast has been larger than the right since the original surgery last June. This is due to natural post-surgical swelling, but also lymphedema swelling that comes and goes. Now that I'm 3+ weeks post-radiation, we see that the implant on the radiated side did well. In fact, the excess skin/tissue at the bottom pre-radiation tightened up and lifted which is great as that would have been a "fix" for the next surgery but now wouldn't be necessary. However, at the top and side of the breast I am noticeably larger than the other side and it doesn't appear to be settling down. Since lymphedema is something I'll deal with for life, this swelling will always be an issue to some extent. He gave me three options. I can only remember two of them hahaha (thank you, lingering chemo brain!). One was to accept the lack of symmetry and proceed with the original plan to just clean up and get nipples. The other was to replace the left implant with a smaller one to achieve symmetry and do the nipples a couple months later. I could hear Bob's voice in my mind asking things like "can she still get it all done in the current plan year (which ends June 30th)?" and "will the smaller implant look smaller than the other side when the swelling is calm?" and "can we still do the hysterectomy and breast surgery the same day even though we're now exposing the implant?". I forgot to ask the first question, but I can call tomorrow to find out how much time must pass between the implant swap and the nipple surgery. I didn't bother asking the second question because I feel that he wouldn't suggest it as an option for correcting symmetry issues if he thought it would just create a new case of asymmetry. The third question was my main concern as the hysterectomy is my first priority right now - I want it done before my cycle returns, and I read something in my chart last week that made this more important than everything else (more on that later). Dr.C explained that normally they won't do hysterectomy or other OB/Gyn surgery at the same time as implant surgery because the OB/Gyn surgery is generally considered "dirty" in terms of infection risk. However, since they're doing it with the DaVinci robot and that part of my surgery will be performed last, after the breast surgery is done and closed up, he is comfortable proceeding. So the new plan for May 18th is to replace the left implant and proceed with the hysterectomy. Nipples will be done after I'm healed and the port will come out when the nipples are done so that I can use it for the next Zometa treatment if I get it before the nipples are done. I'm happy with this plan even though that means I won't have the nipples as soon as I had hoped. But I know that the smaller implant will feel better and less alien and uncomfortable when I have swelling since it won't feel like it's under my chin and in my armpit and I'll be less self conscious about being lopsided (since I won't be anymore) and will not have to hide it with layers of under garments like I do now - this is a big deal as summer approaches since most of our summer involves triple digit heat around here. So that's the plan! Dear Lord, thank you for blessing me with such brilliant and compassionate physicians! Malachi 4:2 But for you who revere my name, the sun of righteousness will rise with healing in its wings. And you will go out and leap like calves released from the stall.

3 comments:

  1. I can't wait to be 'evened up'! But have some wait - have four weeks of rads to go first!

    Like up - always appreciate how lucky I am to have great docs.

    P x

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  2. OK- WOW!!!! I am so glad that they are going to do the 2 surgeries :) less anesthesia and hopefully recovery is less than 2- has to be!!!!
    Good to hear the latest update.
    Love ya

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  3. You are a strong lady! I hope they can perform both surgeries at the same time. Almost healed from my nipple & areola reconstruction...really starting to feel like myself again. Feels nice to have me back! Continue to feel well and good luck with the surgeries!

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