It will have been exactly nine months and one day that I have been sporting these fancy-dancy (not-so-much) tissue expanders when they take them out of me and swap them out for something a little more … comfortable? Oh GOD please let them be more comfortable.
I haven’t talked much about the bumps that replaced what were my breasts. It is, (and I know I’m obviously out-there-and-public-and-open-and-in-your-face) a strange topic that I tend to only talk about face to face with people I know, and I usually talk about it with some humour. I knock the closest hard surface to me and assure the person to whom I’m speaking that the tissue expanders are basically ‘that hard’. I laugh and say I’m looking forward to NOT feeling obligated to apologize for my ‘bumps’ when I give someone a good long hug. I crack jokes about my ‘barbie boobs’ and refer to the ‘detailing’ that will take place after this next surgery. (But that’s a whole ‘nother blog, folks.)
Now, as I prepare to have these removed, I suppose, is as good a time as any to talk about them in some detail. Most people kind of slowly nod their heads and point vaguely at my chest area and say things like ‘so those…aren’t permanent?’ Or, ‘I don’t really understand the difference…’. If I’m generous enough to guide someone’s hand to the place where the port is under my arm and let them palpate that little disc, that experience invariably produces a ‘gasp!’ or ‘OH!’, at which point I laugh and acknowledge the Sci-Fi nature of my present body. For most people, tissue expanders are absolutely uncharted territory, as they were for me nine months ago.
When I arrived for my pre-surgery consult last April, I was presented with my options for reconstruction. I could do abdominal flap surgery, wherein they use your own tissue from your abdomen to build you new breasts, and in this surgery women basically lose a fairly significant amount of abdominal fat and get new, permanent breasts that are made out of their own flesh and require little or no further work. It’s a good option, if you have the abdominal fat to spare. Upon examination of me, my surgeon’s quick response was … ‘And implants it is!’ (If they could use the tissue from my thighs, I’d be set up for some permanent, all-me breasts, my friends, I assure you. Stomach, not so much).
So. At the time of my mastectomies, I kind of got a ‘three-for-one’ deal. One anaesthetic, two surgery teams. Once the surgery team was finished removing my 17 lymph nodes and my breast tissue, the plastics team came in and inserted, through the same incisions, tissue expanders. Implant-like in form, they come with a little port that I requested get put under my armpits. The expanders are put in under the pectoral muscle, and their job over the months to come is to gradually expand the muscle and skin to make room for eventual implants. The expansion happens through ‘fills’ of saline, injected through the little ports periodically over the next little while, until the desired size is reached. They are strictly functional, and if you’re lucky, and I have been relatively so, they won’t migrate around your chest wall and leave you looking all lopsided and uneven.
These tissue expanders are not without their minor complications. There are many stories out there, some of them horror-movie-ish in nature, but I can only speak to my own experiences.
First of all, I very much appreciated waking up from surgery and not being traumatized by my new reality. The surgeons did a small fill at the time of surgery, and so when I woke up, although I was prepared to see a concave mass of twisted gnarly scars, I was actually relieved to the point of saying something to the effect of ‘Hey! That’s not so bad!’ Two incisions, very small ones relative to what I had punished myself by looking at thanks to the wonders of Google, and two absolutely non-concave bumps. Everyone’s experience with this is unique, all surgeons have different approaches. I was thrilled with the results of my surgery.
On to the fills. Most of mine (and I haven’t had many) have gone off without a hitch. I did have one done where my surgeon and I are fairly certain one of the ports was ‘missed’ and the saline just went into my body. I was kind of lopsided for awhile, but I really didn’t care because, as my surgeon said to me over and over again, ‘They’re just expanders.’ It was only after getting ‘evened out’ that I experienced what is always just vaguely referred to as ‘expander pain’. The only way I can describe it is like a slow, very purposeful charlie-horse, but in your pectoral muscle and wrapping around to your shoulder blades. I have had constant upper back tension for months now, and finally went to a massage therapist after my final fill, having put it off because I didn’t think I’d be able to lie on my stomach for an hour for a massage. As it turns out, creatively arranged pillows and strategically draped sheets do the trick and provide enormous relief.
The pain under my left breast has been intense to the point of feeling like I may have had a cracked rib. A chest x-ray (clear again!) revealed that this was not the case, and my massage therapist deduced that the little muscles between all of my ribs are in spasm, and so that’s what we worked on for a few sessions. Huge help. I can now cough and take a deep breath without huge discomfort.
I am looking forward to my surgery. I can’t believe that it has been almost a year since I found that dreaded lump that now (in my mind, anyway) sits in some jar on some dusty shelf in the basement of a hospital. I can’t believe that a year ago, I was dating, and warning the person I was dating that I might have some tough stuff coming up, and so the door was ‘right there’ if he wanted to open it and run. It seems like a lifetime ago that I was launched into that flurry of tests-and-waiting-and-injections-and-scans-and-waiting-and-more-scans and finally sitting right where I sit today, waiting for surgery.
I woke up today and thought back to the night before my surgery last year, when my sister and I parked ourselves at the hotel lobby bar with every intention of going out for a lovely dinner, and instead staying there, drinking wine and eating appetizers, making a few interesting friends that evening, including a bartender that wrote us a card to thank us for sharing our story. That evening ended with my sister cranking up ‘You can do it; put your ass into it’ on her i-pod, and us dancing on the swanky hotel-lobby carpet with our new ‘friends’, before very responsibly ushering ourselves up to bed before 11:30pm. Because, you know, no eating or drinking after midnight!
This time is different. This surgery represents the beginning of the end of this for me. Kind of a wrapping-up of what has been, hands-down, the most interesting year of my life. Exactly two weeks from right now, I will be prepped for surgery and waiting to get rolled into the operating room. And when I wake up from that surgery, I am hoping to be exactly the opposite of traumatized. Two weeks from now, I will have just a little more hair on my head, almost enough to look ‘on purpose’, and I will have what I promise to learn to love as my new breasts. There may be a lingerie party in my future. Stay tuned.