Last week I got the call I’ve been waiting for (and maybe dreading in equal measure). The local plastic surgeon, who had had my referral in since early November, and whose answering service clearly stated that if your referral was less than four months old basically don’t bother leaving a message, was ready to see me. Like soon. Like today.
My hope for reconstruction was that I would have the Diep flap surgery, an abdominal surgery that involves taking the skin and fat from your abdomen (I’ve been growing mine since August) and moves it to your chest, covering mastectomy scars and forming lovely plump breasts made from your own flesh. Dreamy, right? No muscle removal necessary, minimizing the risk of hernia and other various sundry annoyances. My surgeons from Winnipeg encouraged me to gain 10-15 lbs and come back when my skin was nice and strong and they would fix me up. Yeah. Not going back there. That decision was made about two months after being diagnosed with PTSD, following my two-in-a-week wide-awake surgeries there, when my implants were summarily removed in front of a team of residents and I was lucky enough (please, please hear my sarcasm here) to be very much awake and present for all of it.
I was very excited to hear about the new surgeon in town. I knew he had done the Diep flap surgery, with much success, many times before.
Well. It turns out he doesn’t do it here. There just isn’t a big enough team. And I get it. They need a specific kind of plastics team to do this surgery. There’s micro-surgery involved. It’s pretty complicated. Blood supplies being transferred from groin to chest and such.
What he does do is the latissimus dorsi flap surgery. He takes a flap of skin AND MUSCLE from the back, tunnels it under the skin under the armpit onto the chest, so that it actually never leaves your body. Reattaches it and forms, again, a lovely breast. Not so plump though. Tissue expander (again), swapped out for implants later (again), but with much less risk, because the skin he’ll be working with has not suffered the slings and arrows of outrageous radiation. That skin, apparently, is simply no longer viable. Whatever that means. The surgeries are not without their risks, for sure.
What all of this means is that I have a decision to make. Do I stay close to home, to family, far away from planes I have to travel with drains hanging off of me, and go with the loss of a muscle from my back, apparently a ‘climbing’ muscle which I won’t miss very much, even in yoga, or do I embark on the endless back-forth-back-forth consultations, pre-op, operation and post-op appointments in another town, far from home, so that I can have the cadillac of breast reconstructions? Do I want my scars in the front or the back (the new ones, I mean)? Is it more acceptable for me to sport a new, hip-to-hip scar above my C-section scars, or to sketch out some new ones, armpit to armpit across my back, that can be neatly hidden by a bra strap that I may not even need with my new stand-on-their-own breasts?
I have four weeks to decide. Well. I have all the time I want to decide. But it would be in my best interests, I think, to figure it out soon. Because this is starting to feel like the never-ending breast saga. Surgery can’t happen until at least July. Likely not until the fall. Which is about 5 months later than I had hoped.
I’m going to weigh the pros and cons. Think about my family, my kids. I’m going to cross my fingers and hope I make the right decision for me, one that will allow me to look at myself in the mirror and see something other than the punishing scars of cancer. One that will allow for full recovery, supported by surgeons I trust and people I count on.