Breast Reconstruction

I have surgery scheduled for Dec. 11th, 2012, to swap out the tissue expanders for silicone breast implants. This final breast reconstruction after  mastectomy is a big milestone that symbolizes (at least for me) that I have almost completed treatment.

The reason I didn’t have the breast implants placed at the time of surgery is because I needed to have radiation (which would damage the implant). The reason I have had the expanders in for over a year is because my plastic surgeon wanted to wait until the effects of radiation have fully subsided before performing the final surgery.

I know people have been curious about what the process looks like, so I pulled a series of photos that I think represent the process that I am undergoing: double mastectomy with immediate partial reconstruction (tissue expanders), followed by silicone implants, then nipple reconstruction, then nipple tattoos.

Thanks to these brave women for sharing these photographs (no, none of these photos are actually of me!) Here is what my reconstruction process looked/looks like:

This gives you a pretty good idea of what things look like post mastectomy surgery once you take the bandages off (although, I don’t know why this girl has her bandages off in the hospital, I didn’t take mine off for a few days). The tissue expanders are in place if you have partial reconstruction at the same time as your mastectomy surgery (which is what is shown here and what I had done). There are surgical drains that stay in for a week or two to drain excess fluid (yea that sucked).

The tissue expanders are synthetic teardrop-shaped pouches that are inserted under the skin to create the form of a breast. The pouch is made of silicone, and is filled with saline (salt water solution). The expander is an elastic bag equipped with a fill tube and a valve. After the expander is inserted in place, it is filled with a small amount of saline. You’ll return to the plastic surgeon’s office every week or two to have more saline injected into the expander. Gradually, over three to six months, the skin and muscle will stretch, just like they do over the abdomen during pregnancy. In order to achieve the most pleasant shape and feel for the reconstructed breast, the expander and final implant is usually placed under the muscle, rather than directly under the skin (info for this paragraph taken from beasurvivor.com, written by a physician).

The tissue expanders are then swapped out with silicone breast implants. This is the surgery I am having on Dec. 11. Of course, the size of the breast implants is decided upon by you and your doctor. In my case, I am sticking with my original size, although you can go smaller or larger depending on your preference. On the side that was not treated with radiation the surgeon will use the same incision point that was used in the original surgery, but on the radiated side, she might make the incision below the breast in an area that didn’t receive as much radiation as my scar.

After the implants are in place, you can choose to have nipple reconstruction. There are many different techniques utilized for this and it can include either just the nipple (as seen in this photo) which is created with either a skin graft or by folding existing skin on the breast or the surgery can also include a raised areola (which I am not going to do). Note: This photo is not the same woman that is shown above.

The final stage of breast reconstruction is tattooing. There are many tattoo artists that have started offering this service and I have heard they are typically better than the tattooing that is offered at the plastic surgeons office. This photo is the same woman that is shown above. The areola is created with a 3-D tattooing technique. You can also skip the above step and just have 3-D nipple tattoos.

Here is a close up of the nipple tattoo. Pretty amazing. The nipple mound was created with a skin graft and the rest was done by the tattoo artist. These tattoos were done by a local Baltimore artist named Vinnie Myers (who has recently moved to New Orleans–bummer!) Vinnie was recommended to me by my friend Barb, she has a friend who is a radiation oncologist, a breast cancer survivor and a customer of Vinnie’s, Barb’s friend says he is the best around. I might have to go on a nipple tattoo road trip down to New Orleans…who is with me?!! 🙂

Here is an interesting article on Vinnie: http://www.washingtonpost.com/business/economy/value-added-the-cancer-survivors-tattoo-artist/2012/02/24/gIQAl0ZecR_story.html?wpisrc=emailtoafriend