Yesterday, Dec 19th, exactly 8 months from the time (my 61st birthday on April 19th) I discovered I had a genetic BRCA1 mutation, I underwent a 4-hour surgery to remove my breast tissue and begin reconstruction. This is actually Stage 2 of this process, as I had a breast reduction on Aug 6th for the purpose of saving my nipples. (See my previous post about this.) I chose to have my implants "OTM" or over the chest muscles. Some people get them behind the chest muscles, but that is much more painful, and I didn't want to mess with those muscles since I need them for rowing.
The first 2 hours of yesterday's surgery involved Dr. Pamela Wright removing all my breast tissue. Did you know that breast tissue extends all the way up to your collarbones? I didn't until a couple months ago. The last 2 hours of surgery was courtesy of Dr. C. Coleman Brown, my plastic surgeon from the last surgery. He created pockets (out of Alloderm) for temporary implants called expanders. The temporary implants are "deflated" and hold a small amount of saline. In a couple of weeks I will start getting regular "fills" by injection to stretch the skin back to the size I was after the reduction. The expanders allow the incisions to heal without too much pressure on them. Although some people are candidates for "direct to implant" (DTI) reconstruction after mastectomy, I was not a good candidate for that.
After about 3 or 4 months, once I've been to the size I want to be for a few weeks, I'll have yet another surgery, called the exchange surgery (outpatient), where Dr Brown will open the pockets he created, remove the expanders, and insert the final silicone implants. He'll also do some fat crafting to contour areas (such as where they removed breast tissue up to my collar bones) to make my new breasts look natural.
I had the surgery at Suburban Hospital in Bethesda, MD - known to be a very good hospital. I was really happy with the care I got there. I stayed over 1 night and went home around noon today. Larry and my son Eli hung out with me a lot, which was nice.
For the next couple of weeks, I have to deal with 4 drains coming out of me (2 on each side), as well as a Prevena 125 Incision Management Wound-Vac System over each breast. The Prevena devices require me to hang two motors around my neck to provide negative pressure on the incisions, which encourages faster healing. So I have 6 things hanging off of me and feel like a Christmas tree!! Two of the 4 drains and both Prevenas will likely come out/off at my appointment next Wed. at Dr. Brown's office.
I am definitely dealing with some pain, but it's fairly manageable. Trying to avoid a lot of the heavy duty pain meds, but willing to have a few these first few days.
Stay tuned for more updates!
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