Mastectomy 101 Part 1: Let's Talk About Nipples

Warning: This blog post does contain photos related to different aspects of mastectomies.

Update

 Before I write anything about my mastectomy, I must formally thank all of you that have reached out in love and support after my last blog post. Thank you for the kind words and for sending me your positive thoughts and prayers. You have strengthened me more than you will ever know. This world is really such an amazing place, with so many amazing people, and I'm so lucky to have such a great number of those amazing people in my life. Truly, thank you.

As for how I have been doing....I am continuing to attend Eating Disorders Anonymous meetings and therapy on a weekly basis. I have been very blessed to be meeting with my therapist from my time in inpatient treatment, as well as from the years of outpatient treatment following my discharge. It has been a special experience to be meeting with her on a weekly basis again. These past couple of months have been an uphill battle, but I am getting there    one day at a time. My eating disorder behaviors have been mostly under control, although I have had some slips, but the real battle is with the eating disorder thoughts. It really is shocking how powerful they can become after slipping for even just a short period of time. I know others that have struggled with an eating disorder or any other form of addiction will understand what I mean when I say that even with the behaviors under control, the addiction is still there, constantly trying to pull you back into its grips. The longer I fight, the stronger I become. Where I am today is a world away from where I was when I wrote my last blog post and I am so grateful for all the love and support along the way      from those around me, from my Savior, and from YOU     my blog readers. So, again, thank you.  

My Surgery    

My bilateral mastectomy is now only 20 days away, 20 DAYS! After the whirlwind of finding out my genetic test results and making all those difficult decisions about surgery (oh, you know, and announcing it to the world on this blog) I became somewhat emotionally detached from all of it. It's not that I haven't been thinking about it at all or talking about it, but I hadn't really started to process the reality of what I'm actually facing until recently. I want to use this blog post to process some of these feelings, as well as inform others of what is involved in a mastectomy, and maybe help erase some of the social stigma and shame surrounding this procedure. I know that I was very uninformed before being faced with it myself, and now I feel a strong desire to help others understand the process, and get comfortable with all that it entails. Chances are, you know at least one woman who has had breast cancer or has had to go through the pain of a mastectomy. Being informed will help you to be more of a support to those women. My emotions about my own surgery have been all over the place, so I hope that this post doesn't turn into a jumbled mess of thoughts. Well, I guess I'll just jump right into to it....here we go:

Below is a very short video, with a very basic explanation of the different types of mastectomies. Although it is a simple video, it answers a lot of questions that people have asked me about my surgery, so I hope you will take the time to watch it.

Since I am having a mastectomy as a preventative measure, I will be doing the nipple-sparing mastectomy. As mentioned in the video, the main advantage to this type of mastectomy is a better cosmetic outcome. I am grateful for this option, not just for the cosmetic outcome, but for the fact that when I look down after surgery, I will still see part of myself there. I believe it will lessen the feelings of loss. With that being said, the outer skin and nipple will be the only parts of my breasts that will still be 'me', and those parts will only be 'me' visually. As shown in the video, all of the breast tissue will be completely cut out to the skin, and the nipple will be cored out. As a result, my breasts will be numb for the rest of my life. What will be left behind is a very thin and fragile layer of skin. 

Necrosis

Because the skin will be so fragile, and the blood flow so weak, I will be at risk of necrosis for the first few weeks following surgery. Necrosis is the process of the tissue dying. Some women who have a nipple-sparing mastectomy still end up losing their nipples. The nipples die and turn black. Extra surgery is required at that point to remove the dead tissue. Other parts of the outer skin can become necrotic as well, and would have to be removed. Here is a photo showing nipple necrosis:

Nipple Reconstruction

Some women without nipples choose to do nipple reconstruction, while others just learn to live without nipples. I have already made the decision that if I lose my nipples, I will  be doing nipple reconstruction. The nipple is reconstructed using the patient's own skin, and once it is healed, it will be tattooed the color of a real nipple. This photo shows one way the nipple is reconstructed:

I have also learned in my research that some women choose to get a 3D nipple tattoo, instead of doing the actual reconstruction. Here is an example of that:

This photo is from the White Tiger Tattoo website (http://www.whitetigertattoo.com/medical/3dtattooing.html)

On the advice of a good friend, I have decided to blog about my mastectomy in small parts. It is all a little overwhelming for me right now, and I'm sure all the information could be overwhelming to my readers. I guess the theme of this post is: I really want to keep my nipples. That might sound a little strange and awkward, but the fear of losing them gets stronger and stronger as my surgery nears.To all of you women out there reading this    have you ever thought to be grateful for your nipples? With that question, I also have a favor to ask of you    please take a moment and be grateful for your breasts... for your nipples...for those parts of your body that maybe you don't think measure up to society's standards of beauty. Facing what I am facing has brought on a strong sense of gratitude for the way my breasts are right now, imperfections and all. I have 20 more days with these breasts, and I feel the mourning process has already begun. I regret ever feeling like my breasts weren't good enough, or that there was something about them that needed to be changed. So ladies, please hug your boobies and be grateful for them just the way they are. Hey, and while you are at it, go ahead and check yourself for lumps. Instructions here