Of all the procedures I will be having this year, the breast reconstruction process will be the most drawn out. As I have mentioned in previous posts, there a several different types of breast reconstruction. Some use a woman's own tissue, some use implants, and some use both. I'm only going to discuss the type of reconstruction that my surgeon and I decided on for me, but I do want to make others aware that there are many options for breast reconstruction and many factors come into play when deciding which type is best for a specific woman.
After consulting with a plastic surgeon several months ago, it was decided that my best option for reconstruction would be tissue expanders to silicone implants. I have had a lot of people ask me what tissue expanders are. I'm going to rely on YouTube once again to start my explanation off. Again, this is a very short video (2 minutes) and it gives a great explanation of tissue expanders:
Tissue expanders (like the one shown in the video) will be placed, by my plastic surgeon, right after my mastectomy. On the day of surgery, my general surgeon will go in and perform the bilateral mastectomy. Once she is finished removing all of my breast tissue, my plastic surgeon will then come in and place the tissue expander under my pectoralis muscle. A material called Alloderm, which is made from donated human tissue, will be placed under the expander and sewn to the pectoralis muscle to create a sling for the expander. Here is a visual representation of that:
My plastic surgeon will fill the expanders with a small amount of saline on the day of surgery, to start the expansion process. The skin after a mastectomy is so fragile that the expansion process will be done very slowly. The purpose of expansion is to create a pocket for an implant. After a mastectomy, there is no breast tissue to hold the implant in place, so a pocket is needed. Depending on how well my body tolerates the saline fills, I will go into my plastic surgeon's office every 1-2 weeks to have more saline added. Once the expanders are filled to the size they need to be, they must stay in place for 3-4 months. After that 3-4 month period, I will go in for what is called an exchange surgery. My plastic surgeon will take out the expanders and replace them with silicone implants. Alloderm will again be used as a sling for the implant in the same way it was used for the expanders.
Some of my worries....
I have talked to a lot of women who have had tissue expanders, and have yet to find anyone that doesn't hate them. They are uncomfortable, hard, and tight in your chest. They often make your breasts look deformed. Many women have told me that each time they get a saline fill in their expanders, they are in pain for the following couple of days. Basically, what I'm trying to say is that the expansion process sucks and I am not at all excited for it. I'm worried about the length of time (around 6 months or more) that I will have to deal with the discomfort the expanders cause. I am also worried about the possibility of infection around the expander. Some women develop infection, at which time the expander must be removed until the area heals. Another surgery would then be performed later to place it a second time, and the whole process starts over. Are you starting to see why I described the process as 'drawn out'?
I guess the only positive thing about expanders is the relief that comes when they are switched out for implants. Some women refer to their implants as 'squishies,' because they are so soft and comfortable compared to the expanders. I know I will be counting down the days to my exchange surgery! On a side note: I will have magnets in my boobs while the expanders are in, so that will be interesting. I've seen women post pictures of soda cans, keys, and other metal objects stuck to their breasts! You have to keep a sense of humor through all of it, right?
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