Time To Get Filled

I’m not talking about going to fill up my car with gas. Or being filled with emotion. Or being full from a meal. Nope, now when I’m talking about getting filled these days, I’m referring to my boobs!

Sometimes I forget that this whole cancer thing started with a lump in my breast. Since the initial find and surgery, my cancer journey has had little do to with my breasts. True, I felt tremendous sadness and there was definitely a mourning period after learning I’d lose my breasts. But medically and physically speaking, compared to chemo, this part of the journey has been a breeze.

From the beginning, I was grateful for some of the humorous experiences I encountered along the way. Fair warning, some of this blog does get a bit graphic.

One of the first things I had to do after learning I’d be undergoing a bi-lateral mastectomy was to choose a Plastic Surgeon. My Surgical Oncologist referred me to two different doctors that she regularly works with because as it turns out, this is a highly collaborative process between the two doctors. After meeting with both choices, our decision was clear.

The seven hour procedure started with the Surgical Oncologist. She made an almost semi-circle incision tracing my nipple and across my breast towards my armpit. She then removed all the breast tissue. I was lucky because my cancer was located in a position that would allow for ‘nipple sparing’- meaning I’d get to keep my nipples. Yay? Hadn’t even thought about the fact that I wouldn’t have nipples, but yeh, many women going through this process can’t keep their nipples and end up either going without a nipple or using a tattoo artist that creates a fierce looking three dimensional nipple. But yes, YAY, I would get to keep mine. So in addition to removing the breast tissue, my nipples are removed, scraped clean to make sure there are no cancer cells and placed to the side for the next step. She also removed two lymph nodes to check if the cancer had spread.

After the Surgical Oncologist is done, she hands the surgery over to my Plastic Surgeon, who places expanders in my breasts. Expanders are kinda like little balloons or pockets that, well, expand when fluid is put in them. They have a valve where saline solution can be inserted to expand the pocket and create a space where the implant will eventually be placed. At the time of the surgery, the plastic surgeon places a small amount of saline in the expanders, so I actually left the hospital only a little smaller than I had entered. But over time, the expanders could be filled further.

A little fun/ weird fact: the expanders are covered with cadaver skin so the body doesn’t reject them. That kinda grossed me out for a second, but it quickly turned to gratitude for the people who donated their skin so that I could have a successful recovery.

The Plastic Surgeon completes the surgery by replacing my nipples, placing drains in to make sure I don’t accumulate fluids, and stitching me back together. I was surprised when I learned that I wouldn’t be wrapped or bound at all after the surgery. Instead, there was a very thin adhesive placed over my entire chest that held everything in place.

Seeing my chest for the first time afterwards wasn’t really shocking at all. There were lots of sutures and my left arm was more sore from where the lymph nodes had been removed. But honestly, my breasts didn’t look a whole lot different than before surgery.

The worst part of the whole recovery for me, hands down, was the drains. I had four drains, emptying fluid into these little bulbs, and they were very uncomfortable and cumbersome. And because of these drains, I was unable to shower for a couple weeks. Ewwwww! I’m a shower lover, so taking that away was not good.

Emptying the drains was not the most pleasant experience, but my younger son really got into it. He’d empty and measure every morning and track my progress. Two drains came out one week post surgery. And when the other two drains were removed a week later, I felt free! It was wonderful.

The rest of recovery was very manageable. The expanders were uncomfortable at first, feeling like they were wedging into one of my rib bones, but after a while, that subsided. By four weeks after the surgery I was able to use my arms and get back to driving again.

So let me get to some of the amusing experiences! I’d assumed I’d have to wear something binding after surgery, so when my Plastic Surgeon told me I couldn’t wear a bra, I was surprised. I’ve always worn a bra. Always. Hmmm….ok. But to ensure the nipples stay where she placed them, the doctor said I shouldn’t have any pressure on my chest. OK, so no bra. I’m happy to report that several months later, I’ve come to really enjoy the braless experience. In fact, when this is all done, I’m not sure I’m going to enjoy going back to being bound up!

The other thing that I found surprising was when I realized my nipples will always be nippy! All. The. Time. I’m not sure why the doctor never thought to mention this little tidbit of information. I mean, I guess because they were removed and placed back on me without being attached to any muscles or nerves, I should’ve known it, but a little head’s up would’ve been nice! So it’s kinda weird to look down and always find them nice and nippy. And since I can’t wear a bra, the rest of the world can see that too. I’ve managed to get around it a bit by wearing t-shirts with a lot of designs on them. My doctor said if it bothered me (Am I the only one who is self-conscious when my nips are nippy?), I could either wear a shelf bra, (No, thank you. In the heat of the LA summer, adding another layer is not an option.) or pasties. Tried the pasty once, left a rash on my skin- so that’s out. Ok, I guess I’ll deal with the nippy thing.

Also, I have absolutely no sensation in my breasts or nipples; I can’t feel when I touch them at all. I thought to ask about this before surgery, so it wasn’t such a surprise afterwards. My husband and I both had a bit or a mourning period about the loss of what had been a very pleasurable part of my sexual experience. I guess it’s just one of the casualties of this cancer. But it’s a strange sensation for sure, to give someone a hug and feel something between us, only to realize it’s my breasts! Or to try to lay on my stomach and feel like I’m being supported by a foreign object!

But so far, the most fun part of the process has been getting filled! I’ve returned to the doctor’s office twice to be filled. The second time I brought my husband so he could have a good laugh too. First the nurse places a magnet on my breast to find the valve in the expander and marks it. Then she takes this big ‘ole syringe filled with saline and a big ‘ole needle on the end and inserts it right through my skin into the valve in the expander. It is REALLY weird to see a big ‘ole needle stuck into you and feel NOTHING! And here’s the best part- the nurse begins to inject the saline and I can actually see my breast enlarging! It’s so cool!

The first time I had it done I was immediately aware of the additional weight I was now carrying in my breasts. It felt like they were weighing me down and causing me to lean me forward. (They probably weren’t really, but it felt that way!) And because it was so warm out and the saline was cool from the doctor’s office, I felt the coolness in my chest. Just so amazing!

At the second filling, I was unsure about using the full syringe of saline to fill me because I was thinking it would make my breasts too large. So the nurse filled me up half way, giving my husband and I time to look and see how we’d each feel about the possibilities of going larger. There’s a strange irony in deciding the size of my breasts after all of this. The nurse shared that this is the one part of the cancer journey that most women really appreciate because WE get to control the outcome. We get to decide what size we’re going to be. Bigger? Same size as before? Smaller? I get to choose! In the end, I didn’t go larger than that half syringe. I felt I was already pretty full!

My younger son is just in awe of all of this. He jokes that I should go Dolly Parton big. But I’m actually enjoying having breasts that are full again. After breast feeding both boys, my breasts had deflated dramatically and now that is remedied.

At the beginning, I’d wake in the middle of the night feeling something getting in my way only to realize it was my breasts. They stay up even when I’m down! I guess that’ll just take some time to get used to!

So this part of the process is done. The next time I see the Plastic Surgeon will be a pre-op appointment to discuss the last phase of my reconstruction, when the expanders are removed and the implants are placed. I learned there’s another bonus to this phase because in order to make the implants look more natural, the doctor will take fat from another part of my body- most likely my stomach- through liposuction. At first I was adverse to this idea because it will add to my recovery time. But I was told that choosing to do this really does make a difference aesthetically and as my husband reminded me, it will allow me the freedom to gain a little weight during my next phase of chemo guilt free.

But because nothing can happen until chemo is done, the final stage of this cancer journey will happen around Christmas when my new breasts will be complete.

For now, I’m enjoying having these liquid filled expanders. My boobs are squishy in a way they never were before, kinda like having little water beds in my chest. The scars are starting to fade. And soon, this will all be just a perky memory.

In loving,

Sarah

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