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Reconstruction: shopping for a new boob

BY KATHY LATOUR | MAY 24, 2012

Reconstruction was the last thing on my mind when I had breast cancer 25 years ago. With a 1-year-old and stage 2B breast cancer that included a rather large lymph node, I was much more concerned about living than having two breasts. In fact, I told them I wanted them both off, but they wouldn't do it back then. From what I understand, it's a common procedure today for a young woman who wants both removed to have a bilateral if it's justified. I just didn't care about my breasts. They were trying to kill me, and I wanted to be around to raise my daughter.

Immediate reconstruction wasn't done as routinely then as now, and since I went in initially to do a lumpectomy with radiation (which changed when my surgeon found long finger roots and one big positive lymph node), we hadn't planned for it. I sort of mentioned reconstruction after surgery and was told, if I remember correctly, that I needed to wait a few years to recover from chemo.

Now, I have to be honest here. I have the sense that someone told me they wanted me to wait to see if it came back, but I may have been telling myself that.

I did choose to be reconstructed a year after surgery because of my daughter. At 2 she was beginning to notice body parts and that mommy had a "boo boo." I didn't want her to grow up with my boo boo in her face and wasn't going to banish her from my bedroom. I also noticed that I felt lopsided.

So, around a year after they took it off, I started shopping for a new boob.

There are many decisions to make when you begin shopping for a new boob--first is the plastic surgeon.

Now, shopping for a plastic surgeon is not like looking for any other doctor. Plastic surgeons are artists and just as you travel the gallery circuit when you are looking for just the right piece for your entryway at home, you need to spend a lot of time in the ladies room for show and tell for the art of the plastic.

When I found my plastic, I was overjoyed. He had pioneered some of the surgeries I was considering; among plastics, he was Picasso.

The next thing in your shopping basket is the kind of surgery you want. When I found out they could make me a new breast out of my stomach, I was elated. I had been saving it for just such an occasion. When I told the plastic surgeon what I wanted, he pointed at the exam table and told me to hop up and let him see if we could.

Whaaaa? See if we could? I had a stomach that needed to go away, and I needed a breast. What's the problem?

Well my C-section scar was the problem. If he cut across it, he told me, it would destroy the integrity of my stomach. Now that was a real shock since my stomach had no integrity. It would sell out to the first piece of chocolate that walked by. But no, he said, the stomach muscles stayed where they were.

So I was back to his first recommendation, which was to move my back muscle to the chest wall and put a small implant under it, which we did.

You know, taking off the breast didn't hurt because they cut the nerves. But the reconstruction hurt a lot until I was introduced to the morphine pump. This wonderful invention had a button that allowed the morphine to flow. I used it solicitously until I found out it wouldn't let me overdose and then it became my best friend.

I went home a week or so after surgery and gradually the pain left and I got used to having two breasts again. They matched fairly well since I had convinced the insurance company to pay for lifting the left breast to match the right. Now that was an interesting phone call!

After replacing the implant the next year all went smoothly until 2007 when I was diagnosed with DCIS in the left breast, and I faced another mastectomy and reconstruction. Boy, that was when the fun really started. More on that later.

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COMMENTS

Your story made me smile as it matches mine in so many ways! I think you did a great job of describing the reality without making it too scary.

I always say that "reconstruction" really means "under construction" and at least having some idea of what lies ahead gives you the tools to ask the right questions, choose the right surgeons, and move ahead with appropriate expectations.

Looking forward to hearing the rest of the story...maybe, maybe not! Sitting here today at 4 years NED following a right mastectomy, latissimus reconstruction, lift on the left, I hope my future story doesn't match yours anymore than that.
- Posted by Heather 5/25/12 2:56 PM

Love your take on this...similar to my own. The first time I had BC I had lumpectomy, chemo and radiation. 2 years later a reduction on the other side for symmetry. 8 years of living my "new normal" in fear of recurrence I was diagnosed with a recurrence near the original site. That was it...I decided I needed a "one and done" surgery so I had a bilateral mastectomy with immediate DIEP flap reconstruction. Loved that the bonus would be a tummy tuck! Recovery was not for the faint of heart...BUT...love the results. It was such the right thing for me. The other bonus is that I opted not to do nipple reconstruction (just did the tattoos) because with these new perky foobs (fake boobs) I don't have to wear a bra. This is an EXCELLENT perk!

The thing that bugs me is that not all doctors tell you about all the options. Quite often they only tell you what their hospital offers. Personally, I think that is criminal! I actually knew that I wanted a DIEP if I ever had a recurrence so I put that plan into motion the day I got the diagnosis. Now I'm two years out and rarely think about breast cancer any more. There is a certain peace that comes with mastectomy and reconstruction. You cease to wait for the other shoe to drop. And with immediate reconstruction you go to sleep with boobs and wake up with boobs so the loss did not affect me as much as I thought it might. And did I mention the tummy tuck and no bra thing? :-)
- Posted by Wendy 5/30/12 5:16 PM

I am now 15 years post mastectomy for DCIS followed immediately by reconstruction by a TRAM flap. (this one provides a tummy tuck, and a fairly uncomfotable recovery period.) At the time (1996) my plastic surgeon suggested making a new perky boob and then adjusting the remaining breast to match - rather than making the new one match the old. I was shocked that he would consider operating on my perfectly normal breast. So, I dismissed the idea. Well, now that I am 15 years older, and gravity has been at work, I wonder if he didn't have the right idea!

I second Wendy's comment that the tummy tuck was a welcome part of the whole ordeal - just be prepared for six weeks or so of recovery.
- Posted by Jackie Burleson 5/30/12 6:13 PM

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