Thursday, May 26, 2016

Finally, the last of my three four doctor appointments arrived.  All of the previous appointments have been generally about the cancer itself.  Regarding the cancer, there are very few decisions that I need to make.  Sure, I could refuse treatment or otherwise do something unorthodox, but in general, there is a protocol: If you have X type of cancer, you do Y procedure.  Case in point, Dr. Zap’s flowchart.

But the decision making process in plastic surgery is different.  First of all, there is the option to do nothing, no reconstruction at all.  Many women seem to do this, and I’m sure they all have their own reasons.  It would certainly involve the least amount of surgery.  The second option is to rebuild things as they are – reconstruct Righty to look exactly as Righty looks today.

Or, there’s the third option: execute on PROJECT PERKY!!!

After my own introspection and discussing it with Tad, I have decided that if we’re doing this, we’re doing it right!  I asked Tad how he felt about the girls getting a down-sizing, and he commented that we’ve done the well-endowed thing for a while, let’s try perky for a while; let’s mix it up a little!

Then he said, with uncharacteristic seriousness, “What am I supposed to say?”

I said, “Exactly that.”  He’s THE BEST husband ever!!!

So my decision upon walking in to Dr. FixIt’s* office was: Reconstruct Righty to a perfect perky C-cup, and reduce/lift Lefty to match.  Voila!  The Perky Girls!

On top of that primary decision, Dr. Demo had prepared me for further decisions – there are multiple ways to do breast reconstruction, primarily the “lat flap” versus an implant.  She advised me to do my research ahead of time so that I could make a quick decision, which would allow the surgery to get scheduled sooner.

I still was uncertain about all this when I met with Dr. FixIt, but in the end, Dr. FixIt did not need me to make this decision.  Once he understood my goals, he knew exactly how to do his job.  (The lat flap option is soooo three years ago.)  Nice.

As with all my previous doctor visits, I got yet another breast exam … but this one was with a twist.  He had no interest in lumps and tumors (someone else would get those out of the way for him); he just wanted to take measurements.  He said, “Yes, your left breast is quite large.”  Thank you, Captain Obvious…

With the plan agreed to and measurements taken, Dr. FixIt sat down with me and talked me through the surgeries that would be required.  Yes, I said “surgeries…”

Surgery #1: This is the big one.  It’ll take 2-3 hours.  First, Dr. Demo will do the mastectomy.  The breast skin after a mastectomy is very thin (they remove as much underlying tissue as possible), so Dr. FixIt will then insert something called Alloderm (radiated cadaver skin) to provide structure.  Under the Alloderm he’ll put in a tissue expander, which will start out un-expanded (deflated).  This is to allow time for the surgery to heal and the blood flow to the skin of the breast to reroute (its normal path is directly through the tissue that is being removed during the mastectomy).

Surgery #2: Over the course of ~2 months after Surgery #1, the tissue expander will be filled, a little at a time, with saline, until it’s the desired size.  We’ll then take a break for 2-3 months of healing.  Finally, for a total of 4-5 months after Surgery #1, Surgery #2 will take place.  This one will involve replacing the expander with an implant, and the reduction/lift for Lefty.  Recovery time is shorter than for Surgery #1.

Surgery #3: Finally, 2-3 months later comes the (hopefully) last surgery, which is sort of a touch-up.  Dr. FixIt will remove fat from my abdomen (yay!) to fill in the gaps around the implant, and otherwise do some fine-tuning.  (I said, “Like caulk , or spackle!”  Dr. FixIt did not even smirk at my joke.  Hmph!!  I guess surgeons do not like analogies to home remodeling…)

By my math, this should all be done by around January.  (Yes, there is a Gantt chart coming up in a future posting…)