Sunday, February 12, 2006

implants a la michelle

my fellow blogger and 'breast' friend, michelle emailed me her wealth of info on implants, so i thought i'd lay it all out here for everyone's benefit.

There is an excellent forum on breastcancer.org.
http://www.breastcancer.org/ubbthreads/ubbthreads.php. You can search a
lot threads using the key words: reconstruction, tissue expanders, implants, saline, silicone, etc. I've read about one woman who had a one-step reconstruction but this is very rare and I'm not sure what this entails.

The normal route these days, however, is mastectomy + immediate reconstruction. I had a double SKIN SPARING mastectomy + immediate reconstruction.
I think you just had a single mastectomy, right?
YES - LEFT SIDE ONLY

What is your radiation situation? This has a significant impact on how your reconstruction schedule will go. Radiation can cause problems with skin healing so you'd have to wait several months for it to heal before operating. And for those who have expanders before radiation starts, there are all kinds of risks including capsular contracture and
expanders "popping" out of radiation-damaged skin.

Well, what happens is they cut open the pectoral muscle and create a "pocket". Then they slide the tissue expander in. Hopefully your PS will insert some saline to get you started. Over time, he'll perform expansions in increments that aren't too painful. I don't recommend anything more than 30cc at a time or 50cc if you pop lots of Vicadin.
I HAD 100cc's AT A TIME -- NOW I UNDERSTAND WHY IT HURT SO DAMN MUCH!!!!

You need to be expanded to 10% greater than the size you finally want to be. Note: tissue expanders are really hard and uncomfortable.
THIS I KNOW
You become accustomed to the discomfort over time, however. - SORT OF - MY VALVE IS SO LOW THAT NO MATTER WHAT BRA I HAVE ON - IT HITS RIGHT ON TOP OF IT OR ACTS AS A TOURNIQUET ABOVE OR BELOW. IF I DON'T WEAR SOME KIND OF BRA, THE REAL ME SITS ABOUT 4" BELOW THE FAKE ME - QUASIMODO STYLE.

When you're finally ready, then you can go in for your final "exchange" surgery. The best implant, in my opinion, is silicone. It's heavier (which will make it droop more like a natural breast), squishier like real flesh instead of a water balloon and be more comfortable. Saline tends to "swish" and stick out more, giving them a "fake" look. Either way, it's hard to make reconstructed breasts look totally natural because the skin on our chest is tight and there is no natural tissue to
protect them. My PS put a layer of Alloderm over them for protection.

So, you should know that I'm biased against DIEPs and FLAPs because they're so invasive. As an athlete, I couldn't deal with moving much-needed muscle from my back or belly (even if I had it). Implants, IMO, are the best so solution for me. You can be as big as you want to be and my take on this is, hey I want NICE boobs as my consolation prize
for going through this crap.
Are you considering a prophylactic mastectomy as well?
I SHOULD HAVE THOUGHT ABOUT THAT EARLIER - I GOTTA LOT OF THINKING TO DO...

If so, your reconstruction can done so you match very well. Gravity will eventually take over the natural breast whereas
the implant acts like its in space travel.

Does any of this help? Feel free to shoot me specific questions.

Process: http://michelle.wolfmadness.com/archives/000339.html
Expansions: http://michelle.wolfmadness.com/archives/000344.html
When I had problems w/my expanders:
http://michelle.wolfmadness.com/archives/000376.html
About silicone: http://michelle.wolfmadness.com/archives/000392.html
Radiation w/expanders: http://michelle.wolfmadness.com/archives/000411.html

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