It’s less than 48hrs until my bilateral sapling oophorectomy (fancy talk for removing my ovaries and fallopian tubes) and hysterectomy. And, yes, that’s part of this whole BRCA2 issue that cannot be ignored. But, the real concern here is breast cancer, right?
I have been joking for years that if cancer were to be come part of my future, in some way, I’d be glad to trade in mine for a new pair. I’m a small, B, if I’m lucky. In fact, I believe the plastic surgeon described me as “deflated,” or something similar. Moms who breastfed, you know exactly what I mean. The girls just aren’t what they used to be. So, getting to “start over” sounds great, huh? Well, sort of.
If you hadn’t guessed already, I will be having a bilateral prophylactic mastectomy. There are several types of mastectomy: simple or total mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and nipple-sparing mastectomy. The choice to have one of these types of mastectomy depends on the woman’s situation, with a radical mastectomy being the most invasive and having the harshest recovery. BreastCancer.org has a fantastic website offering simple-to-understand yet detailed descriptions of each type.
Now, you may be reading this blog and be thinking, “well, that sucks,” and in some ways, yes it does. I am the fortunate one in this situation, however. I am CHOOSING this path. Women who actually have cancer are not so fortunate. They may face removal of the lymph nodes, a dangerous and painful procedure with a very long recovery. I had first-hand experience watching my mom try to recover after having her lymph nodes removed. She couldn’t raise her arms above her shoulder level for months and her recovery was much more arduous than what I will face.
So, healthy prophylactic mastectomy: what am I facing? I have three choices:
- Simple mastectomy without reconstruction.
- Simple skin-sparing mastectomy (SSM).
- Nipple-sparing mastectomy (NSM).
I am opting for reconstruction, so that leaves me with options 2 and 3. In a SSM, the surgeon removes the skin of the nipple and areola and the breast tissue beneath. In contrast, the NSM leaves the nipple behind. According to the Breast Preservation Foundation, NSM causes much less scarring because breast tissues is removed through a small incision around the areola (warning- link contains graphic photos).
Now, don’t get me wrong, I’m rather attached to my nipples (pun intended), but the nipples do not retain sensation after the mastectomy. Having nipples means covering said nipples. No nipples means I will not have to wear a bra if I don’t wish after this procedure. To me, the choice was obvious. I’m not attached to the aesthetics. I just want my clothes to fit. I may feel differently when I see my “empty” chest, but at this point I cannot see the value in retaining what no longer has a sexual benefit. Thankfully, the hubby feels the same. Honestly, I think he’s just thrilled at the idea of me walking around braless. Ha!
That being said, I am facing some confusion on how the implant process will work. I will have an implant because I’m not a candidate for flap reconstruction (for info on that procedure, try the University of California San Francisco Medical Center). My plastic surgeon, Dr. Hassid, indicated that there has been some change in the medical field regarding placing implants below the muscle. Information published by the UCSF Medical Center, however, indicates that “an implant or expander must be covered with muscle, not just skin, or it will look unnatural and may become infected.” The Susan G. Komen foundation also states that step one of the implant procedure involves inserting a tissue expander “in the envelope formed by the breast skin and chest muscle.” Dr. Hassid specifically said I might be a candidate for placing the implant on top of the muscle. Now, granted I am interested in retaining a small to average C-sized implant as too much bounce would get in the way of my athletics, but I will certainly be asking Dr. Hassid more about his logic because research indicates under the muscle is the way to go.
Anyone heard of implants on top of the muscle? My quest to be an informed patient continues….
Bye, bye boobs!