Tuesday, October 20, 2009

One perky & one saggy?

I got to the clinic this afternoon only to be told that my appointment was canceled. When I asked why, no one knew. So, I informed them that I was not leaving until someone released me to go back to work! The surgeon worked me in and checked me over. He then started talking about reconstruction. I said "Whoa, back up the truck!" as I didn't recall even discussing breast reconstruction. Just what I need, one perky boob and one saggy one! Then, what if the right one needs to come off? I'll be back to one boob again. I'm not sure how I feel about that. When I babbled on about this, Dr. Haynes said that I would be able to see the difference between the reconstructed breast and the remaining breast when naked. But when wearing a bra, the breasts should be alike enough in size and shape that I should feel comfortable about how I look in most clothes. He went on to explain that they could take "fatty" tissue from either my lower abdomen or butt for reconstruction. I pointed out that my butt doesn't have much "fatty" tissue as it is a nice butt. He almost laughed. Or they can put in a breast implant.
Utilizing the "fatty" tissue is called tissue flap procedures. These procedures use tissue from your tummy, back, thighs, or buttocks to rebuild the breast. The 2 most common types of tissue flap surgeries are the TRAM flap (or transverse rectus abdominis muscle flap), which uses tissue from the tummy area, and the latissimus dorsi flap, which uses tissue from the upper back. These operations leave 2 surgical sites and scars -- one where the tissue was taken and one on the reconstructed breast. The scars fade over time, but they will never go away completely. There can also be problems at the donor sites, such as abdominal hernias and muscle damage or weakness. There can also be differences in the size and shape of the breasts. Because healthy blood vessels are needed for the tissue's blood supply, flap procedures are not usually offered to women with diabetes, connective tissue or vascular disease, or to smokers. In general, flap procedures behave more like the rest of your body tissue. For instance, they may enlarge or shrink as you gain or lose weight. There is also no worry about replacement or rupture.
Adding to my uncertainty was the very nice woman I met in the waiting room who told me her breast cancer story. Four years ago she had a lumpectomy (right breast) and then chemotherapy. The chemo was so toxic that it landed her in the hospital so her "chemo cocktail" was changed. This past spring, her cancer returned, this time in both breasts. She had a radical mastectomy and just finished chemotherapy. She was there to have her port removed and discuss reconstruction. At least I can return to work tomorrow. Yeah!

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