The reconstruction saga continues: Part 2

IMG_20180403_142250It feels like this post has been a long time coming. Being able to share what will hopefully be the last chapter of my breast reconstruction journey for a long while. It was emotional putting these pictures together, remembering that innocent hope as I headed into my first surgery that I would be back to work in 6 months and have this all behind me…but I was so wrong. The past year and a half has been a constant stop and go, building up enough strength only to have to pause, recover, and repeat again after each surgery. Every time I went in I kept saying to myself this is it, I’m done only to have the disappointment quickly set in and spend the next few months anticipating yet another surgery. But I knew deep down going into this last one that I was at my limit. I could feel the toll it was taking on me emotionally and physically and wanted nothing more than to move forward and get my life back again.

At my first follow up appointment last week, my surgeon removed the remaining steri strips and discussed how everything went. During my revision surgery, two inches of excess skin had been removed from my left breast which helped tighten things up and in the end I didn’t need as much fat grafting done as initially thought. I still had about 100ml of fat taken from my stomach though to fill in the gaps which is still slightly tender even 4 weeks post surgery but it definitely helped soften the gaps and smoothed things out around my implants.

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One week post surgery
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Two weeks post surgery
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Four weeks post surgery

 

The one thing that really bothers me though is the scarring and discomfort in my left breast. While there’s nothing physically obvious to account for the discomfort, I could do more fat grafting in the future to try and cushion around the edges of the implant which could be rubbing in certain areas. But at this point I am done and can live with a little bit of discomfort if it means avoiding another surgery for awhile. The scarring on the other hand has less invasive options including a combination of micro needling and non-ablative laser treatments to help soften out the colour and thickness which I will be trying out tomorrow for the first time (stay tuned for an upcoming post on this).

Throughout this whole process, I’ve been asked a lot of questions about my choice to have the latissimus dorsi flap reconstruction and whether I’m happy with the results. It can be difficult to answer sometimes but hopefully the following Q&A’s below will provide a little more clarity around my decision and provide some valuable information to those considering this reconstruction option:

Quick surgery recap since my diagnosis:

June 2, 2016 – lumpectomy and sentinel node biopsy

June 15, 2017 – prophylactic bilateral mastectomy with immediate latissimus dorsi flap reconstruction

October 2, 2017 – surgery to exchange expanders for 210cc Natrelle Inspira smooth round gel implants

March 5, 2018 – breast revision surgery including fat grafting and removing excess skin from left breast

Why did you have a lumpectomy and then opt for a bilateral mastectomy one year later?

Halfway through radiation, I was given the news by my medial oncologist that there was a possibility I still had cancer cells remaining in my breast after getting a second opinion from another pathologist. The recommendation was to undergo a unilateral mastectomy; however, I opted to have both breasts removed for peace of mind as lobular breast cancer is more likely to be multifocal or occur in the other breast at a later time.

Why latissimus dorsi flap reconstruction?

At my first consultation appointment with the plastic surgeon, he outlined the three options available to me: implants, DIEP flap, or latissimus dorsi flap reconstruction. He advised that because I had prior radiation, it would be difficult to achieve the desired natural looking results with going straight to implants and recommended using a flap procedure instead. I also had a long-lasting infection in my affected breast after my lumpectomy so by using healthy donor tissue from my body, it would offset the risk of infection and complications. I didn’t have enough tissue in my stomach area for the DIEP flap procedure so that left me with the only other option which was the latissimus dorsi flap. You can find more info about my surgery choices in my post here .

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Are you happy with the results?

I often get asked this question and, quite honestly, find it really difficult to answer. While one part of me is happy overall with how my reconstruction turned out, the other wishes I could’ve done some things differently. For instance, looking back I likely would’ve only had one side reconstructed with the lat flap. My non-cancer side has caused me the most issues including more indentations, more scarring, more discomfort and, as a result, more surgeries. What I am happy with though is how natural they look. Because the surgeon used healthy tissue from my back, it helped provide more elasticity to the skin on my radiated breast and feels much softer than anticipated.

Ultimately though, I wish I never had to be in this position where I had to worry about amputating a part of my body and making this choice of whether to reconstruct or not. It’s been an emotional rollercoaster going through each and every one of these surgeries and trying to get my body back to a place that it will never be. But even though breast reconstruction may not always be perfect, sometimes it’s about looking back and saying you got me through this and I am grateful for you. I respect you. And I am going to embrace this beautiful body of mine that found the strength to get me to where I am today.

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