91. Operation Finale : Phase One = Complete

I'm lounging in bed with lots of pillows, cups of tea, Jurassic Park and moggits.  Two days ago I went in for my (take a deep breath......) bilateral breast reconstruction liposculpture fat grafting, nipple reconstruction and dog ear revision surgery.  Basically, I had my lardy bits pummelled out and pumped, very expertly, into my reconstructed breast tissue, had the ends of my scars snipped off and finished and had some nipples made from my own skin, which all took 4 hours.  I'm still a little swollen so it will take a while to see things settle down and I go back to see comedy surgeon in 2 months time for a review.

I've been hanging onto an extra 8-10lbs I gained over the summer (thank you implant) in anticipation of this surgery.  It doesn't look like much but they are much fuller, about a whole cup size and instead of being empty in the top of the bra cup, they now meet the material and fill the cup - AMAZING!!  From a 35A to a 36B again.  I may lose 50% of the fat injected but that is remedied by one or two more liposuction sessions.  I've never posted photos and I plan to dedicate a whole blog post  from the beginning to the end when I'm complete, like closing the book on things and demonstrating visually just how amazing plastic surgery is these days.

My breast reconstruction was 3 years 7 months ago now and over the last 2 years, after being passed to the Plastic Surgery team, I have developed a really relaxed and jovial relationship with comedy surgeon, an expert in the field of breast reconstruction and correction of breast asymmetry.  He treats me like a person, not a lump of flesh and we have a good laugh.  He knows that I expect his very best work and I know that he gives it.  

I was very impressed with his plastic surgery team, one very handsome surgical assistant and one very handsome anaesthetist - sweet!  The anaesthetist team were excellent, introduced themselves to me individually as I led on the operating table. 

Handsome anaesthetist put a cannula in my hand and joked about stuff whilst everyone else hooked me up with sticky monitor pads and tubes.  Then I had the G 'n' T drowsy stuff which always makes my heart race.  It could make you feel panicky if you let it but you have to breath deeply and relax and go with it, you are in expert hands.  They then give you the proper stuff and you are gone in seconds.  The next thing you know you're in the recovery ward.  I'm not sure if someone sits with you the whole time you are still under, waiting for you to rouse from your induced sleep, but there has always been someone right there when I wake up.  It is so comforting to have someone there.  I talked gibberish but knew where I lived and my name so that was good news.  Then, as if my magic, I am on a ward, so I guess I passed out again and missed the trip through the hospital corridors and lifts.  

Two hours later I was starving and eating cheddar Burts crisps with my husband by my side, then felt nauseous and my nose was mega itchy, so I must have had morphine somewhere down the line.  Anti-sickness and anti-itching pills were administered and 20 minutes later I felt much better.  Hooray for not eating the meatball dinner.  My backup chocolate and jelly worms would came in handy.

I bummed out on the bed lottery, the only one on the ward without a TV and a dodgy bendy light with a broken switch.  It was also closest to the toilets and right next to the nurses desk. The snoring, coughing, painful moans, old man shouting, toilet visitors and general chit chat was never going to let me sleep.  My phone had died just before I'd gone into surgery so I had no music at all.  I was left with my earphones so I stuffed them in my ears anyway, ate chocolate and jelly worms, did puzzles and drank Horlicks at 3am until I finally got to sleep, 4 sweet hours of it.

The pain is minimal unless I move.  I don't visibly bruise much but they are beginning to come out over my hips, outer, inner and backs of my thighs, under my boobs, my belly, and my boobs themselves with some uncomfortable swelling at the ends of my dog ears, but generally things went very well and my boobs are looking fuller and more even.  I can't wait to meet my new nipples next week! It's going to be bizarre!

90. Pre-Op for the Finale (Phase One)

After a second night of insomnia and only 2 hours sleep I had to get up for my Pre-Op assessment on Thursday.

What is a Pre-Op?

Pre-operative assessments involve blood pressure, weight, blood, swabs and a chat about medical conditions. I can highly advise taking an 8am appointment if you can, as with doctors surgeries, the team gradually run late by the afternoon. I have, in the past, on a number of occasions now (I am getting old hat at surgery now) spent over 4 hours in a Pre-Op Assessment ward with an afternoon appointment. Hot, stuffy, boring as hell. My 8am appointment was over in an hour and half, brilliant stuff and the best experience of Pre-Op yet.

6.45am  Alarm...eurrghh!

6.55am  Cup of STRONG coffee

7.10am  Lashings of anti wrinkle cream

7.35am  Out into the crisp new autumnal air and into the 8am rush hour

7.45am  Discovered the 8am commuters are grumpier than 9am commuters and way more aggressive.  How rude!

7.58am  Arrived at the hospital and was spoilt for choice with parking spaces, this is a rare, rare event and I liked it.

8.01am  Entered the doors to a gentle world of fresh shift of hospital staff willing to help, smile and direct me to where I was supposed to go.  Felt sad that most would leave feeling knackered and frustrated having walked past some of them clocking off and going home on my way in.

8.03am  Arrived in the peaceful and friendly Erme Ward, filled out my form and took a seat, watched the Paralympic hand cycling.

8.10am  My name was called and the poking and prodding commenced.

Step One: Blood Pressure & Weight

Having just driven there with a bunch of aggressive driving commuters, I wasn't completely relaxed, plus I always get a little anxious entering hospitals. It always baffles me why they do this bit first for that very reason. My blood pressure was fine, 112/75 (blood pressure explained), but apparently I should have been dead with 238 heartbeats per minute!! Holy cow! Thankfully the machine wasn't working properly, so it was the old fashioned wrist and watch beat count = 75bpm. Phew! I was still alive!

The next bit was the depressing bit, the weigh in. I think all weighing scales in hospitals make you heavier than you are. I had an progesterone implant put in 4 months ago, and suddenly put on 8lbs in weight, which is good for my upcoming surgery but highly unusual for my stable weight record. Back in November 2011, comedy surgeon was concerned that I didn't have much fat for him to work with for fat transfer. I can officially confirm that he now has plenty to suck out and juggle around.

Step Two: Chat & Questionnaire

I ramble at this part. Sat in room with a closed door and a nurse, there is a 4 page questionnaire that the nurse goes through with you, asking about eyesight, allergies, previous operations (which I find weird as they have records of these..surely?), mental health etc. It is this stage that I realise I'm pretty healthy at 39 years old and feel lucky to be that way. The nurse was a lovely lady, we laughed a lot and found out that she had never had a general anaesthetic - lucky woman!

Step Three: Bloods & Swabs

The blood and swab nurse was lovely and chatty.  She took my nose, throat and groin swabs for MRSA tests and took my bloods.  A few pokings, a small scratch and a nice compliment about my dress later I was done, free to leave.

9.35am  Walked out of the hospital feeling good.

9.37am  Walked past the medic team waiting for the air ambulance to land.  As it landed about 50 feet away, a sudden upwelling of emotion came over me as I remembered the day my ex-fiance didn't quite make it to hospital in the air ambulance that tried to save him.  He died as it landed on the helipad at Salisbury hospital after a big RTA.  That day I should have been driving, not him, that day I was spared my life or serious injury at least, and although I have endured other battles, I am still here and I can still fight them.  My mortality is very real to me.  Most people don't think of death but I am very much aware that I am alive and I want to feel it everyday, not sit when I am 80 and realise that I sat on my arse, watched tv too much, stayed indoors, never took risks, did nothing with the time I had here on Earth.  I shed the tears that came from nowhere from the moment, wished the person inside made it, and then sat in my car and smiled to myself remembering some good stuff and then made my way to work.

The countdown starts here for Finale: Phase One = nipple reconstruction, back scar revision (part 2) and fat transfer for breast augmentation (amending one flat one to match the other with a little extra pillow plumping).

Weeeeee!! Here we go!

89. Sporty stuff - the challenges and limitations

There are a number of posts that I have been meaning to write recently.  This one is about sport.

When I was a kid, I lived on a bike, dangled from trees, swung on ropes, ran like the wind and hid like Harry Potter in his Invisibility Cloak.  As a teenager I hit balls with bats and sticks, threw them into nets, chucked balls and discs and ran like the wind.  There was majorettes, swimming, rounders, cycling and hockey.  I loved competing and being outside exercising.  As a grown woman I had discovered big kites, cycling, snowboarding and sea kayak paddling.  I have always been involved in sport, whether participating personally or team supporting someone else.

Three years ago my LD Flap surgery stopped me in my tracks and left me very frustrated.  For those who have been through the same surgery or are considering it, my journey has been particularly hard, probably because I am an active woman and the limitations, long-term and short-term have been noticed more than someone less active. I thought it would be useful to list all the sporty things that I feel that I can now do, what I have tried and what I have pondered about.

Snowboarding

Awesome!! I had to develop a method to get up on my toe edge as heel edge standing from sitting demands too much from my arms, shoulders and pectoral muscles.  The falling bit freaked me out too, with outstretched save my face arm landing jolts my whole chest and I get horrible spasms for hourse after.  The key is....don't fall over.  Yeah! Right...so..I don't snowboard much but I will come back to it again.  I guess skiing would be far easier and a defo yes!

Mountain Biking

Yes!! I now regularly go out riding cross-country and downhill mountain biking.  The suspension in the forks of bikes now means I don't have to absorb all the bumps.  Push ups for downhill can get a little sketchy on steep parts and I need help so I always ride in a group.  It's so good for you, I can get aerobic exercise, toning and fresh air all in one.  I adore my bikes!  The body armour is comfortable too, which I was concerned about but I wear IXS 2012 women specific armour and it's big but robust.  I have taken a few tumbles and just get minor bruises and I know that my precious boobs and scars are well protected when I fall.

Surfing

Ummm...nope! Well, on a surfboard anyway.  I guess bodyboarding (spongeing) with fins would be okay as your legs do the paddling work instead of your arms.  I had to sell my surfboard (which my hub bought as my wedding present) after I realised there was no way I could board surf anymore.  The strong paddle required to get into a wave is something I just can't do now.  My arm pull is weak and I would spend most of my time frustrated at not being able to catch a wave.  I have lost all desire to be in the water with my lack of swimming stroke strength these days.  Gonna stay safe on land!

Kite Flying

Weeee!! I can still fly a 6ft kite no troubles, but for smaller periods of time.  I have flown a 3.2m kite with a harness to take the pull out of the gusts and this is fun. So glad I can still get excited about the windy stuff!

Swimming

Yippee! I was surprised that a few lengths of breast stroke didn't bother me.  Before my nerve cutting surgery to reduce the muscle spasms, I couldn't have swum anywhere for very long.  Backstroke and front stroke are not ideal and hurt, crunch my crunchy shoulders and I stick to breast stroke or lie on my back and just kick.  It's nice to be able to still swim, I have to say.

Sea Kayak Paddling

Yes! Although I now go with my husband in a double kayak, I am fit and strong enough to take short paddles a few hours at a time, in a single kayak, in less choppy conditions.  This activity always needs lots of planning for tides, wind and general weather conditions anyway but extra planning for locations and routes is now needed to make it safe to cope with.  Too many accidents come to paddlers who don't take time to plan or carry all the right equipment with them.  Stay safe kids!

Tennis

Maybe? Not tried but I imagine it could be okay now that my twinges and spasms are gone.  It's a very strong arm movement kind of sport, those which I actually avoid if I can and I have never had the urge to play tennis, badminton would be much better with lighter rackets and objects to hit.

Yoga

Yes, although I have some restriction on full stretches, this is the best thing I can do for my body to keep it supple and flexible.  Piltates is stronger but also advised by my physio.

Aerobics

Hmm...I haven't attended any but most classes cater for your limitations and it would be good to have a chat before you join to make sure that they can help you get the most out of sessions.

88. Podge, Pondering & Self-Esteem

For the last 3 years I've enjoyed some hard earned emotional respite and peace from my genetic breast cancer worry.  Facing more surgery in the not too distant future has new and interesting mental challenges.

Podge  Since comedy surgeon gave me strict orders not to change my current weight in preparation for my fat transfer surgery, I've struggled a little.  I am currently fluttering around my trigger weight, the one that normally makes me kick my own arse into action and exercise more and eat less shite.  Looking at the scales everyday and knowing that I can't lose any of those 'oh my god, sort it out love' pounds is, quite frankly, bizarre!  It's made me learn to accept that being a little fuller figured is okay.  Age may be playing its part here, having recently edged ever closer to big  4Oh my god! 

Pondering  People are like teddy bears; they are nicest when they are brand new or when they're worn at the ears and nose from years of love with stuffing knocked about from many adventures. I had my stuffing pulled out by my surgeon and it is one of the biggest adventures of my life, both emotionally and physically.  I have lost and gained (not talking the extra poundage here) along the way.

Self-Esteem  Most women struggle with their body image and I was once one of the many. I had such a negative view of my body and I forgot how to be feminine, how utterly sad. In the past, years of school days bullying by boys teasing on the size of my curvaceous rear end and the teasing that continued by a man that I once loved, damaged my body confidence deeply.  It took years of comforting words from my incredibly caring and loving husband to change that, but it wasn't easy, I had to believe he meant it and I had to allow myself to feel it.  The problem with being BRCA+ is that once you know your genetic status you have to choose to either stay as you are or chop your breasts off.  The latter comes with major issues, body image issues involving risks, scars and body changes that some cannot face. I know a lot of very amazing BRCA+ women who have been through the mangle with surgery and their emotions. They are more beautiful than they ever imagined, radiating confidence, living life, loving people and being free despite being scarred mentally, emotionally and physically for life. 

There is something incredibly liberating about facing your own mortality and flirting with your survival instinct. It is utterly priceless - a life adventure. Most people who have pulled a mooner in the face of death tend to live life fuller, love deeper, risk more, are kinder and more forgiving of others.  Thats the way everyone should be, but it takes some major event to scare the shit out of you before you take a long hard look at yourself and what you feel about everything.

What was the purpose of this blog post? Just a vent, another fugly morning mirror look at myself and sorting it out for the day moment. How being a little podgy is not the end of the world, that I've come a very long way and I'm not who I used to be.  What a fabulous thing!  I wouldn't change any of it.

87. Plumping my pillows

What an absolutely gorgeous day it was today.  As I drove around the fringes of the city towards the hospital, the school kick out traffic slowed my pace.  I was able to people watch a little and sat perched on bus stop benches in the sun were women in colourful skirts, exposing freshly shaven legs - with freshly cut and blood scabbed shins.  Lovely!  Guaranteed, the minute the sun comes out, the first 'exposure' shave will end in tragedy with blobs of tissue stuck all over the place to stop the never ending bleed that comes with a razor skinning.  

As usual, nowhere to bloody park.  I drove through every single car park in the hospital grounds before I found a spot, where I wasn't supposed to park.  Sod it!  On entering the Outpatients some woman was ranting about photocopying a piece of paper, which obviously needed the attention of ALL FOUR RECEPTIONISTS AT ONCE!! Two other patients and I waited a polite little while until I wanted to shout, 'Get the fuck on with it will you!!', but I didn't, I'm too pragmatic in such situations so I just stepped right up to the desk and forced one of the receptionists to deal with me.  She stretched with here hands on her face and yawned, "Can I help youuuu?".  Rude cow.  The usual security questions were asked.  Security, seriously? If anyone wanted to steal someones identity, just hang out in Outpatients where patients reel off all manner of personal details aloud for all and sundry to hear.  Good place for stalkers too, phone numbers given out and addresses - genius NHS, utter genius...

For once Waiting Room 2 was nearly empty and the open window seats were free.  Phew, it was hot - like 22C hot, nice for outside but not sat in a stuffy hospital.  Comedy surgeon was late but I did't mind, I was twittering to some funny ladies and looking at the people as they were called for their appointments, one by one, emptying the waiting room further.  Finally it was my turn.  Into the small room I've seen many times before along this journey but no gown today which can only mean no boob flashing.  This was a first, I often feel exposed (of course) and talk a lot with nervousness when I'm half naked in front of two men who poke and squeeze my boobs.  Comedy surgeon and sidekick surgeon entered the room and smiled with familiarity and I felt comfortable.  I proudly announced that today we were going to talk fat transfer.  He flicked though my two inch thick file and his notes, nods and mumbles then told me to stand up so he could check me over for wobbly areas.  Thankfully I'm harbouring enough lardy bits (thank you cake, pizza and revision laziness) to make the operation possible, but I am not allowed to lose weight.   

We discussed the downsides of the surgery; possible infection, cysts, fat necrosis, loss of fat cell percentage (30-50%), uneven breasts, bruising and soreness.  I have to stay in overnight for the first procedure so they can manage the pain levels.  I'm sure it won't be that bad, nothing can compare to what I have already been through with my first surgery.  

The positives of this type of surgery are that the fat transfer is natural and good results are achieved.  The fat that forms new blood supplies in the breast tissue will stay forever and change with my weight, which is one of my big issues, and I will gain volume in the upper part of my breast too which will help fill a bra cup more fully.  Obviously I will have a more svelte bottom, thigh and tummy region where they liposuck (sp??) the fat from and bigger boobs.  Yay!

The first procedure will take 3 hours maximum as my nipples are being done at the same time.  The second and third procedure will just be fat transfer via liposuction so I can grow some more podge in between each session (about 2-3 month intervals).

So, by Christmas I might look more like Dolly Parton and less like Popeye's wife, Olive in the boob volume department.  No, seriously though, I will be happy to gain a cup size and some fullness so I can go back to normality, as close as I will ever be.  Just waiting for the appointment now and I am excited!  

86. Fat transfer appointment...tomorrow!

Note:  All links used in this post are NHS pdf files and previous posts within this blog.

After a couple of phonecalls to comedy surgeon's secretary, an appointment arrived promptly in the post.  Tomorrow I go to meet comedy surgeon and discuss my fat bits (joy!).  I've been holding off reducing my wobbly bits in anticipation of this meeting.  Hanging on to the wobble for a few more weeks.  Never have I been happier about saying, "yes, I have fat bits, isn't it great?!!".

My risk of breast cancer was so high, 85% high and after three years of waiting for everything to settle down after my LD Flap breast reconstruction (you can read more here) I've finally arrived at the end stages.  I lost a whole cup size and a couple of inches through my surgery, despite being told they would use small implants if the muscle, skin and fat was not enough to match what I had before (I was a perfectly formed 36B when I was a complete woman) yet they were never used.  I'm pretty pleased about that, I never wanted implants anyway but I never expected to be so much smaller than I was.

From the front I look even and proportioned and they appear even but a side profile reveals the loss of volume and I can't find any bras to fit me.  The left is much flatter than the right.  Tomorrow I will go to get measured for a bra fitting and take that info to comedy surgeon.  I'm 63kg at the moment (about 3kg over my norm) and even that small weight gain makes me feel flat chested.  My body spreads its weight well, I'm an all over girl, but my breasts never change size with the rest of me.  I didn't realise how much that would bother me and it was never really explained that it would happen.  The reason is due to the location where the skin and muscle was taken from; my back.  Most people don't put much weight on their backs, unlike TRAM Flap which is stomach fat and muscle, an area where women tend to gain weight easily.  Fat transfer may change this for me, introducing fat from areas of the body that store fat; hips, thighs and stomach and so, as the cells settle in, they will act as they always have, gaining and losing fat with the rest of me.  About 40-50% of the fat injected will be reabsorbed and several visits are required to achieve the results discussed.  The maximum increase is usually two cup sizes.

I'm a little apprehensive but quite excited.  Comedy surgeon has seen me change my mind a few times but this time it feels right.  My time is now, lets do this thing and get on with the rest of my life.

85. Justification for Cleavage

A bit of someone else's cleavage. 

Cleavage.  I miss having cleavage.

I would like enough to

a) wear sexy bras again
b) be able to nuzzle into

If you lost yours wouldn't you want it back if you could?  Well, at least you would look at the offer before you shut the door on it, right? This is a sore subject for some who have had less than sucessful surgery like mine, through implant rejection or cancer and I have deep admiration for those that have been truly scarred for life.  Those women will not scorn me for my choice but rather rejoice in the fact that I have the choice at all.  The whole point of knowing my BRCA1 genetic mutation was being able to choose between life (minus original boobs) and the gambling game of my life and cancer risk.  I chose.  I also get to choose again. I have been given the opportunity to play around with fat transfer for breast augmentation.  I know I said I wasn't vain enough to get them done, but let me explain that when I have tried many a push up bra on (used to be my favourite), I get creases, like old lady boob skin crinkling, going on instead of the full breasty-breastiness of real boobs.  Basically my top bit is a bit empty of boob.  Fat transfer can sort all those bits out a little.

The procedure can take up to 5 hours, its not easy, bruises will be a-plenty on the first visit but the fat is stored for the 2-3 revisits top up injections.  My hourglass figure has become more pear shaped these days and when I put on a few pounds everything puts on weight except my new reconstructed LD Flap boobs.  They look great though, I should be happy but saying no to this would be like waving goodbye to 'beautiful, what you used to have boobs'...forever!!  How can I resist?  Oh the vanity of it all.  I suppose this is the question to myself, am I fully justified? Do I need it? Why do I need it? Just because it is offered to me, should I take it?  I suppose you need to lose parts of your body before you can answer that question.  The answer to myself is, yes. The body sculpting part isn't even part of my justification or reasoning.  It's all about the boobs. Simple.

84. Before I actually say no to the boob plumping

I have just seen some fat transfer videos and can't believe how amazing the results When I was keen on this surgery a while back, comedy surgeon reckons it wasn't really worth it but that was a couple of years ago.  Now the procedure is more common, he is offering it to me and I thought I wanted to be finished as I am, but now I am not so sure.  Maybe I do want a bit of re-sculpting all round - as weird as that sounds - a part of me wants to experiment down the path of 'lets make your boobs bigger with fat transfer' (non-graphic fat transfer breast augmentation video here) and a fantastic before and after photo gallery of natural breast augmentation.

Now I know in my last post I said I wasn't going for this but my 'this will only be offered to you once, you only live once, why not' brain kicks in.  So, I think before I get trim for the summer maybe I should just relocate it instead? I am calling my comedy surgeon tomorrow and telling him I want the complete finish me off works.  A girl only has one life and although I am on my second pair of boobs, they could do with a little enhancing of the natural variety.  Fuck it, why the hell not? 

83. Time to get Nipple-tastic!

Time, as it does, has passed.  It's been nearly a whole year since I last posted and, as usual, its been a mixed bag of life, adjusting, accepting and blossoming in the esteem department.  The revisions that were done a year ago worked out really well (indentations now gone) but there is still work to do and I popped back for a visit to my cheeky surgeon about two weeks ago to discuss the end.  Not any old end, the end of my surgery (I hope) apart from the tattoo maintenance that comes with reconstructed nipples.

For the first time there was no woman present, which I thought was odd but it didn't bother me and I was introduced to the young male assistant I assumed was a doctor in training. 

My comedy surgeon to young male Assistant: "Now this, this is a very tidy breast reconstruction!"

I was unveiled for his perusal.  The eyebrows raised and a pleasant or surprised look crossed his face (probably a mix of both, it was hard to decipher).  He didn't say a word for the rest of the appointment - maybe I scared him a little, I can be a bit motor mouth at times, particularly when feeling nervous or exposed!

My comedy surgeon starts to discuss nipples, how they will be made, explains how they will STICK OUT ALL THE TIME.  Yes, I know this, but it poses a problem.  I hate wearing bras since my reconstruction.  Nothing fits, nothing is comfortable.  You go without a bra for 3 years then try and put up with one all day long...my god it is torture!!  Rip the bugger off at the earliest opportunity!  Bloody hate them - pretty things but not for me anymore.  And so the problem of permanently erect nipples.  How am I going to live with them?  I guess I will just have to let people stare and wonder what type of floozy I am to wander around without a bra on, letting my nips stand out for all to see, all the time.  Well, fuck them...fuck them all.  If they knew what I'd been through physically and emotionally in order to get them then they can friggin' well enjoy them too.  I am not covering them up all the time with a boa constrictor of a bra in order appease their narrow minds about women's undergarment choice.

To the procedure - here's a pic of how comedy surgeon will make my origami nipples:

Having done Graphic Design at college, this strangely reminds me of flat pack designs for packaging for toys but in real life, I've seen a friend's and they look amazing.  I just hope mine do to.  

As for boob plumping, I've been offered fat injections to make them a bit bigger but that might only last for 3 years, and the fat cells may not even take and I don't want to face anymore weirdness thanks.  I've decided that my vanity is not strong enough to want them bigger, despite old grievances about the loss of my perfect 36B breasts.  My new ones are lovely, forever pert, small but beautiful and they just need finishing off.  The ends of my 16 inches of back scars need rectifying again so that's booked in at the same time...UNDER LOCAL ANAESTHETIC!!  Local he said, where I am awake.  WTF? I did ask him if I would put him off with all my talking..and what if I sneezed?  I have no idea how this is going to work but he convinced me that I can in fact have myself cut up whilst I am awake..and I agreed.  Gas and air will be at the ready - maybe I need a training run on that to make sure I don't giggle my ass off (I can do that without gas and air) and end up with extra nipples.  I'm up for the challenge - at least I can keep an eye on them and, as comedy surgeon says, I will find it fascinating! True I guess.

So I await my appointment for the knife, again.  Hopefully my exams will be over and I can then get on with my summer and getting some areola tattoos done.  

The end is in sight.  Smooth and sticky out I shall forever be!