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!

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.

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.

82. Unveil the revisions nurse!

A lot has happened since post 81. Bouncy Ball Therapy so I will try not to waffle on.

The update for today is really that I am fresh from a visit to see my GP nurse, after having my revision surgery unveiled for the first time. I can tell you, I am elated. I have suffered this last 18 months with my neck, back and muscle cramping spasms in my chest. I feel so much more comfortable today, despite the soreness and stickiness of my skin from removing dressings and sutures. The band of tightness has reduced and although it is still there all the time under my arms, my reconstruction breast muscle has been released from that spasm. I am relieved. I risked losing my flaps if the blood supply was cut by mistake but my surgeon did good.

Background story
SKIP if you know my story of reconstructed boob spasms and whining about neck pain. FIRST TIME readers - heres a brief low down...

It has been 18 months since I really re-entered life again after my LD Flap breast reconstruction some 9 months prior. I started Uni so I could retrain after being made redundant from my job. That was September 2009, and after only a couple of months back to a basic but normal life, I started to go downhill physically with weak back, neck and shoulder strength. I wasted a year of Uni because my neck was getting worse, not better and lots of typing and sitting down doing my computing course were not helping. I even had to rethink my career path because of my neck and spasm issues. I felt better being more active but without lifting weight or typing lots. I decided on an Extended Science BSc course and it has been challenging with all my appointments this year; with physiotherapists, doctors, surgeons, hospital, all on top of my studies but I made it through and did pretty well this year. Very pleased indeed!

To summarise, it has been a tough 18 months (with added complications which I don't need to bleat on about right now) but 7 days ago I had my 4 hour revision surgery with the lovely Mr Camp, my seriously wonderful surgeon. My overlapped nipple patch sections have gone - now smooth, my dog ears have gone - now smooth, lengthening my scars to about 8 inches each on my back and I have two new scars, one inch each, vertically, under each armpit through which the spasm causing nerves for the LD muscles were hunted down and snipped. I have decided to get some will be getting some photos posted soon of my whole process but was feeling a little shy before but I feel it is time to share it as I am quite proud of what surgeons can do for women in the predicament I find myself in by being BRCA1 positive.

I had my surgery at Derriford Hospital under the superb care, level headed and joking manner of Mr Camp, a plastic surgeon and the staff of Freedom Ward and Lynham Ward were brilliant. Short staffed but calm, friendly, helpful and kind. I stayed overnight with some great people under the weather with an interesting selection of different physical issues. An unstoppable nosebleed, implants balancing odd breasts, an ulcerated throat, a thyroid gland removal and a leg injury..oh and me with my breast reconstruction revisions and denervination of muscles.

Clean, infection free, comfortable overnight stay with extra helpings of toast and jam for breakfast please. You were all brilliant!

I, on the other hand, am healing very well and looking forward to going shopping for summer vests that I now feel I can wear without conscience of onlookers staring at my indented nipples patches (paddles) through my tops. I am still not sure if I will wear a bra again. So many friends have commented about how nice it would be not to wear one ever again and I am so used to it. I might just get some nude coloured covers like these after I get some little nipple bumps done - not sure I want anything too much of a nipple really - and these would help cover them up in sheerer clothing. Nipple Patch - Silicone Petals

59. Time for a check up..another flash episode

I've lost count with how many times I've had my boobs inspected now. Today I will go to see my surgeon and breast care nurse who will rate the progress of my new boobs.

As a woman I have a few little things I would like sorted out, after all I am a healthy, young woman with a figure and lost a great set of boobs to all this and I would like some reasonably nice ones to keep in exchange. Sometimes I feel like I am being picky but actually, I have decided that it is MY body and I want it to look good. I have already dealt with the loss of a cup size and I didn't have much to give away in the first place so the least they can do is snip off my dog ears (the ends of the scars on my back near my waist that stick out) and nip and restitch the muscle in my left boob which is not the same shape or hanging the same as the right one. This will cause me problems with ever wearing a bra again as they are at different levels and the underwired bras, the pretty ones that can also give you some extra if you want it, will hurt me. I have a long way to go before I get to wear a bra again but I am planning for the future. I have a school prom to attend with my husband next month and I have to wear a dress without revealing my still kinda scary looking scars on my back, my sticking out dog ears and actually fitting a dress cup. The problem I face now is I used to be an all round 12 and not my upper body is a 10 and my lower is 12. I have come a pear shape and I hate that. That is the thing I am struggling with. My body used to be balanced, equal, in proportion and now I am bottom heavy. I can't explain how upset this makes me, even as I write this I well up. I didn't really appreciate how beautiful my body was before, how perfectly designed, how balanced it was. Now I have a distorted view of myself and I know I will get over it with time but right now, I struggle.

So, I will update my blog later after my appointment. Right now I have so much to write about but trying to stay off the internet to let my brain rest. I think I will do some retail therapy at the garden centre and cheer myself up on the way back, pick up some new bird food to feed my hungry couples who increasingly frequent my bird tables and in turn they will bring their new families to my garden..and hopefully return as adults in the hard winter months. Right now though..spring has well and truly sprung.