Breast Reconstruction is a complicated thing. Especially when you are small in stature. Especially when your scars misbehave. Especially when your name is Amy.
It is completely different than Breast Augmentation, where one is just getting implants.
The difference with reconstruction is that there is no tissue to work with. Breast tissue is taken during a mastectomy, and what is left is chest muscle and skin.
I have history of having issues with my reconstruction. If you have been reading this blog and my cancer story awhile, you already know this. I started out very happy with reconstruction surgery results right after my mastectomy. But, then things settled and my right implant decided to have some fun and slide down a bit. I had that fixed August 2011 and all was well–for a short while.
Enter keloids. A keloid is an over abundance of scaring. You know the singer Seal? He has a beautiful face, but also is known for the keloids that have formed on his face.
I have history of keloids. We have figured out that when I am cut twice in the same spot (like my port scar–once to put it in, once to take it out) I form a keloid.
This happened after my plastic surgeon fixed my slipping right implant. The incision he made was to the right of the implant, toward my armpit area. About an inch of the cut was an area that was already cut once by the previous surgery, and yep, it formed a keloid.
Keloids are treated by steroid shots. If left untreated, they will just continue to form scar tissue. Keloids are stubborn, burn, itch and are not pretty or fun. Speaking of burning, the steroid shots that treat keloids burn like heck, and are not fun either. It takes a lot of courage to walk into a doctors office knowing you are going to get burned. Yowza it hurts!
I had the keloid on my right side treated with steroids. I was hopeful it would help. I’ve had success with steroid shots in the past with my stomach scar from Melanoma (2 time cancer survivor here!) and with my port scar.
But… no such luck. Well, maybe too much luck. It worked so well that it thinned the skin out too much in that area. Over the last 4 months we have been watching it closely, and it has been no fun. The skin is so thin to the right of my implant that it looks like someone punched me in the boob. No joke. Thin skin = blood vessels show through, and it looks permanently black and blue and just simply yuck. It has started giving me pain when I sleep on my side. Doc looked at it and said “if that breaks open we will have a mess on our hands. Time to get it fixed.” Yes…time for more surgery.
Is this too long and detailed for you yet? There is more. Much more. If you are not a details person feel free to stop reading here, and just know that surgery is October 24.
One positive about new implants is that there is a new type of implant that the FDA just approved in the state of Nebraska. It is called Highly Cohesive Breast Implants, but in breast cancer reconstruction world we like to call them “gummy bear” implants.
Before there were only 2 types of implants to choose from:
~Saline =liquid.
~Silicone = gel (this is what I currently have)
And now, there are Highly Cohesive Breast Implant. They are still silicone but when you cut through them it remains a solid, like cutting through a gummy bear.
I will specifically be having Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants.
Pros for gummys:
~The results are beautiful and more natural shaped…like a teardrop type shape compared to just round.
~They are slightly textured on the outside which helps keep them in place, and we all know I want that..no more slipping!
~They won’t leak like saline and silicone tend to do.
~They have been really well received specifically by breast cancer survivors.
~They don’t ripple like saline and silicone do, especially important when working with the thin skin and no tissue of breast cancer survivors.
~They feel very natural.
Cons:
You are limited in size depending on how wide you measure from armpit to armpit.
I only measure 10 1/2 inches across from armpit to armpit, so my visions of a bit more cleavage was not going to happen…or so I thought.
I have visited my Plastic Surgeon a few times talking out my complicated case.
Here is what makes me a very hard case:
~I keloid
~I have no breast tissue to work with.
~I am very small, no fat in the area.
~I tend to form ripples due to how little fat I have in the area.
~To the sides of my implants toward the armpits there is almost a hollow area, it literally is skin and bone. I can feel and see my ribs right there. A typical round implant does not fill that area in at all.
~Above my implants I have tissue. You actually grow breast tissue all the way up to your collar bone. They cut out my breast tissue up to a certain point, and again, since I have no fat it is obvious where they stopped cutting and where the tissue starts. Once my implants settled, it looks like collar bone, then tissue, then no tissue then round implant. Not natural.
These issues caused my Dr. to stare at me from across his big desk and look deep in thought. It was almost a humorous moment. There were headless photos of my naked chest spread out all over said desk, taken in 3-4 month increments over the past 3 years, and he is just tapping his pen with an occasional “hmm” deep in thought. I did not like looking at the photos. I especially did not like how great the reconstruction looked 3 years ago, before I had a runaway implant and before keloids. It was either a laugh or cry moment. I tried to laugh, but my heart was crying and I tried not to look down at those photos on his desk. He finally told me his plan.
He would go in, cut out the thinned skin, add some Alloderm (cadaver tissue that has all the dna removed from it–blech) under the skin in my cleavage area to address rippling. He would take fat from my belly (free lipo baby!) and fill in the “dented” area to the side of my implants by my armpits where you can see my ribs. He felt the new tear drop shape of the new implants would take care of and fill the area above the implants where tissue meets no tissue.
He told me my implants would be the same size I have now or maybe smaller.
Smaller?! That made me sad.
If I’m going to go through another surgery I was at least hoping for a bit more cleavage and va-va-voom!
So you would think the story stops here…it doesn’t.
I saw Dr. on a Friday. I was called by him personally on Monday morning.
“Amy, I’ve been thinking about you and your implants all weekend.”
(a sentence you would only want to hear from your doctor or maybe husband)
He had come up with a whole new plan.
Here it is:
~2 surgeries instead of one. One for expanders. Second to replace expanders with implants.
~Adding expanders –Why? He is worried that after getting rid of the area where the skin thinned out so much, he would not have enough left to do a satisfactory surgery. It gives him much more control as a surgeon to do his art and gives me a bit of control in figuring out what size I would want.
~by using expanders, we can fit a larger implant in, which should fill in both the upper rib area by my armpits where I am skin and bone AND where non-tissue meets tissue above my implants. No free lipo with this plan, but also no new scars in stomach area which could keloid.
~by using expanders we can fit a larger implant. That was worth saying twice. {grin} We will still be using the Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants.
What this means:
~surgery October 24 to add expanders. (would you believe I scheduled surgery around our yearly trip to the pumpkin patch? We go the 19th, and I don’t want to miss out!)
~trips to Omaha (one hour drive) weekly to get expanders expanded.
~being slightly entertained by seeing my breasts grow every week
~4-6 weeks of expansion, depending on how quickly I expand and how big we want to go.
How I feel:
~relieved to have a plan Dr. feels good about
~taken care of by him as he thought about me and came up with the best plan
~apprehensive about 2 surgeries.
~apprehensive about the experience of expanders. I remember a fellow survivor explaining that they are hard as a tortoise shell and uncomfortable. The minute you get comfortable, it is time for more expansion.
~hopeful to have a good, va-va-voom outcome
~tough because I know I can handle it all
~scared because I have not had to go through surgery in so long. I feel out of practice! Bravery seems to come easier when I’m in survival mode. Not that I want to be in survival mode!
If you are still reading you deserve a medal. Truly.
Thank you for caring about me and my…ehem..breasts.
Billynda Griffith
July 8, 2015 at 1:23 pmI just came across your site when I was searching for ‘surgery gifts’. I make lip balms, and I am trying to come up with a clever way to make the label 🙂 I’m a young mom who had to go through this too! (At 26, while pregnant – I’ll be 33 next week, and looking back, I can see all the blessings God gave me during those dark days) Hope you’re doing well!!!
JacquieLeigh
November 10, 2013 at 7:44 pmAmy,
I am sending you healing blessings and warm wishes for what I know will be a successful series of surgeries. I know that spirit will guide you through these next few months. You are already affirmed as the perfect being that you are, in perfect health, mind and spirit.
viepourcettetemp
October 26, 2013 at 5:48 pmAmy,
I thought I had read somewhere that you had to have surgery again and so I looked up your page. I will be thinking of you as you have had the first surgery and are settling in with the expanders. It sounds painful…but I am thankful that you are in remission in both cancers you have fought. I am also so thankful for a dr who looks for the best possible outcome for you. May the Lord give you strength as you journey forward and continued wisdom to those helping you in this healing journey. I’m excited about what those new silicone implants have the capacity for doing in so many people’s lives. thank you for sharing about them. Praying that your body accepts them well and that your other incision sites heal without the hard scars forming. be blessed friends.
Michelle McNiel
October 26, 2013 at 1:51 amAmy, I have followed you and shared some of you wonderful things from your blog on Pintrest. Even though I don’t know you, I consider you a friend. I ask the Lord to bless and protect you everyday. You are such an inspiration and I will continue praying for you complete and restored health in Jesus name. Thank you for all you do!
AmyT
October 25, 2013 at 12:28 amYou are going to do great. Just float with it and it sounds like some of the tissue expansion will be during the holidays which is a good distraction. No complications allowed! I’m rooting you and the gummy bear boobs on and hope you get the results you want ultimately. Just take it a day at a time and let the doc visits be the time to plan and project into the future. It’s today that matters. Get some rest. Oh and I have keloid scars in a few places just due to my skin type or something. I’ve had some experience with the fact that if it takes longer to heal, it keloids. I stupidly once put some peroxide on a surgery incision b/c the very edge of it looked red. (I think a knot was under the surface and trying to poke thru). So, stupidly i put on some peroxide on a cotton ball and thought it’d “help” it heal. NOT so much. Don’t use peroxide for your kids either. It apparently hinders wound healing. I think the thin skin coverage via your own tissue sounds like a way more appropriate option since you have the ability to grow some. NOT fun but better than having patchwork skin. I imagine that they will have less incision lines than with a patch of donor skin or can contour it to your body shape. Take notes on how you’re healing and what you’re doing and what the scar comes out like this time. That’ll inform you on how to maintain your body for next time. Include stress factors, nutrition, hydration and how you manage your wound care. Maybe journal it. Sounds tedious but might help going fwd to prevent those scars. Luckily mine are just a knee one that’s faded and just slightly raised and one behind my knee sort of so it’s not very visible. Hang in and breathe.
Helen BC
October 17, 2013 at 1:02 pmwell my expander had to come out due to severe infection (Cocci) provably contained one of the pokes/fillings and I am letting my body to heal properly for next “round/try” may be next year …. however what helped me with scar tissue was a “Massage” – Coconut Oil or Magnesium OIL (for good “sliding”) and Chinese Cupping (I prefer Silicone cups over glass) … even I had 3x cut on the same spot due to daily 3min massage area is in very good shape and not too much inside scar tissue build up.
Janis Cano
October 7, 2013 at 8:19 pmI’m at a loss for words to convey the impact your ‘journey’ has and has had on people… your willingness to share your story..to be vulnerable…. sharing details you’d rather wish away….is encouraging. You will be in my thoughts and prayers as you do your first surgery…. I know the Lord will be there with <3
Anonymous
October 6, 2013 at 9:10 pmYour post made me laugh, just cuz your funny and cry cause, because I remember when my mom showed me post mastectomy surgery body. So praying for you and all that comes with sucky cancer. You are a champ!!
-Rebecca
So Many Little Things
October 6, 2013 at 3:53 amI’m here smiling and cheering for va-va-voom! I’m so glad you shared this!
Peppermint Ph.D.
October 5, 2013 at 2:27 pmAmy, I just can’t thank you enough for sharing your journey. I think strong women opening up and publicizing their intimate battles with this evil disease helps spread the word. “Breast Cancer” becomes alive then…and not just a common phrase every October. Hang in there!!
Darlene Colwell
October 4, 2013 at 4:53 pmAmy, I hope that all goes well with your upcoming surgeries and that the result are va-va-voom perfect!! Thanks for sharing your journey with us!
amperezrosales
October 4, 2013 at 1:33 amHope it all goes as smoothly as possible. There’s a lot of breast cancer in my family so I would be not at all surprised if I have to face it some day. I hope that if that time comes, that I can do it with as much grace as you! Thanks for sharing your story.
Linda@Creekside
October 3, 2013 at 11:01 pmYou are brave and strong, Amy. And your honesty is refreshingly inspiring. I’ve learned a lot here tonight. And I’ll be back …
Praying for you, cheering you on! Va-va-voom, girl!
;-}
Karen Gerstenberger
October 3, 2013 at 8:29 pmAmy, you are brave and your honesty is a blessing – it frees everyone around you to be honest, too. I am grateful to know that you have your wonderful husband, daughters, extended family, friends, and above all, your faith to support and sustain you as you face this new “adventure.” I pray you will have a successful surgery, an easy recovery and an outcome that relieves your physical discomfort – with all the va-va-voom you could wish for!
Nothing But Blue Skies...
October 3, 2013 at 8:05 pmYou are such an inspiration! Keep your mind focused on the prize. God is good. He will bring you through it. I know what you mean about being in survival mode. (I was in that mode during my 6 months of chemo) As a colon cancer survivor of 4 and a half years, I remember what it feels like to armor up for battle. You just DO what you have to do, right?
I will be keeping you in my prayers. You are such a strong woman! God has a plan for you, take comfort in that. I hope all complications are minimal, and you heal better than anyone expects.
P.S. – Not that this would make a huge difference with Keloids, but I drank Aloe juice before and after my surgery to help soothe my skin and aid in healing. I think it helped a bit, and certainly can’t hurt…(I too, had a nasty scar after my port removal.)
Best to you and your family!
xo-Lisa
Jean
October 3, 2013 at 6:09 pmI so admire your attitude and strength! I pray that your surgeries will be successful.
Sheri Bennett
October 3, 2013 at 5:14 pmAmy, I am in awe of you and how strong you are and of a God that watches over you so well that He gives you a doctor that goes above and beyond. Maybe we need to fatten you up a little so that you’re less of a problem child! 🙂 I’ll share some of my tissue/fat–I’m sure I have MORE than enough so I would be happy to share! wink wink! (But seriously, I would definitely do it if it’s possible.)
Kristin
October 3, 2013 at 4:25 pmI am also a breast cancer survivor (11 years now yay!). I don’t have keloids- but most of the other issues that you have. One of my implants got a tear in it (even 10 years ago there were gummy bear implants- so no leakage). I had them replaced in January with the new, shaped implants. I also have very thin skin and not much of it- and lots of scarring. I am very happy with the results- but they are a little smaller and don’t have as much cleavage up top. Because my skin is so thin- I actually think there is a bit more rippling- the implants are a bit thicker. The biggest bummer is recovering from surgery- drains, no driving for a few weeks, no lifting your arms above your head, etc. But now that it is over- all well worth it and I love the shape of them. Email me if you have any questions 🙂 And good luck!
Amy Bowman
October 3, 2013 at 5:26 pm11 years! Whoop!! Love that. ohhh…so the shape is new…and just recently approved in my state. Do you know what size you got? Yes, I needed those reminders about surgery healing…it has been awhile and you tend to forget. Bummed cuz I just got into a good routine of yoga…wont be able to do that for a while! So glad your outcome is one you are happy with.
LaNita Copeland
October 3, 2013 at 4:02 pmYou are one of the bravest women I know. If I ever have to endure an inkling of what you have already gone through, I hope to have a brilliant friend like you by my side! God Bless!
Amy Bowman
October 3, 2013 at 5:21 pmoh thank you! I have many brilliant friends by my side that makes me brave…all of you!!
SusieE
October 3, 2013 at 4:00 pmExpanders are not fun, but they are temporary. I worried that my final shape would look like the expander, but it doesn’t. My PS told me that they tend to push our toward the armpit, but that doesn’t mean your implant will live there!
I found that my weekly fill made me grouchy, ( the more accurate description starts with a b…) It isn’t incredibly painful, but the constant pressure got on my nerves. It is sort of like having your braces tightened. I found that a glass of wine at bedtime worked much better than the muscle relaxers.
You have been through way worse, and you can totally handle this.
Praying for you!!!
Amy Bowman
October 3, 2013 at 5:20 pmthankful for the “heads up” of the grumpy. Another thing to prepare for and makes much sense. They do sound very irritating. Good thing Trader Joes has cheap wine!
Katrina Johnsen
October 3, 2013 at 3:08 pmSuch an amazing attitude you have. Keep the faith knowing God holds you in His hands. praying for you!
Amy Bowman
October 3, 2013 at 5:21 pm🙂 You should have seen my pouty self this morning…frustrated with med side effects. Your comment made me do an attitude check and lifted my head. Thank you!