Pink Ribbons ~ The First Visit with a Plastic Surgeon

This is a copy from my journal dated October 2010 while I was going through treatment for breast cancer.  I opened the journal to share with others who are going through treatment or have loved ones doing so.  It is not current events and it does not substitute for medical doctors.

Tuesday morning, my birthday - was difficult.  I was getting dressed, putting on makeup to give me the confidence to speak to a plastic surgeon. Let me tell you that is intimidating...knowing how often they look at perfect bodies. In the process I found that sometime between Sunday and Tuesday I had lost nearly all the eyelashes on my right eye. It stinks! I can draw a fake eyebrow but I still have eyebrows. They are lighter but quite adequate. 

But the lashes...I have like 10 lashes total left. The left eye has lashes missing in spots.  There are blank spots but when I add mascara you see the blank areas very clearly. Ever tried to put mascara on one eyelash? It doesn't happen. It was deflating. I felt like everyone at the hospital was looking at me and wondering “what is wrong with her eye!”

We loved Dr. Puckett.  I had been told by some of his patients they loved him.  Then others told me was kind of serious and reserved.  Totally not that way with me.  The resident noted it was my birthday and told me it was also Dr. Puckett’s birthday.  He came in and I sang Happy Birthday to him, and told him it was mine too.  In seconds, we were laughing, joking with each other and I thought he was pretty spectacular. 

His resident was very good too, so cute and that was awful. Picture a cute man picking up your boob cupping it and lifting it up to wherever it should sit. (Apparently laying across the tummy isn't the desired position.) lmbo But it was uncomfortable to have a Matthew McConaughey lookalike playing with your boobs with icy hands. Of course the girls perked up...the betrayers. I told him his hands were freezing – like this was the reason! He agreed it was cold thank goodness.

He was clear. He explained Dr. Puckett does the surgery I want - implants. He went over the other options tummy flaps, back flaps...I told him I wasn't interested for a couple reasons. It was a much more painful recovery and longer. You have to be in ICU for 2 days to make sure the flaps blood supply stay intact.  But also I said I have to lose weight again to lose more estrogen in my belly. And I lost boob bulk from losing 70 lbs. I don’t want to do those surgeries and lose my new boobs in fat loss. He agreed that could certainly happen.

The other reason...I have gone through pain, nausea, vomiting and the two - three surgeries.  I want, no I DESERVE perky boobs as my reward for getting through this.  The resident’s name was Dr. Daniel. He tried to not chuckle but I told him he could. So he did and he told me that it was just as valid as any other reasons.

So what happens is during the reconstruction, they place the spacers behind the muscle walls. Then they inflate the spacer with a small port (I will have so many freaking ports in my body.) using saline at that point.

I want a c cup at finish. So every week they will pump up the saline a bit more until I get to a c cup. Then we wait for 4 months… FOUR months. You decide in that time if you like the size...are they placed well. Are they symmetrical? And your body takes the time to adapt to the change in anatomy. After the FOUR months, you go in an outpatient surgery to have the spacers pulled out and silicon implants are replaced. Then after you recover it sounds like you are done. That was the good.

Now the not so good. I had one lymph node biopsied and it was positive. I don’t understand the roll of chemo if not to kill cancer cells. So isn't it feasible that since it was only a few cells that chemo could have eaten the whole cluster? I know you aren't qualified to answer.

So I learned that at my surgery they will most likely do an axillary dissection and send the whole section of lymph nodes off to be checked. It will take 5 days to get the results from the pathology. What the plastic surgeon prefers to do is to NOT to do immediate reconstruction at that time. For the BEST results he wants to wait and get the axillary lymph results. If I don’t need radiation then we would schedule a new surgery about 8 weeks later to start the reconstruction. :( However under that same plan...with no tissue stretcher in place, if I do need radiation, he will not touch me until I am a YEAR post radiation!!!!! I held it together there but I was dying inside. They don’t have experience with my oncologist or surgery doctors.  Dr Puckett is an University physician so he’s only used to University doctors. I asked about going ahead and placing the expanders.  Going ahead and doing a little expansion to give me Something for my clothes. He said we could do that. But he said often the radiologist will request they be removed for radiation. :(( sigh  He said there was also the concern of how my skin would react to radiation. It could get hard and encapsulate the expander, making further expansion difficult. If he places the expander, he can pump me up a bit, let me do radiation. But I would still have to wait an entire YEAR for the final expansions and implant surgery AFTER the four month settling time. He said there was the risk I could wind up with a hard gnarly boob...not the best results. So I talked it over with Kel. He is the only one besides doctors and nurses who see my boobs..although right now that seems like a few hundred people. My final desire is to wear pretty bras and look normal in clothes. If I have a hard gnarly boob...undressed won’t bother me.  So K and I decided that we were okay with the less than the plastic surgeon’s ideal results. So I called Dr. Bryer, the radiation oncologist. HE said he has never had to ask for a spacer to be removed to complete radiation. He's never asked someone to go for wait for reconstruction. I asked about encapsulation. (An inflexible pocket around the expander or implant). He told me there is the occasional issue but to keep in mind women who do not have radiation also have had the complication. It was up to DNA and skin type. IF I had to have radiation it would be the arm pit and skin, not deep into tissue like with a lumpectomy. So it is crucial that I not have radiation. Please pray with me it will not be needed. However we have decided that I have will have the reconstruction and expanders placed. I will believe in faith that radiation won't be required. If it’s God's plan to me to have it anyway...well I will have a little boobies made of saline for an entire freakin’ year before I get the real thing. But it will be something! I read a case of a woman who had not done a reconstruction. I don't know why. But she was extremely anal about being seen without her "boobs" on. One night while on a business trip the fire alarm went off at her motel. She threw on her clothes and ran out to the parking lot. She looked around and everyone else was in pjs and robes. She realized it had been more important to be seen with her boobs than dying in a fire. She then got a reconstruction. I told K I didn't need perfect looking boobs. I just needed to feel womanly in a bra and in a dress. Mom goes without her boobs at home. But if she knows company is coming she’s hitting the bedroom to put them on. I don't want to have to think about them that much.   So I have all that to think about. The day got worse when we got home.  Our sweet, old Pomeranian Bandit was in respiratory distress.  He had been struggling for 2 years, having the occasional seizure that was awful to see.  He had been on prednisone for serious skin allergies over the years and we knew that would shorten his life.  He was a pretty special, our pomeranian we had him since he was 8 weeks old. He died that very night.  Yes, the night of my birthday.  I don’t know if we will ever celebrate anything again. That was wretched.  He died in hubby's arms.   We didn't know he was that close to death, but knew he was not doing well.  We made arrangements for the vet to put him down and then Bandit acted a little perkier so we thought maybe we made a hasty decision.  But he quickly decompensated and died before the vet could arrive.  It was awful to watch, and Bandit was more hubby's personal companion than mine....he sobbed.  I cried and I'm sad, but his heart broke. It’s been such an awful week. I'm weepy and sad. It doesn't take much to get me crying. My sister sent me a picture mail of mom sitting up in her hospital bed and grinning. Yep I lost it!

Sally - well that's really crappy about the lymph nodes....that’s scary.   Praying you don't need radiation.    I saw this today and thought this might give you a laugh.  Boob hats for breast cancer awareness.

Rosey - that is crazy. I have thought about baking boob cakes when I can get back to ladies bible study. Wonder how they'd like wearing boob hats too. lol 

Tricia - Continuing to pray about the things you stated...and I just have to tell you, the part about the eyelashes really got to me.  I'm so sorry for you about that.  There are hats and wigs and things for our heads, but eyelashes?  That's just not right. Just my opinion. 

Pink Ribbons ~ Three’s a Charm

Pink Ribbons is a feature series I have started that is posted every Thursday.  I am a Pink Ribbon Warrior, having gone through the chemo, surgery, radiation, the year of waiting and recently stage 2 reconstruction...which I find is really the first of many little surgeries.  I am at a place in my life where I am willing to open my journal from that time and share with you my anger, fears, challenges and pain of finding out you have cancer.   This is me sharing with you from the other side of breast cancer.

 
These are not current events, events are from October 2010

I apologize for the length of time since the last post.  My family is in flux at the moment and my access to the internet is spotty.  I am now going to attempt to upload blog (I've still been writing offline.) entries weekly and scheduled by blogger.  I'm sorry for any distress I may have called.  I DO not have a re-occurrence of cancer as a concerned reader emailed to ask.  ;)

Chemo last Friday went pretty well. Dr. wasn't happy with the nausea and vomiting I had previously. So he worked up a whole list of meds for me, some IV for the chemo infusion and some to take orally here at home. THOSE were not cheap, as we had to go to a non-provider pharmacy but the insurance will reimburse us about 80% of it. Let me tell you they knocked me on my butt! They kept the nausea down for sure. I just had a little up til Monday and it was gone. But sometimes the cure is almost as bad; I thought I was going to crawl to the bathroom a few times. I was so lightheaded; everything was so bright and whitewashed....I was not digging it!

I had the Neulasta Injection a couple of days ago, but he reduced it to a half dose. IF it’s going to fire up my bones it will be tonight. I can feel my bones kind of tuning up now. One bone will throb and it will stop and another will start. The nurse giving the shot suggested I start taking the Percocet at the first throb of pain. I had more muscle and joint pain earlier in the week from the Taxotere. I run fevers with it too. Its not fun and it hurts and slows me down. But it never gets to a level where I’m gasping in pain. It’s more of a groaning, “want to cry” kind of pain. Everything just throbs, walking is pain and a serious chore. But it’s like a level 6 at its worse. I mean it hurts, and moving is hard but I’m not crying out in pain. :/

When I was at chemo, a woman from the American Cancer Society came around and gave everyone a little gift. It was a tea cup with chocolates and lip balm and lotion samples. You KNOW that I was thrilled with that.

I told Dr. Joe about mom’s surgery and how family had forbid me to go. He said as far as my treatment...her surgery was scheduled perfectly for me. 2 days before chemo MY LAST chemo! So IF I feel up to it, I’m going to the hospital. If I’m still having pains I won’t attempt it. It’s still two weeks away and things can change a lot by then.

I had a laugh last week when I went to Kohls to check out their breast cancer awareness display. There amongst the therapy socks and gloves were "quick dry hair clothes" with pink ribbons embroidered on them. They are supposed to soak up moisture and dry your hair faster. I know I have had such a hard time getting MY hair to dry. I burst out laughing. People probably thought I’d lost it, standing there - bent over and holding my stomach and laughing with tears in my eyes. It just struck me as hilarious.

This week K and I have had a few giggles as we attempted to dry my hair. lol It’s good to have a mate who is right there with me in this. One day he surprised me with a banana cream pie...oh my. I asked him what he was going to eat? He thought I was joking. So I let him have a piece, maybe two. Since he also surprises me with the occasional chunky monkey....I thought I could share.

Linda –

That is rather ironic and funny about the quick dry cloths being right next to cancer paraphernalia.

Thanks for the update! Be sure and take your doctor's advice and take the percocet. My former doctor (now retired; I miss him!) always said that the pain is faster than the medication, so don't wait until the pain is unbearable to take your percocet.

I am praying that your pain eases and that you're able to be with your mom when she has her surgery, and praying that her surgery goes well.

I hope you don't think it's silly, but I also prayed that you'd be able to taste the chocolate. (((Tina)))

Rosey –

No Linda not silly. I consider chocolate an essential food group. :) I have taken a pain med already as I can feel the bones are amping up. I can groan through pain at a 5 or 6 so if it stays below I can deal with it. I’m sucking on banana pops to try and stay hydrated too.

The funny thing about the hair towels was that they were pink BCA merchandise as well. I know that people without cancer buy the pink ribbon stuff in support of someone or as a donation. I thought it funny that the merchandisers or the store didn't consider how a survivor would view the towels. I choose humor but I have a friend diagnosed the same day who is having a really hard time. October is beating her up because she feels everywhere she turns; the world is shouting she has breast cancer. :( I’m kind of enjoying all the pink. It’s like the world is supporting me in recovery!

She’s still working and that just seems impossible to me. My father worked all through his chemo and radiation treatments and now I understand how much he suffered and how hard it was. He told me that there were times his coworkers just carried and covered him. I’m even amazed that he got up every day and went to work. He’s been gone nearly 10 years but I wish I could go back and give him a hug. For years, I would go home for the week of his chemo. His chemo was every day for one week a month. That week I was there to cook, clean and run their errands. Now, knowing exactly how hard it is, I’m so happy I was there for him.


Tracy -

I'm glad you saw the humor in the quick dry hair cloths. I truly believe that a person's attitude does affect their healing. Your sense of humor is keeping you sane!

Pink Ribbons Post - Am I Going To Die?

Pink Ribbons is a featured series of my blog about my journey with Breast Cancer.  

At the bottom of the page, you will find the links to the other posts.  

I am currently "No Evidence of Disease" (NED)

7.29.2010
 I got the results from the biopsy.  They confirmed cancer, I have it in the lymph nodes already.  The Radiologist called yesterday to tell me herself.  Hearing 'you have cancer' takes the wind out of you.  When she told me it was in the lymph system, I started to shake.   I dropped the cell phone and KJ thanked her for calling so quickly.  She told him I needed to schedule an appointment as soon as possible with a surgeon.  I remember a keening kind of cry and then I started rocking back and forth, sobbing.  Kelly wrapped his arms around me.  He took today off for this very reason.  I clung to him, while he assured me that he will be going through this right beside me.  He told me, You don't have to do this alone but you have to fight this.  To think that my mom and my dad and my lovely aunt Doris all heard those same words.

I kept thinking "I'm going to die.  People in my family don't just get cancer.  They die from cancer.

Actual post of 7/29/2010 to my WOW girls

Oh my dear friends. I know this upsets your apple carts too. Though only a few of us have met in person, we have shared so much in our lives with each other. I am fine with anyone sharing this with prayer partners or women’s groups. I think it hits close to home for everyone with breasts.


I had no idea there was any issue with the boobs. I do self-breast exams nearly every shower. The radiologist said without the mammogram I would not have felt this tumor for at least two more years. By the time I would know there was a lump...ca could have been all around the body. This mammy, allows me to get this treated before it is throughout the body. 

I'm having a pelvic ultrasound tomorrow. That one scares me. I was supposed to have gotten it done in May but the hospital says they never got the order. They called this morning and KJ told me we need to know if there are any ovarian issues before talking to the surgeon. *gulp* He's right. But IF I had breast AND ovarian ca...Just pour me into a rubber room.

Several people have texted today and offered to drive me to appointments and one friend has offered to leave us her extra vehicle for weeks, if I have clusters of appointments. 

We will be working to get the house all cleaned up this weekend. I came home from moms, it was cluttered. With days of in and out, it looks like a laundry and paper bomb went off in it. Have you ever questioned...if I died in an accident today what would people find in my house? blech not a pretty sight. I just look around when leaving sometimes and hope I get back to pull that underwear off the ceiling fan.  Not that I have underwear on the ceiling fan here...I don't have ceiling fans.  lol  

The surgeon's visit is next Monday at 10 am. This is a 'new to me' doctor. My old surgeon doesn't "do" breasts anymore but said he would do my surgery because I'm a former patient. His first appointment wasn't until the 19th of August and no way could we wait till then. KJ's mantra is…get it out, get it out! So I opted for another surgeon and just took the one available. His name is Etters. I don't know anything about him. But his nurse, Mandy called me to get some information. She was amazing and very reassuring.  She's working on scheduling all the tests now.

***

Monday, August 2, 2010 - Got a call a little while ago that Dr. Etters wouldn't be available for my 3 pm appointment today. He found out he had OR on call. So he told them to reschedule me first pick as "she is a young woman with new cancer so I know she's scared. Schedule her first over the returns." He may have just won my heart with that comment. :) You know how everyone falls for their OB? I wonder if the same thing happens with a surgeon. 

Fighting Cancer is hard when 

you’re afraid you’re going to die.

Recommended Resource - 

Navigating Breast Cancer

Lillie D. Shockney, RN, BS, MAS

Administrative Director

John Hopkins Avon Foundation Breast Center

University Distinguished Service Associate Professor of Breast Cancer

John Hopkins University School of Medicine

Department of Surgery, Gynecology & Obstetrics

Associate Professor 

John Hopkins School of Nursing

Baltimore, MD

Breast Cancer Survivor

Pink Ribbons Links:
#4  Scared
#3  This page
#2  When They Tell You Have Cancer
#1  The day They Said Cancer.

Pink Ribbons post - When They Tell You, You Have Cancer

Pink Ribbons is a featured series of my blog about my journey with Breast Cancer.  

At the bottom of the page, you will find the links to the other posts.  

I am currently "No Evidence of Disease" (NED)

 

Rosey's Story

I can't describe the buzz that begins in your head when a tech tells you to come to the ultrasound room. "There is something we want to investigate." I was here for a routine mammogram! This was not how it is supposed to go!   She was supposed to come out and tell me it was okay to go on home!

I laid on that table in total disbelief. I remember looking away, asking 

"God...really? Are you sure about this? 

Do I really have to do this?" 

And then my next thought was about my husband. He's out there waiting for me and it's already been considerably longer than expected. I asked them to go out and tell him I was having more tests. They did but it turned out they alarmed him even more, because they would not tell him what was going on. "She is having more tests" is all they would tell him.

We are a single vehicle family. I am a home maker. He has a new position at the Hospital where he works. It's a stressful position and he has new hours. 8 - 4:30 doesn't leave a lot of room for scheduling appointments. So even though this date, is our 31st wedding anniversary; I had scheduled an appointment for a routine mammogram.

Still I told myself they are just being cautious. This was not really happening.  I struggled to hold myself together. Just a few moments into the ultrasound the Radiologist came in and told me "I am certain this is cancer. It is ductal carcinoma." 

And just that quickly she changed my life. 

In that moment, something in me gave way, like the way the ocean waves dissolve the sand castle.  There was a kind of shift where denial is left behind and you face a different future with a cold sweaty, absolute horror. You are facing the Unknown. It made me shiver.

She turns to me and speaks, "I'm here now and I can do a biopsy right now and get that out of the way or you can go home and schedule a biopsy at another time." My blood went solid. I tried to speak. My throat is so dry. I cleared my throat and tried again.

"Are we talking about a needle biopsy?"

She nods and tells me "We can do this now, so you have a final answer. I am certain this is cancer, but I understand that you need the confirmation. But if you would rather, you can schedule to come back to have it done later in the week."

"NO!" my mind screams. The idea of waiting around with this THING inside me, is something that makes me shake. "Where is my husband? I want my husband." They told me that men are not permitted back out of respect for the other women. I nodded because I think that's what I'm supposed to do. But this sucks.  I am alone and trying so hard not to panic, not to come unglued.  The technician gently takes my hand and squeezes. Tears drip from my eyes, collecting in my ears.

I know what KJ's answer would be. He would tell me to get the biopsy now. So I tell them, "Go ahead." Then I ask them to please send someone to let him know that we are now doing a biopsy. They do. But when he asks, why? They won't tell him. He told me later that he knew then. I wouldn't have sent someone out to him, if it was something normal.  So unknown to me, he sent out a panicked prayer request by texting our pastor Jason and his wife Marcia. "Pray for Tina. She was having a routine mammogram today. But she's been back there over an hour and they keep coming out to tell me they are doing more. They won't tell me what is going on. So please, pray."

I turn my head away as the Radiologist takes her position. She explains that this biopsy tool looks similar to a large syringe. The needle is large, a 16 gauge needle. I cringe. I know what that means. It is a huge needle. She explains that I will feel a pinch, then a sting. She will cut a tiny incision to insert the needle. "Whew," I told her. "I wondered how you would get that garden hose through my skin" She pats my arm and knows what I know. I'm just trying to be brave. I'm willing myself not to panic. I'm trying to cope with humor. I tell myself just one breath at a time. In and out...concentrate on breathing.

"Really God?" Are you serious? 

Have I not dealt with enough in my life?"

The room is suddenly freezing. I started actively shivering. The hard surface I'm lying on isn't helping my herniated disc, but I barely acknowledge the muscle spasm. The room is silent but for the soft whir of the ultrasound machine. There's the pinch and the sting. I can't believe this is actually happening to me. Now I understand the concept of living through a nightmare.

As she takes the biopsy, the device makes a snapping sound that makes me jump. "I will take a biopsy from two positions on this tumor. It is a small tumor, Tina. You caught it early." She adjusts the instrument. Another snap and another jump. "Tina, you will need to make an appointment with a surgeon. Do you have a surgeon?" Have a surgeon? Does everyone have a surgeon in their contact list. It so happened I did. "Dr. Pitt did my lap band."

"Oh, He is an excellent doctor. You are in good hands. He's a wonderful breast surgeon." Despite my resolve to maintain some dignity, a tear rolls down my face. I have to hold things together. I want things to slow down. I can't believe I'm now talking about surgery. She is STILL talking. "If there is no involvement of the lymph nodes, you can have a lumpectomy. If there is involvement of the nodes...well he will go over your options." Silently I tell her, there will be no lumpectomy. These breasts have betrayed me.  In 2005, I had a cancer risk assessment done.  Because mom was negative for BRCA 1 & 2, I was told I was at no more risk than the general public.  Now I feel anger. I could have had mastectomies before I got cancer.  The question crowding my mind is "how much cancer do I have?"   I already know, I will choose a bilateral mastectomy.  I won't go through this again.

The Radiologist is speaking again. I strain to hear her over the machines. "Tina, there are 2 lymph nodes that are a little large. Not grossly large, they are just on the big side of normal. But since I am right here, I am going to take biopsies of them too." I nod that I understand and continue to instruct myself to breathe. Two more snaps and a jump. 

I cannot prepare myself for those snaps.

Dr. Radiologist is speaking again. I shake my head trying to shake loose the buzzing in my ears. The room has become so loud and hot. The buzzing lifts an instant and I hear her. She's been talking so I catch mid-sentence..."Steri-strips over the incisions. They will come off on their own. Take it easy tonight. I'm giving you an ice pack to use for the drive home. Let your husband drive. Take Ibuprofen for the pain. If you develop redness, swelling or fever, call this department immediately and they will page me." Again I nod that I understand while my voice hoarsely answers, "OK."

They help me sit upright on the table. Gravity hits my head, and the buzzing is back. My mind cannot focus. I am struck with irony as I pick up my bra to dress. I just bought this bra yesterday. Pink with hot pink and yellow lipstick kiss marks all around. It was a fun bra. Now I stare it blankly. 

The fun has been drained away.

My knees are weak as I headed for the door. I stagger slightly and walk out of that chamber of horror. As I walk down the hallway toward the waiting room where Kelly sits, I stiffen my spine. I fight back tears. I have to explain what happened. I have to be strong for him. I just walked the longest hallway in the hospital. I tell myself how relieved I am that we celebrated the day before, because I just ruined our 31st anniversary.

I open the door to the waiting room and I see my husband jump to his feet. Just seeing him there breaks my resolve. We are alone in the room. Tears break forth and stream down my face, despite my determination that I will not cry. I fought the urge to run to him. As I move closer to him, he is shaking his head as he says, "They found something didn't they?"   It was not a question.  I had lost my ability to speak. He swept me into his arms and buried my head into his shoulder. And I sob.  His touch had melted my resolve to hold it together. He is an anchor in the rapids swirling around me.

I honestly don't know whether he was crying too or just stunned into silence. His voice shook as he directed me to the door and out to the truck. I think we are letting go of what once was. But I know whatever happens. I won't be facing it alone.

Fighting Cancer is hard 

when you just found out you have it

This is an ongoing special feature of my journey through Breast Cancer.  I was diagnosed on 7.27.2010 and am currently NED (No Evidence of Disease).

Link to next Pink Ribbons post -

#4   Scared

#3   Am I Going to Die?

#2  This page

#1  The Day They Said Cancer 

I've Lost My Pucketts, Meet the Foobies - Graphic Estrogen content

This was me the morning of my exchange surgery.  Well Actually I was a little more sassy than that.

The pink ribbon emblem show to the left is a place marker.  It does nothing but sit where I would have put a photo.  When finding that google was showing my reconstruction photos along with all the photos of my family, myself and friends, I took the reconstruction photos off the blog.  I don't have any problem with friends who are curious or women searching for breast cancer stories.  I have put the photos off site and every time you see the pink ribbon with a link below, click the LINK and it will take you to that photo.  I hope this clears up any confusion.  It's less convenient, but it's google.  If you right click the link, you can open the photo in a new tab and not lose your place here.  :)



My pucketts (TE) had been expanded to 750 ccs of saline but the right one kept leaking.  The decision was made to hasten to the implant exchange to July 5th.  The longer the TE was left unexpanded the pocket would begin to shrink.  Even after they took it out, I was told, "it was definately deflated but we couldn't tell why."  So because you need the pressure of the Tissue Expander to keep that pocket or capsule stretched out, they scheduled me for surgery.  So there I was.

I arrived at surgery center for my 2nd stage Breast reconstruction otherwise known as the "Exchange" surgery.

To see photo, click and use rosey2012 if asked
This was the last view of the pucketts, 
may they rest in pieces .  The cleavage was
cool while it lasted.

.
Took 3 sticks to start the IV.  Yeah, for lidacaine!  They believed me when I said, hard stick - shy veins.

To see photo, click and use rosey2012 if asked
This is the bilateral view of the TE on
5/3/2012  The tapes and bandaids
are from the expansion to 750 cc

To see photo, click and enter rosey2012 if asked
Dr. Puckett went a little nuts with
the black marker.  The spiderwebs?
not sure I want to know.

I found out what doctors do when they have to poop during surgery.  He first said "we just do it".  And I was like "Whoooaaaa, that has to break the sterile environment!"  Before I blurted that, he continued that they run out, take care of business, have to scrub back in and pick it up where they left.  He said they try to take care of that kind of thing between surgeries because anesthesiologist get really cranky when they are left in sole charge of a patient.  The wienies.

There was a BIG hoopla because I'm supposed to be allergic to Keflex.  Because the IV took so long, they were rushing to get all the other presurgery stuff done.  Someone hung Kflex.  uh oh.  Nurse noticed it was running.  She stopped it and they were rushing around to find out what ELSE to give me.

I get to the OR and I'm surrounded by rushing women who seem more like chickens than nurses, surgical techs or nurse anesthesists.  I was given happy juice which was fun.  I made the ceiling tiles spin.  I looked at the Nurse Anesthetists and asked "What antibiotic am I getting?"  She answered "I don't know yet" and then put me to sleep.  I did find out yesterday I was given IV antibiotics in surgery.

For you who are curious about the surgery and have the scientific nature to watch, I found a very well done video that shows a reconstruction from TE to implant.  I wanted to imbed it but the opening video image was too graphic for those who cannot watch surgical procedures.  Be aware this link is actual surgery done, not simulation or computerized.  Woman's Exchange Surgery from TE to Implant

The first thing I noted upon waking up was the strange sensation of little pain.  Wasn't expecting THAT!  They buzzed around while I tried to get my eyeballs to point in the same direction.  I told them I will recover faster if you allow my husband back her to keep me focused and talking.  They rushed out to get him.

He came back and while I was uncomfortable, it was like 5 on the scale using the pain I awoke with from the Bilateral Mastectomy with 1st stage reconstruction.  THAT was my 10.  They gave me some IV medication of morphine.  Rosey was in good hands.

Yep.  That's me on Morphine.  My new foobies are under all that ace wrap.  It seemed promising under all that wrap.







I was sent home with a list of scripts on of them for Keflex as we discovered at the pharmacy by my husband.  I was given really GOOD drugs.  By 8 pm I had finished with a meal and was feeling beat and for bed.  I took a Dilaudid for sleep because I wanted to not move the new foobies.  Not one way or the other.  I never knew how Dilaudid would affect me, never having it before.  It was the first drug EVER that I felt.

I have been given fentanyl - my pain laughed at it.  One nurse told me after a different surgery that I had been given enough pain fentenayl to put down a horse.  I snarled at her, "Well this HORSE is still kicking.  Find. Something. Else"  She got me Morphine.

Morphine makes me sleepy.  A little goofy if you ask Mr. Rosey, but to tell the truth, I'm not all that impressed with it either.  I could have eaten Darvocet as a cereal and it never budged any pain.  It's taken off the market.  It was a bad drug anyway.  Tramadol makes me sleepy and throw up.  Not a good combination.  I don't know if could take pain away.  I always HAD the pain until I threw up.  Vicodin that people loooove on the black market.  Does not a thing for my pain.

Demorol together with valium finally brought my mastectomy pain within a bearable range, 5 days after the surgery. Percocet can help but not with intense pain.  Having experienced intense pain with the BMX, I was pretty pleased to be so comfortable after the exchange...and I have LONG incisions.

Thurs night.  I took the Dilaudid and before I closed the computer, everyone within my facebook family knew it was affecting me as well.  It became the topic of much humor at my expense.  What I wrote looked something like this....

hi my loves,I lo ed all the pink lips. Yrs, i am ighgh. i can't get the keyboard ro worj right. I habe no diea what the foobies, look liiiiiiiiiiiiiiik. i am wrpaped like nnlike a mimmy...mummy. In wading up i coulf tell immediatlu that thia ws mcuh easier. i did not waked up skeaming. just hurting, insision pain .........

To interpret the above, I wrote, Hi my loves.  I loved all the pink lips.  Yes, I am high.  I can't get the keyboard to work right.  I have no idea what the foobies look like.  I am wrapped like a mummy.  In waking up, I could tell immediately that this was much easier.  I did not wake up screaming.  Just hurting, incision pain...and there was a lot more but this gives you an idea.  I was NOT feeling pain at that point.  Now I finally know what I need after surgery.  I am like my father.  It was hard to get pain meds to work for him too.  We must have some kind of internal resistance.

Friday I went to the clinic and had the giant ace wrap taken off.  I looked down at the new foobies and was pretty discouraged.  Not what I was expecting.  The bottom of the photo was taken at my neck, pointing down if you need orientation.  I was expecting bodacious cleavage, and coconut shell foobies.

To see the photo, click THIS link and use rosey2012 if asked
This was my view of the cleavage looking down my chest.
To say I was discouraged by the sight would be
an understatement.  I felt as if I had gone through
all the pain for PANCAKES?

I have two big round sets of 2 stacked pancakes.  Big and round but they barely project off the chest.  In a dress, I am flat chested.  I was discouraged and felt defeated that night.  I am told by others who have gone there, that I am expecting too much too soon.  That I have to wait for the foobies to "drop and fluff".  No idea what that means,  But I know that I could find no one on the internet that ever showed me what their implants looked like the next day, or a even weekly progression.  There's always a before and an after which is well after the healing is complete.  I plan to take weekly photos.

To see the photo, click this link and use rosey2012 is asked
Nice Bilateral view of the implants from
underneath?  lol  I was nicely drugged at this point.

I took this photo and for the life of me, I can not figure out how I took it. It looks like I held the camera low and shot upward.

To see photo, click this link and use rosey2012 is asked
View of the left incision and missing chicken skin.

I was curious about the long scar on the left side.  Then I recalled him telling me he planned to remove my "chicken skin".  The long scar reached back to the chicken skin area, so he could pull up that loose skin and get rid of it.  I'll trade you a scar for chicken skin.







Sat. I had lunch in town and was looking for a baby gift at Samsclub.  I thought I could handle it as I felt pretty good.  It was hot there, crowded and people were rude.  I couldn't reach the baby clothes.  I was feeling nauseous.  I'm hunting for Mr. Rosey when a sea of breast rolled over me.  Technically, it was a group of 12 - 20 college girls. They walked toward me down the aisle and then split to walk on either side of me.  All of them wearing tube tops, spaghetti straps, halter tops with headlights pointing various directions, different sizes and shapes.  Sitting in a motor cart, my head was breast level so it felt like a sea of breasts.  All of them braless and I was overwhelmed.  Tears welled up in my eyes and I wanted to shout at them,

You don't know how lucky you are to have breasts that you don't have to think about!

Yes, I am a bit breast obsessed right now.  Now. Let me tell you there is a very powerful emotional impact to seeing your reconstructed breast.  I was not prepared for that.. I have found myself looking at breasts, wondering what the bra size for THOSE are, and what is real, padded, propped, and foobie like mine.  I found Mr. Rosey and we went home.  

I'm frustrated because Mr. Rosey doesn't understand how I am feeling and can't understand that he can't fix it. I tried to tell him, I want him to be quiet, say I understand, cluck a time or two, and feed me some chocolate! I'll try to explain this to you. You go into reconstruction, hoping when it's all over, you will feel normal, look normal and feel pretty in a dress. They take the dressings off and you are hit with a big "THAT'S NOT NORMAL!" It's a very low point. Even if what you are seeing IS normal for the day after the surgery, it's the in your face reality that you are never going to be "normal". All you can achieve is to look your best. So this takes a few days to digest and I'm still reeling from this reality.  I think all reconstructed women need to know this ahead of time.

In the meantime, it's summer and every where I look I see breasts. Nearly exposed BREASTS. I found that I saw older women with boobs that obviously needed a stronger bra, and I was still jealous because I will never even experience that. You know my paternal grandmother died about 3 years ago. We used to joke about her boobs...she never wore a bra. She literally had to move the sag bag to wipe her heiney. (please note, I'm smiling in affectionate memory, not in sarcasm or criticism) To my knowledge she never had a mammogram and still did not die of breast cancer. Her old breasts served her well.

I am grateful that medical technology, Dr's skills and science has progressed to the point that women have the OPTION to reconstruct a breast. Our predecessors were hideously scarred and nothing was EVER done to even make the scars easier to look at. My 3rd grade teacher had to have a breast removed. I saw her at the city pools years later. In her suit, her right side looked as if acid had been poured on her. In those days, they removed the breast, and a good portion of muscle as well. Her body was left with a mess of twisting scars that were scary to see. A woman today can choose to remove her breasts and not reconstruct. She is left with a clean line where her breasts used to sit.

But I am still having to face that I have been treated for breast cancer. It was a HARD thing to do. Despite having a reconstructed breast, I'm not sure right now that I will ever feel normal. I'm not sure I will confident. On the street, I do not think people are going to point and me and say "she's not normal", but they will look at me and think...she sure is flat chested or she's had a mastectomy. I know. Because I did.  Maybe because mine started growing at 9 years of age, I have always been breast obsessed.   Over the years, I compared mine to ones I saw. Not in critical manners (not usually, unless they were UNCOVERED). I would note, nice pair, or she needs a different bra, a little on the saggy side and sometimes those women who have reached the age where the girls started sliding down hill, but the woman had not reached the age that she knew it was time to DRESS her age. Yeah, those woman.

I told Kel what Dr. Puckett needs and I think I'm brilliant for this...they need a "clinical care counselor." On staff, to meet with breast cancer patients....well actually ALL cancer patients. But someone to sit down with you and tell you about what to expect from the surgery.  Someone who tells you this is how you feel after this  kind of surgery.  This is what you will see when they cut off the bandages...this is a week.  What a women have to deal with is the emotional impact....and all those things that we don't know to question the doctor about.  Someone who will check in with us through the first 3 months after each surgery to make sure we still feel like we're on top if this.  I am told there is still a lot left to do that can make me feel more and more normal.  Apparently I thought it would happen all at once.  It doesn't.

The next observation.  It is hard to shiver with no nipples.  Seriously, your chest shivers and ripples.  With nipples the shivers all head to the nipples and then out the body...creating the famous headlight sensation.  Every woman knows if she shivers, first reaction is to cross her arms across the chest because those shivers much escape through the nipples.

With no nipple, the shivers just race and ripple around your chest, ricochet down the arms and back up.  It's actually fairly miserable.  They are looking for the exit and they are stuck.  So I wound up shivering a lot longer because they had no escape from the body to relieve me.

Now,  a myth buster. It is said you can tell a woman has implants because she she lies down, her boobs still are topside and not slid down to her armpits.

As snopes would say.      *FALSE

FACT: When you lie down with silicone implants, the bleeping things go where ever they want. It can slide down to your pit, one can stay up while the slides down. Regardless, my "implant pockets" are still healing so sitting up is NOT fun. This is a scientific kind of thing and some other home school mom might know the real term for it. This silicone is called "adhesive gel". It feels like cranberry jelly (think of it without the berries please, that would hurt). So I have this sack of cranberry jelly. I COULD cut the gel separate it slightly and it would slowly ooze together and become one piece again. IT would not look it does coming out of the can, but it comes one piece again. That's the kind foobies I have. There's a scientific name for the process but I'm brain fried. So when I lay down, they S l o w l y ooze to the side. And when I get up they s l o w l y ooze back down. It is not at all what I expected. And because of the surgical process and all the stuff he had to cut out, that oozing process hurts. And maybe mine are too big (the implants I mean). But that concrete bra is gone, the hard re-bar and cement baseball pucketts are gone. I'm left with marshmellow that seems to hang where it wants.  There are things to be grateful for.  I have seen the botched constructions of numerous brave and courageous women that you will never get to know.  I belong to a special club, The Cancer Warriors.  The admission cost is way too high and the steps are daunting.  But when you get to the top of that ladder, then you have the fellowship of amazing warrior women like yourself!

Reconstruction 101 - GRAPHIC PHOTO WARNING

Some of you are aware that Rosey has been in Crisis.  On Wed. this week, I was doing chores and realized the "radiated skin and muscle" over my tissue expander, suddenly felt squishy and mushy. I called the office immediately, as I knew this was not normal, and it was not good.  They have always been a rigid and stiff feature of my body.  Hard like baseballs stuck under the surface of my body... requiring my arms to hang like a gorilla.   

I was shocked to find that having my photos on the blog did not just make them visible to you who are reading the blog.  It made these photos visible on google search with my name and personal information.  I have removed my photos and replaced them with this space marker and the link to take you to the photo site.  If you asked for a password, it is rosey2012  I don't mind sharing them with women who are looking for information.  But not for the world to view with my address, and personal information. If you right click you may choose "open link in new tab" and not lose your place here.  I know it's a little more inconvenient.  I apologize for that.
     

They have been in my body since 12/6/2010.  We have a love/hate relationship.  They have for the last year and 7 months been sources of great pain, discomfort, agony or torture.  I hate the pain.  I love that I have the option to build foobies (fake + Boobie = foobie) and to feel feminine in a dress.  Not so much like a trussed turkey with hot silicon "chicken tenderloin" breast prothesis, harnessed inside a chicken wire bra.  Okay the bra is not quite that bad.  But the whole kit is heavy and hot.  I am so ready to pass them on to a needy person.
     They wanted to see me asap, which happened to be this morning. Dr. Jon poked and pushed and said..."You are right, you are way softer than you have ever been but there is still some tissue expansion in there."  But he was proceeding with the idea of surgery this Monday, July 2nd for my "second" stage exchange.  That means replacing the TE with real implants, the Second Stage surgery.  Then Dr. Puckett made a visit and decided he was not convinced it is a leak, perhaps there was just to change to my "capsule cavity" or to the muscle itself.  They all agreed I was mushy/smushy so Dr. Puckett said, "Let's fill you up to the rim and see what happens.  They did a 90 cc fill and I did not feel any pain, none of the "dislocating my ribs" level of pain that I considered normal.  I had only the sense of pressure against the skin and the weight.  
     I have reached the holy grail....750 cc. The largest silicon implant in the Mentor brand is 800 ccs.  So when you reach 750, they know you will accept the 800 without trouble.   I did leak back though the needle site.  Once home, it FELT like the TE was softer.  I fully expected to call and tell them there is a leak.  But upon observation, I realized I still feel pressure against the skin and the ribs, so if there is a leak, it is not a gushing leak.  I am in a holding pattern until Tuesday morning when I see Dr. Puckett again.  I will report the results to you.  Do we have a miracle or do we have a leak.?   Dr. Jon asked me if I believe in magic.  I told him 'no.  I believe in miracles."   At the end of the post, I will show photos of fully expanded pucketts.  
     Let me me clear.  As you scroll down, you will see NAKED reconstruction photos.  They are not gory.  Certainly not pornographic, but you may not want Jr or Juniorette walking by as your scroll through this page.
     I have also gotten a few questions of curiosity from some by email, who just aren't really certain "breast reconstruction" meant or what the result is.  So I have bravely set forth to assist in your education.  A reconstructed breast is nothing like what Pamela Anderson sports around.  At the VERY end I will show successful before and after reconstruction images so you understand what is possible as well as what a normal expectation may be.
     Mine are fondly referred to as the "Pucketts".  Of course some of you may not know that Dr. Charles Lin Puckett is the surgeon who PLACED these instruments of torture in my body.  I love him.  sigh.  I got recommendations of him as "an excellent knowledgeable doctor with no sense of humor."  I don't know which Dr. Puckett they saw.  My Dr. Puckett, an older gentlemen who is slow to speak, listens intently, grins widely at me and maybe it's just cause I'm his favorite patient.   *wink*   He jokes with me and laughs.  So if a friend or reference says...this doctor is excellent in skill but he has no sense of humor, go interview him.  It may have been your friend without the sense of humor.  Doing a consult with a doctor is not hiring him to be your doctor.  Making a second appointment isn't either.  You haven't really hired a doctor until you sign the consent for treatment form.  And I suspect at the last minute you could still climb down from a table and say..whoa, I'm done, outta here, I have changed my mind.  I'm not doing surgery...and you could probably pull it off.
     To add clarity for those who do not know me, I had a Bilateral Mastectomy in Dec 2010 for Lobular Breast Cancer.  After research and determining who I was and how I dress, I decided that while I might be able to deal with a breast prosthesis on a temporary basis.  I could not however look at the future and accept that I would either be flat or wear the whole mastectomy bra get up.  I did not want to think about it that much.  So I interviewed with Dr. Puckett and made arrangements to have him do my Reconstructive surgery.
     My first visit with him after the surgery, I sternly told him that I had not been informed that Tissue Expanders (TE) were constructed of concrete and rebar.  I love my doctor and he listens to me, but I found it pretty much across the board; plastic surgeons typically don't volunteer information such as THIS IS GOING TO REALLY HURT.  My actual breast surgeon (The doctor who actually the removed the breast tissue before Dr. Puckett came in to rebuild) asked me later if I felt I had been prepared for the reconstruction process.  I emphatically answered NO.  I was told, "It will require a longer recovery than if I just had a mastectomy with reconstruction coming later."  I was not told "Because it will hurt, spasm and burn like fire from Hades itself."  

These are filled Mentor brand
 Tissue expanders

 aka "the Pucketts" ----->

The tissue expander looks like when empty--->
It has a soft ridged texture...kind of like that piece of gummy that got lost in the bottom of your purse, with all the fuzzies stuck to it.  That's how it felt.  Not velvety, not bumpy.  But when you ran your fingertips over the surface there was a soft drag of  resistance.

Some expander brands have ports that are not part of the actual expander, but the expander has tubing connected to a port sutured in the skin.  Thank you Jesus for sparing me of that.  I'm a side sleeper (Once this all healed enough) and if I had those ports sewn into my sides, I would still be sleeping on my back.  *shudder*

The round dark circle is where the needle is inserted IN your port to fill the expanders once they are.... implanted.  The circular port is magnetized metal.  The doctor takes this small magnetic device (shown below) and moves it across your skin.  When the device is moved over the area where your post is located, the magnet immediately stops and essentially POINTS at the port.  The doctor presses down on the pointy end piece and it leaves a small X imprint on your skin.

I looked for a non bloody image of the expander in place.  I didn't want to gross you out too much.  The expander is pushed under the pectoral muscle and as it is expanded, scar tissue surrounds creating a "pocket" or "Capsule".     The implant is "exchanged" months after the surgeon feels he has expanded enough OR the patient has decided this is enough or can't tolerate more.  That is called your EXCHANGE or Second stage surgery. and it supposed to be less painful.  A resident told me Dr. Puckett doesn't use drains for the exchange surgery, I hope he doesn't find a reason to make an exception for me.  Supposedly the concrete bra sensation goes away.  Many women after the exchange surgery refer to the implants as smooshies, squishies or foobs.                               

This photo is nice and all but the depiction of the
syringe is totally out of scale.

This is what they bring in to do the actual expansion,not that little syringe shown in the above photo.  Those two HUGE syringes contain 60 ccs each (one for each side) but they connect to a itty bitty (diameter/gauge wise) long...butterfly needle.  You can see the green "needle butterfly wings" lower on the photo than the syringes, right above those foot long needles.  Ok. Maybe not foot long.  But they are 5 - 6 inches long.

Magnafinder is use.

For more photos of this woman's bravery through cancer treatment
and reconstruction go to Angela's Cancer Story

This image is of a brave young woman who upon finding out she was BRAC2 positive made the decision to prophylactically remove her breasts to lower her risk of breast and ovarian cancer.  She had an 85% risk before this, but her prophylactic mastectomy (PMX) reduced it down to less than 12%.   She having a "fill" or "expansion" in progress in this photo.  You can read more of her decision to prophylactically remove her breasts at April's Story

Read more of her story at
http://cancerfnsucks.blogspot.com

This is what radiation can do your skin,  muscle. This is NOT my puckett.  But this is almost as bad as mine was on day 24 of radiation when the radiation techs pushed my right elbow into my left ear.  I screamed in pain and they jumped back in horror as my red swollen tissue split and slid off to the side.  Doctors and nurses came running.  I loved who grabbed the pain meds on her race to the Rad. room.  I was given the pain medication, the scans were quickly done and then the nurses coated silvadene cream onto telfa pads to lay across the open flesh that was now weeping fluid and blood onto the pristine steel table.  They bandaged me up and then my Mr. Rosey marched into the women's dressing area, DARING anyone to stop him.  He gently covered my body with his large soft white undershirt (silvadene turns black on cotton...just be aware, the garments will be ruined) and wrapped me in my fleece cape.  He took me home.  I think he hurt almost as much as I did.

To view photo, click link and enter rosey2012 if asked

      It was a pretty horrendous experience.  If you can remember the worst sunburn of your life...then think about going out 5 days a week, day after day to get that burned all over again?  That's how radiation burns feel.  My skin literally dissolved over the whole region.   The skin, muscles and blood vessels are so traumatized and fragile, my Plastic surgeon wouldn't consider doing further expansions or surgeries for a year after this is done.  You can have skin issues up to a year after radiation is over, so he waits to pass that window.  I in fact DID have issues in the eleventh month.  I went through physical therapy and the blessed Ginny and I got the puckett ready to expand.  

     Alrighty then, I have done my best to educate you on the PROCESS of reconstruction.  After 14 months of waiting, I am able to restart the expansion part. When I first unveiled the pucketts TO Dr. Puckett, he kind of exclaimed "WOW!"  And he told me I had done an excellent job both healing AND rehabbing the skin and muscles.  He did a 60 cc expansion just moments later.  I'm now three expansions later and at 660 cc's.  And it hurts again.  It doesn't hurt too bad IF I DON'T MOVE.  But even lifting a cup to drink pulls on the muscles.  Picking up the laptop makes the muscle yell at me.  And there's a lot of pain under the scar as well.  WHICH is good in one sense as it means things ARE expanding.  Adhesions are breaking, scar tissue is being stretched and my knarly scar is being stretched and pulled.  It SUCKS.  But it's doing what it has to do.

To see photo, click link and enter rosey2012 if asked

These are my knarly pucketts.  On the left side of my chest (think backwards of this photo) you will see loose skin hanging out below.  I refer to this as my "chicken fat".  Dr. Puckett was very pleased to have that excess skin.    Having extra skin like that is helpful to the plastic surgeon. It can be pulled up and over the implant. Now the right side....this is the radiated side that is giving me all this trouble.  You will note the absence of "chicken fat."   I had some to begin with, but radiation ate it.  It is taut all the way around.  If you look closely you may note some indentation on that scar, where the other scar is nearly invisible.  A lot of my "discomfort"  this fill is stretching that scar as well.  So owie.

     So many people ask me "is it worth it?"  I think the answer will be yes.  Right now?  Well right now is not a good time to ask me ANY question.  It hurts like Hades, and I don't have great mobility around the pucketts as one does with regular breast tissue.  The pucketts are hard, baseball structures attached to muscles under your skin.  As one doctor states, turn to fast and those expanders could knock someone out.  Shove a baseball under your armpit, walk around and you have a good idea what a TE feels like.  I push through this pain because one day I want to put on a dress without having to wear those hot, heavy mastectomy prosthesis.  I want to have that confidence back.  While the pain is obnoxious and restricting, I know it won't be here forever.  It will go away and I will have a bosom that I don't have to think about.  THEN ask me if it was worth it.
     As promised, I saw Dr. Puckett today, all of us thinking I had a leak.  So after a 90 cc fill now nearly 2 lbs of water (which I will be sure to subtract tomorrow morning from the scale) this is how the Pucketts are looking.  Total in - 750 ccs.

To see Photo, click link and enter rosey2012 if asked

This front view shows the puncture mark from the needle.  Nice bilateral view of the chicken skin.  The chicken skin on the right is new.  The bandaging on the right puckett looks serious, the saline was leaking back from the injection site.  They placed a small pressure bandage there to soak up the back flow.  It still soaked into my bra and left a dollar coin size stain.  6/29/2012 

To see photo click link. If asked password is rosey2012

Bird's eye view (so to speak) of the skin and tissue damage left  from radiation.  That rippling is not supposed to be there.   I fully expect that Dr. Puckett will pull that chicken fat under the arm forward as much as possible and try to excise that damaged skin. 6/29/2012

To see photo click link and enter rosey2012 if asked.

Looks are deceiving.  These are not as huge as they look.    haha But this is a good view of the tissue expander "shelf" that is created when they are fully expanded. Much like how a pregnant woman will rest something  on her abdomen, I have been known to set the computer mouse, the remote or and my phone on the puckett shelf.  6/29/2012

I'm feeling pretty confident in saying there is a slow leak...but there is also a big change in the muscle and skin.  I am very pleased they were able to expand to 750 ccs, even if it is slowly leaking.  The skin and muscle will easily manage the implant I desire.  :)  But I must wait for Dr. Puckett to concur.  So that will be July 3rd.  I expect they will schedule surgery in the next week or two.  In surgery Dr. Puckett will cut open the lower "capsule" to let the implant fall down the chest a bit.  He will cut the inner "cleavage side" on both to move the implants closer to center and pulling them out from under the arms. (Hallelujah, Praise God and Amen!)  Then Dr. Diana told me to expect a TIGHT band will encircle my body at armpit level.  I will wear that for a certain amount of weeks until Dr. Puckett is satisfied that the implant/foobies have settled into their new home and will not attempt to climb over the shoulder.

You know the song? 

Do your boobs hang low?  

Do they wobble to and fro,

can you know tie them in a bow, 

can you throw them over your shoulder

 like a continental soldier.....yeah.  NOT good!!

These are public images of successful reconstructions using expander to implant procedures.

The Goal is not to create porn perfect breasts.

  The Goal is to create self confidence in your clothing.  

To know that you don't have to worry about prothesis slipping, mastectomy bras that are hot and heavy, the straps that keep falling down making the prosthesis sag and roll.  We are warriors, and we have battle scars.  We are beyond that.  We just want to walk down the street and no one notice our chest region.  We want to feel beautiful in our clothing without the burden of prosthesis.

Tissue expander  - Left photos.  Finished implant reconstruction  - Rt Photos

Left photo - CLASSIC shelf appearance

Bilateral reconstruction..(tape is to hold scar formation flat)

Right Mastectomy with reconstruction and Left breast lift so they match.

Some breast reconstructions ARE nicer in appearance...

Very normal in appearance

Which is before and which is after?
I wonder if I could have Dr. Puckett give me a
tummy like that too?

...And in case you are wondering, 

this is one method of reconstructing nipples.  

The Aerola is tattooed on by a medical tattoo profesional. 

And Meet the Pioneer of the 3D Nipple Tattoo - Vinnie Myers   Yes, they are flat tattoo's inked in 3D  I might do this.  lol  I think I doubt it...

http://vinniemyers.com/home.html
This one cracks me up!  I often wonder what hubs would say if
I came wearing a "nipple ring"!  Certainly would have to be less painful
than getting a real one!  
The rippling you see can be caused by certain silicon implants.

Now you know more than you EVER wanted to know about Rosey and Breast reconstruction after mastectomy.  Soon I will be starting the countdown to My exchange surgery to Squishy foobies and posting it as soon as I know.

**Disclaimer**  Please note that this post is written about MY experience.  It is not to say that everyone will have pain, trouble with Tissue Expanders, or need radiation.  I do not pretend to think to advice anyone to choose one kind of Reconstruction surgery over another.  I CHOOSE implants because of specific reasons with my doctor.