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Hey Guys, for some of you this post will not be relevant - but after the 5th person sent me a message on instagram asking me about my breasts, I realized I had a duty to write a blog post and explain somethings.
Before I go into it though, let me give you a 101 for those of you not currrently undergoing a mastectomy with reconstruction.
When a mastectomy is performed, the doctors make an incision and remove as much breast tissue as possible. Often times they will attempt to "spare the skin" especially the nipple. This depends on the location of the tumor and ensuring they get adequate margins (space between the lump aka the cancer and the healthy tissue) because cancer is microscopic. The larger the margins the more likely to get it all out. For example, I was unable to save my nipple (see photos) because the tumor was pressed so close to the skin that they had to remove a very large section of the skin from my chest in order to get good margins.
The removal of all this breast tissue and skin is the mastectomy. Think of it like an amputation, they need to ensure that all the damaged/sick tissue is removed so they work hard to scrape out as much as possible.
After, if you opt for a reconstruction, what you're left to work with is not the same as if, say, you were just going to get breast implants. You've got less skin, and also no breast tissue - both of which are what holds that implant in place. In order to work around that, during the removal of tissue the doctor will insert what's called the chest expander.
The chest expander is a flat, deflated implant with a magnetic pump. This magnetic pump can then be located so a doctor can insert a needle and slowly reinflate the implant, expanding the "chest" slowly. I say "chest" because there are two ways to do this, the most common and most likely to get good results is actually done by inserting the expander underneath the chest wall. This makes the expansion more "uncomfortable" but provides better support long term for the implant.
So that's the basics.
Here's the part that gets confusing.
Once the expander is in you have to heal for a little bit. This time frame varies based on your doctor. During this time your chest is completely flat. Once you are ready, the doctor begins to slowly inflate the expander. You go in on whatever your schedule is (mine was weekly) and they add in as much as you can stand (it's uncomfortable slash potentially painful if you do it too fast.) The inserting the needle part looks scary but feels like literally nothing - those nerves were severed during the mastectomy and have not knit back together yet. That area is totally numb. The painful part is the expansion, which feels sort of like you've done too many pushups.
Once the expander is as big as your chest/skin will allow, then you have to wait.
For me this was the hardest part.
The expander is shaped like a perfect circle. It's hard as a rock. It's located in a weird place on your chest. It does not move at all when your body does. You can feel it scraping against your ribs on the inside.
This is the part where I freaked out. This is what most of the questions I get on instagram are about. This part is horrible, not because of physical pain but because of the toll it takes on your psyche.
It looks bad. Not like sexy, porn star fake boobs.. Like there's an alien shaped like an upside down bowl trying to burst through the skin of your chest.
There is a very strong feeling of "holy shit, is this what I am always going to look like? It's terrible."
No, this is not what it's always going to look like.
The point of the expander is to create a "capsule" of scar tissue.
Hence the waiting. My doctor once told me if you did the swap too early it's "a bloody mess in there" and you can't build a good shape. He explained that the capsule is like a fist of scar tissue. The tissue is strong and shapeable to hold the implant. During the reconstruction, they score the scar tissue (here he expanded his fingers creating space between them) to make the shape of the breast. Then he moved his opened fingers in different shapes to show how he could basically do anything with this "capsule" including matching perfectly the shape of my other, natural breast.
This is the part that I think a lot of people don't understand, hence the blogpost. I recently described it to someone like an orange peel. The fleshy pulp is the soft implant. The peel is the scar tissue capsule. Once it's "healed" you can then shape that peel however you want, something that wouldn't be possible with the thin, papery flesh that covers the individual peels.
This process can be frustrating because it takes about 6 months all in. The mastectomy and expansion is a lot of hurry up and wait. You need to heal, then get opened up again, then heal again. There are many steps, each one taking a varying amount of time depending on your body and how it heals.
But once it's all done, you can have breasts that look like whatever you want. I chose something slightly perkier than natural, but closely resembling my 16 year old chest. Not so pert that people automatically assume they are not natural, but they kind of wonder.
You will have cleavage. They will be soft. You will no longer feel the hard, flat edges of the expander sliding along your ribs. You may even need to wear a bra sometimes (I do to workout, and to sleep because it's more comfortable).
It will get better, they will be gorgeous.
Ask me anything, I am here to answer whatever questions you might have.
Sending lots of love and healing vibes.