Perspective Of Yet Another Night Owl

Breast Reconstruction After Mastectomy
September 22, 2007, 12:05 am
Filed under: Breast Cancer, Family, Life, Reconstructive Surgery

Mom and I went and spoke with the reconstructive surgeon today.  I ended up having many more questions than I expected because the procedure wasn’t how I expected it to be.  We had been told that when Mom has the mastectomy that reconstructive surgery would be done at the same time.  I guess we envisioned Mom going to sleep, having one removed, then waking up with a whole “new” set.  It’s not quite that simple.

Although Mom is planning on having the skin sparing mastectomy, the areola and nipple area may be compromised and may end up being removed completely.  That is something I had not realized and neither had Mom.  We both were a bit shocked to hear that part of your breast may not be restored.  There are women who do not care so much about this, but for those that do, there are options.  At this point we have not discussed those too much because those remedies are more follow-up.  Tattooing of some color for an areola is one option, among others.  They sound more painful than worth it.  I suppose that is up to the individual woman.  I honestly started holding my chest as we heard this information.  Mom is still deciding if she wants a silicon implant or saline.  The silicon feels more natural and the saline can be more hard.  I think she is leaning towards the silicon.  Particularly since they have come a long way from the previous issues they had.

This was the first time Mom and I had heard about the Expander. Prior to this, we thought Mom would come home with implants done and boobs in place.  However, immediately after the mastectomy, the chest muscle (pectoral) will be lifted off the rib cage.  An Expander will be placed against the rib cage and held in place with a donor skin graft and the pectoral muscle.  The skin graft will be a thin strip of skin which will be stitched to the pectoral muscle through which new blood flow and capillaries will be established.  The new blood vessels will be eventually incorporated as a part of the remaining skin from the skin sparing mastectomy. The graft helps support the muscle during the expansion which will give room for the implant.

After 1 week, Mom will have a post surgical check up and after 2 weeks she will start going into the office to have the Expander filled with saline.  This is a “temporary boob” and will increase in size gradually.  Mom will go in every 7-10 days to have additional saline inserted in the Expander for 2 to 5 visits or until they are at the size she wants.  Mom doesn’t want them any bigger than they are.   When they reach the appropriate size, the Expander will be removed and the implant inserted.  The entire process could take up to 6 months for Mom to be done with the second stage of surgery which is having the implant inserted and having the symmetry completed on the left breast.  She will be getting a lift out of the procedure as well, on both sides.  In the mean time, Mom will be lopsided and only able to wear Cami’s.  No bras, nothing constrictive.

We giggled today as the doctor measured her boobs because we had never noticed they were definitely uneven. :o)  We also got a laugh when the “before” shots were taken.  Mom had this look on her face that was indescribable.  Mom laughed when I commented that she just wasn’t used to men taking nude photos of her.  (Her face was NOT in the photos, just the boobies, and obviously they were for medical reasons, nothing else.)

I do like the doctor Mom has chosen and feel very confident that she will have good results with the reconstruction.  Now to get everyone’s schedules compared and choose a surgery date. We still have some questions, but there will be at least 1 more appointment before the surgery.  With the news we got today, it was very easy to let some of the questions slip our minds.  One important one is the total cost of all of this.  My Mom has chosen a reconstructive surgeon who is outside her PPO.  Not that the cost is really a factor, but better to know than be shocked.

Mom will have to spend at least 1 night in the hospital.  I will be staying at her house that night and stay with her for the following week (or longer if necessary) to help her out.  Mom will have a lidocaine drip in the breast site as well as a drain tube for a couple of weeks.   She needs to quit smoking at least 3 weeks before the surgery for healing purposes and remain smoke free after, until the healing is complete.  Smoking can retard the healing process, constrict blood vessels and cause the skin that was saved to die which would then mean a much more difficult reconstructive procedure.

This sure is a lot different than when my girl friend went and got implants.  She was in and out the same day with brand new boobies.  I really had some misconceptions about reconstructive surgery. 


14 Comments so far
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Hi Semi!

Just dropping by again and want to say that I have had five close friends go through reconstruction and though excruciatingly difficult (two had to have complete mastectomies without the option of implants), they are as fine and dandy as a girl who came out the other side of mastectomy can be!

I told one about your mom today and she told me that her new “sista” (your mom) is a courageous, victorious lioness!! Please be sure to pass on the mantra to her, will ya?? Thanks… 🙂

Strength to you,


Comment by kahni

Kahni, Thank you. I most definitely will pass it along. I honestly feel that my Mom is going to come through this quite well. We are a close and strong family. Not to mention, we can be damn stubborn! This is a fight we can win.

Besides the diagnosis and the shock of that, I think the hardest thing is we never actually knew exactly what women go through. We have always supported breast cancer causes, did our self-exams and mom was faithful in her routine mamograms (I will be more faithful about it myself now). I have met many survivors, but never heard all the details. Those details can be shocking when you first get them. Now that the initial shock is overwith, we can begin making informed decisions. The key is to ask questions, research, and ask more questions.

Thank you for the well wishes.

~ Semi

Comment by Semi~Charmed

Hey SC,

I too had thought that when you went in for a masectomy that you also had the recostructive surgery at the same time and came out with the new “boobies”. I have talked to some more people about breast cancer and reconstructive surgery and it sounds like you, your mother and I found out about the areola, nipple, and tattooing dealio around the same time. You guys sound like a real strong team-which is good…my prayers are with you still for all times and especially when the stength isn’t so strong.

I am really enjoying reading your stories and others about this and other health/cancer related issues. It is helping me deal with my cousin that has renal cell carcinoma. He is 19 years old and has been battling it since he was 14. It is also helping me (I hope) be a stronger person for others that are close to me that are struggling with health problems.

Comment by Mercedes

Mer, Mom’s surgery is coming up soon (10/10). Hopefully, I will have some time to write a post about what has been up with me lately. I really have only had time to browse and respond, not write. We have just been so busy with the kids, their schedules, work, and making all the plans to be sure there is someone with Mom and Grandpa while Mom is recovering, etc. Luckily, my team consists of my sister and brother, as well as our families, which helps. Bigger teams, more room to spread out the duties to be done. 🙂 Thanks for the prayers. Please know that you are in our as well.

Comment by Krysti (f/k/a Semi~Charmed)

Hey Semi~ Been thinking of you. Haven’t talked to you lately. Hope all is well. As for breast reconstruction–I know a woman who is a survivor and I believe she had a double mastectomy and, therefore, had both breasts reconstructed. She got the work done to recreate the nipple and areola. She loves it. Says it looks real. Best wishes to you and your mom. Still praying for ya–still convinced it will be a positive outcome! 😉

Comment by shadesofpink

I can’t tell if my last comment posted or not. WordPress is being all weird…or maybe it’s just my computer! 😛

Comment by shadesofpink

can anyone out there give me some rough estimates for a unilateral mastectomy, my mom has stage two in one breast and does not have insurance, she was denied assistance through medicaid and here surgery is needed asap. I know that procedurs are often less expensive if on a cash pay basis than if she had insurance but I also realize this could financially devastate us. The doctors have not said she will need chemo as of yet but are speaking of placing radiation capsules in the breast. give me some insight and costs please someone, and has anyone been in this situation, will hospitals do these procedures with 50% down and then bill the remaining or is it all up front???????

Comment by tracie farmer

Tracie, My mom used to work for an insurance company and although she has medical coverage, I know it’s still expensive and some of the reconstruction for her is not covered. Since I do not know the costs off hand, I forwarded your questions to her. I will hopefully have some type of answers for you tonight, but realize they may not be exact and are based solely on what my Mom will be paying or remembers from when she worked for the insurance company. I hope that will help.

Comment by Krysti

Just my 2 cents here, but I think to some extent it depends on the hospital. I know in my area there are some hospitals that offer financial aid and payment plans.

Comment by shadesofpink

Just one thought while waiting to get some answers for you, Tracie.

In our area, a hospital CANNOT turn a patient down because of their inability to pay. I believe this is the case in most areas. I would say schedule the surgery and get it done. If you can only pay $50 per month until, then you can only pay $50 per month. As long as you are attempting to pay, most hospitals will not sue for the balance. As for the mastectomy surgeon, a decent surgeon will work out a payment plan for the mastectomy since the mastectomy and radiation ARE NECESSARY! Reconstruction is usually considered cosmetic and not necessary (technically). The reconstructive doctor may decide not to do that part of the procedure without some form of up front payment.

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