Today’s blog is informational. In other words, no photos of the woods! I figure that some of you out there might be interested in knowing some details about the surgeries I had yesterday in case you consider them for yourselves. If one chooses breast reconstruction, there are a surprising number of subsequent choices to make.

As you know I had a TRAM a year ago to reconstruct my right breast following a mastectomy and tissue expander placement. Often but not always, women have additional procedures done following the TRAM (or implant placement) to increase symmetry between the reconstructed and natural breast.

Yesterday, Dr. Welk made a revision to the fold underneath my reconstructed breast. That was actually the biggest surgery in my view, because it required the largest incision and it is the most painful of the incisions. He also used liposuction to get fat to inject into two places on the upper half of my natural breast. (Well actually, fat is not injected into the breast tissue, it’s injected into the subcutaneous fat to reduce the likelihood that the injection will make cancer scans harder to read.)ย  He also injected fat above the TRAM to fill the space left by my mastectomy as Dr. Beatty removed a lot of tissue all of the way up to my right clavicle, due to the location of the cancer. Consequently, I had a little hollow spot there, certainly something I could live with but when he offered to fill it in, I agreed.

Dr. Welk took the fat from two places on my abdomen (on the TRAM scar so no new scars there) and two places on my thighs. The incisions were symmetrical, one from each side of my abdomen and one from each thigh. I counted all of my bandages when I came home yesterday and there were 10 incisions. Woo hoo! A new record! Nine of them are tiny. The one under my right breast is not, which is why my right side was super achy yesterday and pretty achy today. I have been taking over the counter pain reliever since I got home yesterday afternoon and not very diligently. It’s not painful unless I stand up and I figure that pain is a good deterrent for me against exerting myself too hard. Hubby will tell you that I am not a good patient in this regard. I don’t ENTIRELY agree but I get his point.

Ah yes, there are also the needle sticks to my left arm, all three of them. I have what they call in the IV placing biz, “small, deep, and rolly veins”. The successful poke was to a vein on the back of my hand. I had an IV placed there when I was in labor with my daughter. It hurts more, I think. Good thing I was soon asleep. I am pretty bruised up in both the fat harvesting sites and in the injection sites. The bruises don’t hurt a lot. They are just purple, which is not my favorite skin color. Finally, I had difficulty getting up from the couch yesterday. I had my husband help me up the first time and then I was able to get myself out from then on, just not very quickly. This morning, I was able to get out of bed pretty easily, which is harder than getting up from the couch.

Even though I am pretty swollen, I can tell that I am also more symmetrical. Fat can be transferred in only small amounts at a time, so one has the option of subsequent procedures to shape an area. For those of you taking score at home, here’s a list of my surgeries:

1) Lumpectomy2) Lumpectomy (re-excision)
3) Right side nipple sparing mastectomy
4) & 5) Delay procedure (to my surprise, this hurt like Hell, by the way) and tissue expander placement.
6) Skin graft to repair necrotic tissue.
7) Pedicled TRAM reconstruction.
8) and 9) TRAM revision and a medley of fat transfers.

Yeah, that’s a lot of surgeries. One of my patient’s moms, who has a wild sense of humor said, “Dr. MacKenzie, don’t go all [Heidi] Montag on us. We don’t want you to get addicted to plastic surgery.”
I got a good laugh from that one. Not everyone would have and that’s just a reminder that there’s no one way to be a breast cancer patient. Your coping style may be different than mine and your treatment decisions may be different, too. Even with all of my bruises today, I am happy with my choices. Also, my husband is waiting on me during my convalescence, which is pretty darned sweet. Though I think if I asked him to feed me grape one by one, he might balk a little. ๐Ÿ˜‰