Breast Reconstruction And Fat Grafting

breast reconstruction and fat grafting

After polling on Instagram this week I discovered that almost 95% of you want more surgery/reconstruction content. So, since I have been putting this post off for about 4 months, I figured it is time to bite the bullet and share my most recent surgery recap and insight with you all. When I think about why I have been putting it off, I think it’s because I kept waiting for perfection, and complete satisfaction. After 5+ surgeries I can now say I have accepted the fact that perfection and complete satisfaction are unattainable. My reconstructed body will never be perfect and it will never be what it was before cancer. I have finally come to accept that, that is perfectly OK.

breast reconstruction and fat grafting

If you haven’t been following me since the beginning you can read my previous surgery and reconstruction posts to catch up:

[list type=”like”]
[list_item]My Boob is Trying to Kill Me [/list_item]
[list_item]My Boob is Trying to Kill Me Part II: Mastectomy and Tissue Expanders [/list_item]
[list_item]How to Prepare for a Mastectomy[/list_item]
[list_item]My Free Boob Job: Myth or Reality? (Expanders)[/list_item]
[list_item]Let’s Talk Nipples[/list_item]
[list_item]The Reconstruction Saga Continues (Implant Exchange Results)[/list_item]

breast reconstruction and fat grafting

Before cancer, my breasts were one of my favorite parts of my body. Sure they were huge (36DD) and quite saggy for age 27 (thanks to gravity and aging), but I loved them. They were a part of me and made me sexy and womanly. Going through chemotherapy and a double mastectomy, I felt my femininity was stripped from me. I couldn’t wait for the reconstruction stage, so that I could begin to feel whole again. I saw reconstruction as the answer to my insecurities and sadness about my newly changed body.

breast reconstruction and fat grafting

Just like with many things in life though, the things we see as the solution for our unhappiness never work out as planned. Each surgery left me with new disappointments, added recovery time and new complications to face. Beginning the road to reconstruction was a step in the right direction for me, but being such a long process I had to find other ways to reach acceptance and reclaim my body. Ultimately it was blogging, reflection, and lots of self-love practice that helped me love my body again. It definitely didn’t happen overnight. It took a year and a half of ups and downs, sadness, reflection and lots of work to get to where I am now. And to be honest I still have a lot of work to do – thus my self-love goals for this year.

breast reconstruction and fat grafting

All in all, my reconstruction has lasted 2 years. When the plastic surgeon first told me it could take up to 2 years for the reconstruction process, I didn’t really understand the weight of her remarks. I thought after the first surgery I would be satisfied and it wouldn’t matter that there would be “touch up surgeries” down the line. Now after 5+ surgeries including 3 specifically for reconstruction, I have new perspective and insight on the process. There are a few important lessons I have learned and I am sharing them with you now.

Be your own advocate – Do your research before reconstruction. Look into a variety of approaches (expanders, immediate reconstruction). Research implant types, sizes, materials, surgery specifics like under the muscle or over the muscle. The more you know, the more questions you can ask and the more satisfied you will be with the results of your surgery. Make sure you are the driving force in the decision making.

Be patient – This is the hardest part. Expanders take time, recovery takes time and waiting in between surgeries takes time. Immediately after each surgery, my world revolved around my recovery, my feelings about my results and ultimately my disappointment. The more I learned to be patient and let me body heal, the less I stressed about the results. In time, I was able to reach a healthy level of acceptance.

Take progress photos – Just like with weight loss, it’s hard to see growth when you are looking at yourself everyday. I am so glad that I started taking progress photos at the very beginning of my cancer journey. Those photos help me see how far I have come and how strong I am. They help me celebrate my strength, my beauty and my growth both physically and emotionally.

Live your life – Sitting around waiting for your reconstruction to be perfect can keep you from living your life. When I finally let go of obsessing over my reconstruction I found I had much more time, energy and interest in living life, trying new things and connecting with others. Our disappointment and self-doubt can hold us back from greatness

OK so now that I have I overloaded you with my insight and emotional reflection, let’s get back to my latest surgery. In late August I had reconstructive revisions and fat grafting surgery. The revisions were to remove extra skin and tissue that made my foobs (fake boobs) look disproportionate. The fat grafting was also done to improve the natural appearance of the foobs by adding fat taken from my stomach and hips to my chest. The goal was a more rounded, natural shape. For reference my implants are under the muscle Natrelle Inspira Overfilled Round in 750CC (Silicone).

breast reconstruction and fat grafting
breast reconstruction and fat grafting

I knew from the beginning I wanted to get fat grafting because I mean free liposuction, why not haha? I also knew from my research that fat grafting on smaller framed women is the only way to create a more natural appearance after reconstruction. What I was not prepared for was how painful the liposuction was. I woke up from surgery in horrific pain and my abdomen and hips were painful to the touch, tender and sore for over 30 days. I had to wear compression garments (this girdle) 24 hours a day for 4 weeks!!! I also had the typical 5lb weight limit for 4 weeks and dealt with heat rashes (yay sensitive skin), itching, and the delightful post-surgery care. In terms of functioning, I was able to move around a day after surgery and started a new job 7 days later.breast reconstruction and fat grafting

So you may be thinking… was it worth it? My honest answer is, I am not sure. I am now 4 months out and while the appearance of my foobs is improved, not all of the fat took. The average survival rate for fat grafting is about 60%. Did you know that you are born with a set number of fat cells and that number never changes? The reason you may gain or lose weight is because those cells grow or shrink. When moving fat around in fat grafting surgery, they go in with a scraping tool (yes that’s why it’s painful) and remove cells from areas where you have a large concentration. They then run those fat cells through a processing machine to “purify” them and then they inject those fat cells to the new location. The injected fat cells need enough oxygen and blood flow to survive in the new area. If they inject too many new cells at once the fat cells will die. It takes time to determine what amount of the injected fat cells survived. This process can take up to 3 months. After the 3 months, many plastic surgeons will then suggest another round of the fat grafting. On average most patients go through 3 cycles of fat grafting to achieve the desired results.

breast reconstruction and fat grafting

At this point though, I will not be going through another round of fat grafting. In terms of the appearance, I know another round would help and I would be more satisfied, but it’s just not a priority for me right now. Right now we are focused on pregnancy and a family after cancer. My reconstructed foobs will never be my pre-cancerous boobs and that’s OK.

breast reconstruction and fat grafting

My plastic surgeon and I will revisit the topic after children and may at that time, assuming my body has changed even more, I may go through additional fat grafting sessions. Maybe in the future, it will become a priority again, but for now, I am sticking with this body I have and I am celebrating my foobs. Sure there are imperfections but they are all part of my story. I choose to celebrate instead my strength, my determination and my amazing body that has gotten me through so much.

breast reconstruction and fat grafting

Wherever you are in the reconstruction process, I hope you find peace and love for your body. I now know that no surgery will solve my insecurities, that was something I had to resolve from within. I had to find love for myself and then the body acceptance followed. You are beautiful inside and out and your foobs do not define you! Rock on my beautiful survivors.

Originally published on mycancerchic.com.

Awkward Auntie Question No. 9

reconstructed breasts after young adult cancer

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Question: How carefully do reconstructed breasts need to be handled? My husband and I are going to be getting back into having sex in the new year and I would like to have a medical professional’s opinion on the potential risk of damaging the newly grafted fat. Is everything fair game once I’m allowed to sleep on my stomach again? Are breasts reconstructed from my own tissue safe to handle like original breasts? What about various types of implants (just in case others have the same naive question I do but had different reconstruction)?

I’m 38 and had stage 2 invasive ductal carcinoma in one breast; no chemotherapy (no spread to lymph nodes), no radiation (bilateral mastectomy); I’m on tamoxifen; I had a total hysterectomy and salpingectomy but still have both ovaries. I had a bilateral mastectomy and insertion of tissue expanders, removal of the expanders and DIEP flap reconstruction (I no longer have any kind of implant), and finally fat grafting and revision (removal of the grafted skin patches, and the dog ears on the abdominal incision). One month after the revision surgery, I was applying silicone lotion to the scars as instructed and the skin at the end of my abdominal scar opened up and my finger went into my side; it’s been stitched up again but this made me nervous about the strength of my pieced-together skin and tissue. I feel ridiculous asking my surgeon about how touchable my new boobs are though.

Awkward Auntie: You have really done it all – or had all done to you! And it must have been quite shocking to find your finger under your skin – but that was in the early stages of healing (one month later) and in general terms, we say that full healing takes at least 6 weeks. You don’t say how long ago your surgery was….. but if you are allowed to sleep on your stomach again, then you should be fine to include breast play in your sexual repertoire. Remember that it is YOUR tissue that has been used to create your new breasts and over time (and it can take a long time), your breasts should regain some sensitivity…. some women report that they feel ‘electric shocks’ in their reconstructed breasts for YEARS after the surgery. Altered sensation can be scary for women who have been treated for breast cancer because they usually panic and think that what they are feeling is related to cancer coming back. I would suggest starting off with gentle breast play and it is important to tell your partner what YOU feel and what feels good – and not good. Heavy pressure may not be comfortable for a while….or ever.

Women who have had implants are often instructed to massage their breasts using quite a lot of pressure to reduce the build-up of scar tissue.

In answering this question I searched the medical and plastic surgery literature to see if this has been studied or if there are any websites with specific information about this – and I came up empty handed! It is a real pity that you feel that you can’t ask the surgeon about this – he/she should be talking about this routinely with their patients because if you have a question, it is a pretty good bet that most women would want to know this too!

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

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More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer – and all the things that happen to your body, relationships, and sex during and after treatment.  Are you a young adult cancer survivor?  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Flashback #4: After A Mastectomy You Get New Boobs! Yay! Wait, Not Really

breast reconstruction

To celebrate our 2-year anniversary of being a nonprofit, Lacuna Loft is bringing back our top 31 articles from our archives!  The countdown to our top post is continuing today with Flashback #4: After A Mastectomy You Get New Boobs! Yay! Wait, Not Really, written by Karen. These 31 articles are the best of the best and we’re very happy to share them with you again!  The countdown continues next week!

….When I tell people about my mastectomy and breast reconstruction, I receive lots of support, many questions, and even some rude comments. The most frequent thing I hear from both women and men is “at least you will get perky boobs” (insert awkward laugh here)

For those of you who, thankfully, have not had a mastectomy or been close to someone who is going through one, you might think that this is going to make us feel better. It doesn’t! I understand that it is meant to be a supportive comment, but, I promise you, this is not a normal boob job. Yes, I did get implants to replace my real breasts, but that is where the similarities end………

……

Read the rest of the article here!

Flashback #24: Boobs To Noobs

breast reconstruction

To celebrate our 2-year anniversary of being a nonprofit, Lacuna Loft is bringing back our top 31 articles from our archives!  This is Flashback #24: Boobs To Noobs was written by Mahalia. These 31 articles are the best of the best and we’re very happy to share them with you again!  The countdown continues next week!

….Getting breasts is one of the hallmarks of becoming a woman, but for most of our lives, they’re merely decorative. In the case of men, I believe their’s are God’s way of reminding them their embryos started out as female, to help connect them with the female experience, or maybe they’re just a Darwinian fluke. For whatever reason, everyone has them…

……

Read the rest of the article here!

Boobs To Noobs

Getting breasts is one of the hallmarks of becoming a woman, but for most of our lives, they’re merely decorative. In the case of men, I believe their’s are God’s way of reminding them their embryos started out as female, to help connect them with the female experience, or maybe they’re just a Darwinian fluke. For whatever reason, everyone has them.

In the quarter of a century I had in bras, I only used my boobs for their biological purpose for four and a half months. Then a cancer cell found a nice home to reproduce in inside one of my stretched out milk ducts, and those biddies had to go.

Up until that point in my adult life, I had always had a great self-image. It took eighteen years to get comfortable with my body, but once I did, I was loving it. “Powers” by Blackalicious could best describe how I felt about my wonderful anatomy.

Becoming a mother was a bit of a hit to how I felt about my body. My daughter was a week late, and in that last week my abs gave out and all my stretchmarks came at once and my belly just sagged. But I started cycling to work, and getting back to feeling awesome, and then cancer came along and shattered my positive feelings about my physical appearance.

The first thing that happened was my long, lustrous hair started falling out in clumps, so I shaved my head. I looked at myself in the mirror and I couldn’t even see my own face, but I started to wear wig and I felt a bit better.

Next my eyebrows and eyelashes fell out. It is amazing how much this further changed the appearance of my face. Without this hair to define my eyes, I just looked sick.

Then, I gained a lot of weight. That’s right! I always thought people on chemo lost weight, but not me, I was on steroids, so for the first time in my life I felt a ravenous hunger, and because I was at home and feeling sorry for myself, I just went with it.

And to top it all off my chest went from shapely to concave. I told myself before I had the surgery, that I might actually look forward to being flat-chested; no bras to worry about, and I could exercise without the discomfort of jiggling. But when I went out in public with my new look, passersby could not hide their looks of revulsion.

A fat, disfigured, bald woman with no eyebrows or eyelashes was not pleasing to the eyes of the general public. I even had a couple of people mistake me for a woman who was trying to transition into a man.

So armored in my wig, make up, and knitted knockers, I found people were able to look at me and smile again.

side-by-side

But bras don’t work properly without real breasts. They will ride all the way up to your armpits if you don’t work on keeping them in place. Also, you can’t exercise in knitted prosthetics, and even after I joined a women-only gym, I still got stares. I felt like I needed to wear a shirt that said, “I had breast cancer”, so people wouldn’t have to look and stare at me in wonder.

I’d like to be able to tell my daughter that appearances don’t matter, but judging people by their appearance is an evolutionary instinct. I’m not saying it’s right, but it’s how all of the people you encounter on a daily-basis who don’t know you personally, will experience you. It’s why fashion and cosmetics are industries.

Of course, there is always the option of not caring what other people think, but I tried it, and it doesn’t work for me.  I’m an extrovert.

So I’ve decided to have incredibly invasive plastic surgery, where they will cut new breasts out of my belly fat and sew them onto my chest. I don’t know if I will ever feel like I have my powers back, but I hope my noobs will give me the power to be able to feel comfortable wearing a swimsuit in public this summer.

Have you had a similar experience following your mastectomy?  Did you decide on reconstruction?

How I Turned My Mastesctomy Into Art

mastectomy tattoo

I have always loved tattoos. Shortly after my 18th birthday, I walked into a tattoo shop filled with courage and a bit of cockiness. After studying the wall of images, I confidently pointed to a small cartoon devil named “hot stuff” and said, “Perfect!”

Many people ask whether or I not have any regrets about my first tattoo, but, honesty, I don’t. 23 years later, I look at it and smile. It’s a part of my history, a personalized scar of sorts.

Over the years, I have added other tattoos, so it’s no surprise to anyone that knows me that I decided to add one more. This one however, is the most meaningful piece of art I have ever added to my skin. It is a beautiful ending to a very difficult 6 years. Choosing to remove my healthy breasts because of my 87% chance of developing breast cancer is a decision I don’t regret for one minute. My BRCA gene mutation has forced me to make decisions that no woman should ever have to make. By choosing this tattoo, it was an opportunity to turn my mastectomy into a work of art!

After my mastectomy, I suffered complications with my reconstruction and endured an additional 4 surgeries. I was not interested in another operation to recreate nipples that would never look, feel or work like my real ones. That is when I knew that I was going to do things differently.

My search for a tattoo artist was a personal one. There are many talented artists in Montreal but I needed an emotional connection as well. After meeting with a few I met Meaghan Goeb. Her “realism tattoos” were spectacular and we bonded right away. I knew in that moment that she was the one! She was just as excited about this project as I was and I soon learned that breast cancer had affected her family as well. She understood that I was looking for a piece of art that would become an extension of my body, a new beginning. We both couldn’t wait to get started!

I decided on Magnolias and Cherry blossoms. Magnolias are very tough flowers that represent endurance, eternity and long life. Cherry Blossoms represent fragility and are a reminder that life is beautiful yet short. I gave Meaghan complete creative freedom with the design and colors. We spoke often throughout the month and when I went into the shop to see the final design and layout on my chest, it was above and beyond what I could have imagined.

The day of my first session I was up early, too excited to sleep. I had booked 4 hours. For those who have never had a tattoo that is a LONG time. I was prepared for the worst but hoping for the best. I no longer have feeling in my chest so I was hoping that maybe it would not be so painful. Well I was wrong! It was the most painful tattoo I have done to date. Thankfully, Meaghan and I got along great so the 4 hours were enjoyable.

tat1

After the second 2 hours session was complete and I walked to the mirror to see it fully finished, I could not believe my eyes. It surpassed all of my wildest expectations. The softness and realism of it looks like a painting. It feels like an extension of my body and I am ecstatic with the results. My scar has been transformed and I cannot stop staring!

tat

With an interest in documenting this life altering journey I have been working closely with a videographer named Chris Alsop. Chris is producing a 10 minute documentary in an effort to raise awareness to hereditary breast cancer, mastectomy tattooing and accepting beauty on your own terms.

Although it was not an easy decision, I decided to share my journey because so many women that I have spoken with post mastectomy feel ugly and scarred. Many do not feel sexy anymore and I hope that my story can help change that. Society shows an unrealistic version of what beauty is. I chose to keep one breast scarred because I like the story it tells. I like seeing where my story began.

Remember beauty comes in all forms and I am embracing mine on my terms, scars and all.

You can read more about my mastectomy tattoo in the NY Daily News and in the Global News.

mastctomytatDo you have a mastectomy tattoo or know someone who does?

After A Mastectomy You Get New Boobs! Yay! Wait, Not Really…

When I tell people about my mastectomy and breast reconstruction, I receive lots of support, many questions and even some rude comments. The most frequent thing I hear from both women and men is “at least you will get perky boobs” (insert awkward laugh here)

For those of you who, thankfully, have not had a mastectomy or been close to someone who is going through one, you might think that this is going to make us feel better. It doesn’t! I understand that it is meant to be a supportive comment, but, I promise you, this is not a normal boob job. Yes, I did get implants to replace my real breasts, but that is where the similarities end.

2 days post opp 4 drains

A breast augmentation consists of an implant being inserted behind the existing breast tissue. Typically this is for aesthetic reasons and is meant to enhance a woman’s natural breasts.  A mastectomy “(from Greek μαστός “breast” and ἐκτομή ektomia “cutting out”) is the medical term for the surgical removal of one or both breasts, partially or completely.” (Wikipedia)

I was sent home the day after my mastectomy feeling like I had been hit by a truck. Unable to stand straight, I walked and sat hunched over. The tissue expanders that were placed under my pectoral muscles made me feel like I was wearing a metal corset while an elephant sat on my chest. On top of all that, I was extremely nauseous from the anesthesia and, on the car ride home, it felt like every bump was going to send me over the edge.

drains

As awful as all of that sounds, the worst part, for me, were the drains. I wish I had been prepared emotionally for them because, although it is doable, it is by no means easy to handle them!

The JP drains (Jackson Pratt) are used after a mastectomy to remove any fluid buildup that can accumulate after surgery and cause infection. I woke up from surgery with 4 of them dangling by my side, under the bandages, and they stayed with me for 10 long days.

With every move, the drains would pull at the incision site and, on more than one occasion, I sat on one. Going to the washroom was an ordeal in itself. Where to place the drains? I never really found a great solution for that, but the trial and error was quite entertaining. After battling with the drains for a few days, I finally found a solution that worked the best for me. It didn’t make the drains any more comfortable but I was able to get around a lot easier.

I placed the drains in the pockets of a hooded sweatshirt that I turned inside out. Not attractive, but effective. To prevent the drains from pulling every time I moved, my daughter (who was 2 at the time) suggested “band aids for my boo-boo”, so that’s what I did.

When I returned to the surgeon ten days post surgery to have the drains removed, I was so relieved. I felt some pulling and pinching, but the unpleasantness didn’t last long. Whenever you speak with someone, who has had drains removed after a mastectomy, they will tell you it is a sense of freedom!

These new boobs of mine came at a price, but, for me, it was a price worth paying.

Until next time ☺

Much love

Karen

What was your experience with breast reconstruction following a mastectomy?  Did you have any trouble dealing with your drains?