11.04.09
Check Up Part 3
I forgot to include something in yesterday’s post. Dr. Elliott had mentioned that he wanted to make sure that my breast tissue has become softer. For the first few weeks right after surgery, my new boobies were really hard and stiff. They were actually very hard. It reminded me of how hard my breasts were after the initial implant surgery.
I pointed out a place across the top of my left breast that, to me, felt harder that the rest of the breast tissue. After gently prodding at it a bit in examination Dr. Elliott explained that the harder area is the top of the muscle flap. He also explained that in comparison to what HE meant my hard it was actually very soft and pliant.
Something that I found to be extremely bizarre is that where I thought had keloid scarring, upon examination, appeared to have nothing of the sort. I am chalking this up to a slightly poor fitting Caique bra from Lane Bryant. It is just a little too small and it makes the scar line feel a little lumpy after a whole day of wearing that type of bra.
That’s one more reason to have a proper bra fitting done. Even if you think it’s been done properly, sometimes it hasn’t. Even though their customer service is really, REALLY bad,
11.03.09
Check Up Part 2
Dr. Elliott is EXTREMELY pleased with how well the Twins are doing. He’s thrilled with how much they’ve softened and how well the scars are fading. He’s also pleased with how my back looks.
While he was looking and “groping” (forgive me Dr. Elliott, I don’t know what else to call it when you check to see how they feel) we talked about the things I was curious about. First, I found out the reason my back has that plasticky feeling like someone set down a layer of plastic wrap across a wide section of my back.
The reason for that is that he basically disected my back, probably doing more surgical maneuvering back there than in my chest. The crackly feeling is where scar tissue has formed in kind of a sheet. It will probably take another six months or so for that to release. He gave the same prognosis for the numb areas, although those could take even longer.
We also talked about how subjective the term “recovery” is. You “recover” in the recovery room. You “recover” in the hospital. You “recover” after the surgery and that can take over a year dependent on which aspect of healing we’re talking about. For instance it took me about six months to get my endurance level back to where it was. Some people take more time. Others take less.
It’s subjective.
We also discussed nipple reconstruction. I told him it probably wouldn’t be until this time next year. He said it didn’t matter. We could do it tomorrow, next week or five years from now. Personally *I* was just relieved that he wasn’t planning to retire any time soon.
Another thing we touched on was doing a breast lift. His concern is that there wouldn’t be much point to it because as heavy as the Twins are, they would end up right back where they are in no time at all. I would have to lose at least 30 pounds before it would become feasible.
My big issue with that is around that point the Twins will start getting smaller. As I’ve written before, to watch them shrink away is like watching my original breasts rot away. I just can’t handle that right now. I just can’t. As i sit here typing I can feel the panic rising and the tears filling my eyes. I CAN’T lose them again.
Okay, okay, I know logically that I’m not losing them. They’re a part of me and I love them dearly. I’m just SO not ready for that. And for the first time in my life I’m content to weigh 218.
We also discussed the two little places on my sides that look like little handles. he called them puckers I think. (Dr. Elliott, if you read this please leave a comment and correct my verbage). He said they were normal and occurred as part of the surgery. We could do a little lipo to lessen them but to tuck the skin would require another incision. Dr. Elliott didn’t seem very keen on another couple of incisions on me and I’m really quite okay with that. He explained that when you do the tummy tuck type breast reconstruction you get the same thing at the hip bone area.
Dr. Elliott made a point of mentioning that he was SO happy we had gone with the latissimus flap reconstruction rather than the tummy tuck. We both had been extremely concerned about possible complications. The tummy tuck procedure simply carries more risk and more risk was the LAST thing I needed.
So all in all the Twins are doing great. He wants to see me again Aprilish for my one year check up. In the mean time I REALLY hope that he checks in. He seemed really interested in my blogs.
And in case I haven’t said it enough, he’s an amazing doctor. Every woman who has to go through reconstruction for ANY reason should go see Dr. Elliott at Atlanta Plastic Surgery (http://www.atlplastic.com).
09.30.09
Keloid Scars
I may I have covered this topic before but not as it applied to me, personally. I noticed something last night after I took off my bra. There is a two to three inch area on the underside of each of my new breasts that has some keloid scarring. These spots didn’t have tape on them consistently as they are furthest out towards my sides and the tape kept coming off there.
Imagine if skin could simmer like water and then be frozen in that state. That’s what keloid scars look like. Here’s a photo of keloid scars on someone’s chest.
Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation could be related to the process of keloid formation, but these changes have not yet been characterized scientifically.
The methods now available to treat keloids are:
- Cortisone injections (intralesional steroids): These are safe and not very painful. Injections are usually given once per month until the maximum benefit is obtained. Injections are safe (very little steroid gets into the bloodstream) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
- Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site after cutting away the keloid. Radiation after surgical excision has also been used.
- Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
- Silicone sheets: This involves wearing a sheet of silicone gel on the affected area for several hours a day for weeks or months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
- Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens the site of treatment.
- Interferon: Interferons are proteins produced by the body’s immune systems that help fight off viruses, bacteria, and other challenges. In recent studies, injections of interferon have shown promise in reducing the size of keloids, though it’s not yet certain whether that effect will be lasting. Current research is underway using a variant of this method, applying topical imiquimod (Aldara), which stimulates the body to produce interferon.
- Fluorouracil: Injections of this chemotherapy agent, alone or together with steroids, have been used as well for treatment of keloids.
- Radiation: Some doctors have reported safe and effective use of radiation to treat keloids.
This is not a very common complication, but it can happen. There doesn’t seem to be a bias. It happens equally in men and women as well as all ethnicities.
08.10.09
Complexus Inferioritus
Today marks a fresh start for the BoobCast blog. It may be occasionally sprinkled with updates on my current status but for the most part I’ll be talking in detail about why I had the initial breast augmentation and lift. I’ll also add much more in-depth detail to what happened to me and why it may have happened.
Today I’m going to talk about the reasons I had the surgery done in the first place.
I was always pretty socially awkward in high school. I was about 20 pounds overweight, only a couple friends, unpopular and an easy target because I had absolutely no self esteem. Add to that, when I went in for a bra fitting, the sales woman told me I had tubular breasts. I had absolutely no idea what that meant and at 16 was too embarrassed to ask.
This is what tubular breasts look like: http://tinyurl.com/mp3cwv
Fast forward 10 years, add breast feeding two kids and gravity and I REALLY hated my breasts. They weren’t pretty. They were just a couple of hanging flaps of skin. Add to that my nipples were so overly sensitive that if my partners tried to stimulate them, I was hanging from the ceiling because it was just too much sensation.
It was about that time that I became determined that by the time I was 40 I would have beautiful breasts. It wasn’t always at the forefront of my mind but the idea sat in the back of my mind and became cemented. Every time I went bra shopping the notion that my breasts were horrible and I needed a boob job became more and more firmly cemented in my mind.
At 39 I became completely obsessed with the idea that I HAD to get something done. I started researching plastic surgeons in the area. It took me about six months before I finally decided on one locally. So I made an appointment for a consultation.
With everything else that had been going on with major family issues , school and the business, I finally went to an appointment in the spring of my 40th year.
After taking a look at my breasts, it was announced that I had degraded as far as I could and it wasn’t going to get any worse. This article explains the Gurley Stages of Breast Regression http://tinyurl.com/2d3ds3 and I was a Gurley Stage II
The doctor used a different scale but I am unable to find it. It basically amounts to how big your areolaes are and how much droop you have. Mine were the size of Coke bottle bottoms and my nipples pointed at the floor. So I was told I would need a breast lift to make them look perkier and an implant to replace the volume I had lost from breast feeding and age.
She put a VHS tape in that explained the anchor lift procedure and left me alone to watch it. Please look here for a diagram and description of a full (anchor) mastopexy: http://tinyurl.com/ku5wy5
I will continue this tomorrow since this post is running long.
07.26.09
Midnight eMails
Regardless of the fact that I knew I had to be up early this morning to travel back home from Atlanta, I was down in the lounge at the Westin around midnight. I had, as usual, forgotten to ask Dr. Elliott a few things about the revision surgery we talked about at my appointment on Thursday afternoon.
We had hoped that the little spot near my cleavage would have rounded out a bit more by now, but it is still kind of squarish, So he’s going to kind of pinch that skin together to round it off. He has also suggested doing a breast lift because, as you’ve all seen from the first photo, the Twins are kind of droopy.
Of course, as part of my late night meanderings, I did research on various types of breast lifts. He did not mention a specific type. However in his reply to my email he DID say that there would be no new scars. He would simply make use of the ones I have now. This leads me to believe that he’s thinking of using THIS type of lift: http://www.breastlift4you.com/techniques_incisions.htm
As you can see, this type of crescent incision would use the scars I already have and would be a moderate lift. If the lift is included in the cost of the revisions and nipple creation, I have the general attitude of “Why the hell not?”. He’s going to be doing surgery anyway and I’m paying for it so why not just do the “one stop shop” deal and get it all done and over with at the same time? Dr. Elliott is enough of a pro to be able to do it and do it well.
There ARE other types of breast lifts that, as with the crescent lift above, do not reduce breast tissue volume the way the Anchor Lift does. http://www.plasticsurgery4u.com/procedure_folder/breast_ptosis_surgery2.html This site shows some good examples of the Donut and Lollipop lift.
I always feel better after talking with Dr. Elliott. So I think that, when we can manage the cost, I’ll be having the revision surgery. One thing I learned from my mother-in-law before she died was :Never Settle. So I might as well get what I want.
07.01.09
Emu Oil
A couple months ago I mentioned that I was starting to use something new to try to speed healing of that lovely little troubled spot. I had read that Emu Oil works wonders for many people. I’m here to weigh in on the subject.
Yes, it works. It speeds tissue growth. The problem for me was that it speeds tissue growth in the wrong places. Instead of allowing the skin to grow over the wound from the edges of separation, it grew new tissue in the middle of the wound that actually IMPEDED wound closure. So now we’re doing wet to dry bandages. I’ve explained that process in a previous post.
My conclusion: Emu oil works but you’ve got to be aware of precisely how it is applied.
06.25.09
The Non-Infection Infection
I had my appointment with Dr. Guy’s people this morning at 11:15. There is good news afoot dear reader. According to Dr. Guy’s PA, the troublesome spot on my back is NOT infected. The white stuff is simply “flesh”. That IS a direct quote.
Unfortunately the flesh is inhibiting healing, so we’re back to doing wet-to-dry bandages. I have a follow up appointment in two weeks to check the progress. Hopefully by then the area will FINALLY be closed up.
For those not familiar with wet to dry bandages, I’ll explain. I believe I may have mentioned the profess in an earlier post but I’d hate for you to have to dig for it. When there is a fairly shallow wound in need of debreiding, the least painful ad least invasive way to do it and keep it relatively sterile is to use a wet-to-dry. Here, you take a piece of sterile gauze ad soak it thoroughly with saline. Then you pack it lightly into the wound so that it covers every bit of it, even into the corners. The wet then gets covered with dry gauze and taped. When it dries, the gauze adheres to the biological matter to be removed. When you pull it out to change it, it takes some of the matter with it. Then the process is repeated until the wound is clean.
Our bodies heal from the inside out. Following this process gives your body a clean bed from which to grow new flesh and eventually skin. It can be tedious and somewhat frustrating. Sometimes it only pulls off a little bit. I just keep focusing on the good news that it’s not infected.
06.23.09
9 1/2 Weeks
From the title of the post, it’s pretty obvious what today’s topic is.
Medical updates.
The spot on my back is still troublesome. It’s not really getting any better. I’m still not too worried about it though as no one else at Dr. Elliott’s office is overly concerned. Last night Ken said he thinks I should “be seen” by Dr. Elliott’s contemporary down here, Dr. Roxanne Guy. I have an appointment for Thursday.
Honestly, I am SICK of “being seen”. I am SO over all of this medical crap. I just want to get ON with my life. I think that’s part of the reason I’ve started doing Ta Ta Tuesday. Even though I may not be completely done with all of this, I want to start enjoying the completion of the major stage.
The nurse at Dr. Elliott’s office had suggested that I wait another month to take the tape off the suture line. I got tired of waiting so I went ahead and took the tapes off four days early. Really I could have taken the tapes off at 6 weeks but I tend to be overly cautious as far as suture lines go.
I haven’t taken any acetaminophen for pain in a few days. I’m happy about that. It’s definitely a few steps ahead of where I was. My endurance, however, is another matter all together. I used to be able to be at Disney for anywhere from 12 to 14 hours. Now I can’t walk around for more than a couple hours without getting worn out. It’s possible that the heat could be exacerbating the issue, but I just don’t think so.
Mobility is another issue. I can raise my left arm all the way up next to my head. The skin in my armpit is still a little tight. My right arm is another matter. I can only raise it at a 55 or 60 degree angle without tightness and pain. It HAS improved since surgery. It’s just improving more slowly.
Emotionally I’m doing better, as the idea of TaTa Tuesday shows. I’m still trying to decide if I want to take a chance on nipple reconstruction. Some articles say that in experienced hands the failure rate is less than 2%. On other websites I’ve read women’s stories of how their nipples flattened out between six months to 2 years. There was also a fairly high incident of infection.
I have emailed Dr. Elliott and asked him to suggest someone who makes custom silicone nipples and write a letter of request. Every prosthetics maker I have found that does really good hand painted nipples requires a letter from a physician. Even if I decide to have the surgery later, I will still have the prosthetics in the mean time.
06.20.09
Under There
HA! Just made you say “Underwear”!
Seriously though folks, because of the relatively minor issues with slow healing on my back in a couple spots, I’m wearing camisoles either as my top or as an undershirt. It took me a while to find ones with half way decent support. I’ve found that shelf bras with wide eleastic bands do a pretty decent job. I found a bunch at Kohl’s on sale for $9.99 each. They have thin shoulder straps but the band is pretty wide so that sort of makes up for it.
I found two others at Macy’s with wide elastic shoulder straps and a wide band. I like those better as they tend to give better support. Unfortunately it’s summer in Florida and it is already reaching 99 degrees in the afternoons. I can only wear those once as undershirts before having to wash them. It IS nice just throwig on a cami and capris when I need to run out the door though.
I have all these pretty bras and panties and I still can’t wear any of them until these areas on my back are completely healed. Which brings me to a major complaint about Intimacy. I am STILL missing two pairs of panties. A couple weeks ago I got a call from a manager asking me if I had gotten everything. I let her know what I was still missing and that I had called leaving a message saying as much but never got a call back. She told me that she would investigate and call me back. I STILL have not heard from her.
I’m getting ticked off about this. They have such wonderful products but such hideous customer service that it’s really no longer worth it to shop there. For THAT kind of money per piece I expect MUCH better service. I will, of course, keep you all up to date about what happens. I WILL have my matching panties or someone will be dealing with an extraordinarilly pissed off Maria. That is NOT something anyone wants.
06.18.09
Numb: An Update
On 6/4/09 I wrote about rubbing a spot on my back raw with a new bra strap and causing some pretty major bruising. I simply couldn’t feel what was happening because the area closest to my spine is still insensate from the incisions on either side where the muscle was removed.
A couple days ago I started getting worried because the bruised area had sloughed off skin and the scabbed over area was turning an odd shade of yellow. Yesterday I noticed that it was tinged green. That’s ALWAYS a bad color for a wound. I am, of course, very paranoid about any kind of complications. So I had Ken take a photo, emailed the shot and called Dr. Elliott’s office to talk to one of the nurses.
After asking if I was running a fever or if there was a smell, she suggested that perhaps we were simply keeping it too moist. The bandage was being changed 1-2 times a day and copious Neosporin was applied. She also told us that we should be washing the area twice a day with antibacterial soap. This was news to me as had been previously told that it should be washed whenever I showered. Since I’m so inactive I don’t shower daily as it is simply too draining. I exhaust very easily.
This morning after covering the area with only non-stick gauze and no neosporin, it was back to where it had been previously. So this is a cautionary tale about keeping wounds TOO moist.
As for the numbness itself, it’s getting better. I do think that it’s probably going to take a few more months before my back is completely normal again though. Time will tell.
