The process of Expansion: PHOTOS

I wanted to do a post specific to the process and progression of my results with Temporary Tissue Expanders. These devices were placed under my chest muscles at the time of my mastectomy. They have a thick outer shell and a port in which the surgeon would add saline, a little at a time, to stretch the muscle enough to form a pocket for a permanent breast implant. You can read more about them here. I'm going to warn you now that the pictures below are graphic.


After mastectomy (Total 250cc's per side):

This photo was taken about 4 weeks after my mastectomy. My plastic surgeon has placed 250cc's of saline in each expander immediately following my mastectomy, so I wasn't totally flat.

1st Expansion, 90cc's each side (Total 340cc's per side):

                                                                         Before

                                                                   Immediately After
(The surgeon uses a magnet to locate the port that allows addition of saline. He or she literally marks an "X" for the spot and uses a syringe to add the fluid. Although my skin is numb, my muscle isn't so I felt the prick of the needle. After the fluid was added, I would feel pressure. I felt like I had an iron-clad sports bra on that was 4 sizes too small. The pressure got worse towards the end of the expansion process.)

                                                                              After

3nd Expansion, 90cc's each side (Total 520cc's per side):

                                                                      Halfway done!

Over-expanded, (Total 790cc's per side):

My final implant size with be 750cc silicone. I am over-expanded to 790cc's per side. They do this to "over-stretch" the chest muscle and allow for a better pocket for the implant. It will create a more natural breast. You can see my drain scars. I'm numb all the way to there.

The "caves" under my arms are evident in this picture. That was one thing I was not expecting after mastectomy. This will be corrected some at the time of implant exchange. If it's not to my liking, I can have a revision to smooth out my sides a little more.

The expanders are often uneven. They are not devices intended for aesthetic beauty. They are intended to stretch. They are hard, lumpy, misshapen, and uneven. They are so hard, they do not move at all.

But under a cami, they look ok. I usually wear another shirt over my cami. I look like I have a super duper miracle bra on, but it passes.

My final implants will look like natural breasts and they will feel like natural breasts. They will have a more natural slope and not stand at attention like the expanders. They will appear smaller than the expanders but my surgeon says I will have a nice, full C-cup when completed.

Don't take squishy boobs for granted...

Progress! It's only been a couple of weeks (not a month) since my last blog! Woohoo! Boy, have there been some developments. Things are moving pretty fast again.

First of all, I just want to say thank you to the people who reached out to me after my last blog. I'm not going to name any names, but the messages & phone calls meant a lot. Thank you. I want everyone to know that I really am ok. Even on my bad days, I'm still thankful for all the gifts God has given to me. Bad days are just that.....bad. Blogging helps me (when I remember to do it) work through these feelings that ramble through my head. I'm just thankful to have so many people who care about me. :)

Second of all, I have a huge announcement. My exchange surgery is FINALLY scheduled. YAY!!! I'll be ditching these rock-hard, heavy, misshapen mounds for soft, subtle, SQUISHY, silicone implants on Monday, March 19, 2012 at 10:30am. It will be an out-patient procedure at Presbyterian Main Hospital in uptown Charlotte. I cannot express how excited I am!

That has made me feel a lot better and it gives me something to look forward to. I am nervous, too, I can't lie. There's always concern anytime you have to be intubated with anesthesia and I'm concerned about the "after" results. I realize that there will be more adjusting, more grieving of what was, and some patience to settle into my new breasts. BUT...I will be rid of these expanders! That's the best part and believe me, NEVER AGAIN will I take squishy boobs for granted. I swear that's my new slogan. I'm telling all my friends....don't take your squishy boobs for granted! Someone needs to make a T-shirt!

My third bit of info isn't as happy. After seeing Dr. Appel for my pre-op check, and his thorough examination of my arm, he confirmed my fear. I have developed mild lymphedema in my left arm, even though he said that only 5% of women with a Sentinel Node Biopsy develop this condition. My hands were still swollen that morning and my wedding rings wouldn't budge. He prescribed me some Dilaudid to take at night to help me sleep and sent an order to physical therapy for treatment of the lymphedema. I asked him about a compression sleeve to wear for treatment, but he said that the sleeves were used more for moderate cases. I could go back to Peggy for manual lymphatic draining, so I was happy to have a plan. He said that it we could effectively treat it, we could probably prevent it from becoming a moderate case. Thank goodness!

When I went to PT, I didn't think I was swollen. I could take my rings off and had good range of motion, so I was surprised when Peggy told me that she could tell that my arm and shoulder were swollen. She took some measurements and quickly agreed with Dr. Appel's diagnosis. That was a bummer. She did not agree with his statement about compression sleeves for treatment.

Let me break from this for a quick second and just say that there is a lot of debate within the medical community concerning lymphedema, lymph node removal, and all that. It can attack someone randomly after axillary lymph node biopsy/removal. Someone with only 1 node can be affected, so can a person that has had 20 removed. The same is true in the opposite scenario. Some people say that compression sleeves are a great preventative treatment, some say only in extreme cases. There are different studies to verify both theories, but there hasn't been enough research on this subject to have a concrete conclusion.

Back to Peggy- she was going to do some manual draining, which was very painful, and she was also going to check with my insurance for a referral to the lymphedema clinic. She thinks (and I agree) that I would benefit from a compression sleeve. It will help what is already swollen and hopefully help or prevent any more fluid from collecting in my arm and hand. Summer time is not far away and I know that heat has to make it worse if this is anything like regular edema. I'll find out on Thursday if I'm going to the clinic before or after my exchange surgery.

A lot has happened in the last couple of weeks and that's been a good thing for me. The physical therapy and lymphedema have also slowed me down in regards to soreness. It kept me from going to my dear friend Laura's 1 year anniversary party. Missing that really sucked. I'm frustrated that I have to go back to physical therapy twice a week and miss more work. I feel like I need to be working more, especially since I learned that I was out of FMLA time, but my schedule is what it is. I'm trying to not stress about this for two reasons. One, everything will work out...I know it will because it always does. Two, if I don't take the time to focus on myself and take care of me; I'm not going to do anyone any good. Not work, not the house, not the kids, not my husband. Ward has been such a wonderful support- he encourages me when I need it most and picks up my slack whenever he can.

Am I still exhausted? Some days. It has gotten better since I have nighttime pain medicine. I can usually get between 4 or 5 hours of good sleep before I'm up & down. That's a big improvement, but still not what I would say a good night's sleep was. I am aching to sleep on my belly! Do I still feel lost? Yes, some days. My sleep is better, my pain is more manageable, and I'm still seeing my counselor so all that is helping a lot. Again, it's a process. Am I still having self-image doubts? Yes. That one may take a little time. Do I feel stuck? Sometimes....but I have something today that I didn't have a couple weeks ago & that's a countdown.

13 days until I have squishy boobs!