My Double Mastectomy & Implant Reconstruction

So, let's be honest .... my boobs were not attractive.  Losing weight, having a child and then, more importantly, having cancer has taken it's toll on them and they weren't a pretty sight!  Couple that with the fact that they had tried to kill me, it would seem like a "no brainer" to have a mastectomy.  HOWEVER, it's not quite as easy as that ..... for example, with a mastectomy, your nipples lose all sexual feeling.  You may feel ok about this but it's a big consideration.

I was concerned about the end result in terms of size and unlike a boob job, your surgeon won't say "you'll be a C cup" - they will give you what they can given what they have to work with.

I had done some research and agreed with my surgeon that I would have pear shaped implants (as opposed to round), silicone and ones that had a high profile - ie would give more of an outward projection of a natural breast. With implant breast reconstruction, getting a good profile is more challenging than in a boob job. My surgeon uses Mentor High Profile silicone implants and these were the ones during my research that appeared to give a very good result.

My surgeon also told me the pros and cons of placing the implant above or below the muscle.  I had both options but with his guidance chose under the muscle as I was worried that I had quite thin skin and the implant might be more noticeable if it was on top of the muscle.

So four days before surgery, I had to have a pre-op check that included, height, weight, bloods taken, swabs taken (for MRSA), blood pressure and consent form etc! It was pretty thorough and I was there for about an hour. Actually I had expected to feel very anxious the nearer I got to surgery and I found that I did indeed stop sleeping again. Every so often I questionned whether I was doing the right thing but I kept reminding myself why it was important and so the only real day of panic was the actual day of the operation.

I arrived at the hospital at 7am and knew that I was going to be first down to surgery.  For some reason, I had got it in my head that it was a 2 hour operation - I have no idea where I got that from so was floored when the anesthetist told me I'd be sedated for around 6-8 hours!  OMG that was a scary moment. He also said I would have a catheter in (due to the length of surgery - oh great!) and would wake up in recovery and would spend the first night in Intensive Care, followed by a second night on the ward.  This was precautionary as I have diabetes and so extra care was taken to monitor my insulin/blood sugar levels.

Then it was time to put on the gown and paper knickers.  Honestly who designed those things?  They're like giant see through nappies!  Really really not a good look! 

My surgeon coming to draw on my boobs so he had a record of placement etc was the next step and it made me realise just how much I was in his hands.  I've always had faith in him.  He's always given me worst case scenario (expect the worst and hope for the best) but I secretly knew that he would do his best.  I knew he listened when I banged on relentlessly about needing perky boobs and having symmetry and he nodded politely when I showed him inspiration photos!  How he didn't ask the aneasthetist to knock me out then and there I don't know!

Then it was just me and hubby in the room and a nurse came to get me.  Oh no, it's really happening!  I walked down to theatre scared stiff and in tears.  By this point, I had really let fear take over.  I knew I was doing the right thing but oh my, it's still very scary.  Lying on the bed with the anesthetist trying to calm me down and hanging on tight to the nurses hand is the last thing I remember.  I had none of that horrible metallic taste of going under - I really don't remember closing my eyes.

I woke up in recovery at about 2.30-3.00pm and was told everything had gone well and I had been in theatre for just over 6 hours.  Of course the first thing I did was have a look down!  At this point I still had a gown on so I couldn't see much but the shape looked good! 

A nurse came and asked if I wanted to get out of the gown and into something more comfortable and have a wash!  I was desperate for that but very very very worried about how I could do it but she said not to worry and she'd give me a sponge bath.  It's amazing how when you're clean you feel so much better.  ANYWAY of course this meant that my gown had to come off and I would (hopefully) see my new boobs.

I was so surprised, thankful and excited when I looked down and there was a pair of perfect, perky boobs!  Not a Frakenboob in sight!  The nipple areas were covered by sponge dressings and I had large white bandages under each breast and steri-strips going up from under the breast to the nipple.  Funnily enough, even though I appreciate it might look gory, I was just so relieved that I looked like a woman - like a young me! 

At this stage, because I had a catheter, I couldn't get out of bed and I also had those weird blowie uppie things on both legs to ensure circulation was good so I didn't really notice the drains that were inserted either side of each breast (you can just see the one on the left hand side in the photo - the red line over the blue background)

Having the catheter in was an absolute God send because in 24 hours I managed to wee out 4 litres of fluid!  That was an impressive amount and if I'd had to walk to the loo, I'd have been going every 5 minutes.

Not only was I happy but the two nurses looking after me, stepped back and both said "wow"!  They see a fair amount of reconstructions but not many by my surgeon.  They were incredibly impressed - as was I.

By this point, all I felt was overwhelming relief, happiness it was over and a sense of total calm.  I thought I'd have regrets but I had none.  In fact it was the opposite.  I was thrilled - not something I had expected at all.

If you've ever spent a night in Intensive Care, you'll know that it's like Kings Cross Station.  It's the noisiest place in the world!  Coupled with the fact that the ICU unit in my hospital do blood tests/results for the other wards, there was a constant footfall - so I didn't get much sleep but that was okay as I had been asleep for 6 hours earlier!

First thing in the morning I was transferred to my room on the ward and joy of all joys, they took out the catheter and I could get up and go to the toilet.

Now this is where I realised quite how yuck the drains were.  I had one on each side (I believe some people have 2 on each side but I was lucky with just the 1).  You can see in the photo that it's inserted and held in place by just one stitch.  I was terrified of pulling them out and one did come lose and bled a bit (on day 4 when I was at home and it looked like something out of Texas Chainsaw Massacre) but they actually go inside about 6" so there's no way they are coming out!  There's a thin tube that goes into your body and then about a metre down, it is linked to a wider tube that leads down to a sort of vacuum construction at the end.

The drains are really long and must be kept lower than where they go into your body so when you walk you have to pick them up.  I was given two shoulder bags (one for each side) and they became my companions for the next 7 days.  I have to say, for me, the drains were the worst bit.  I felt totally stuck to a chair and when I walked about was so conscious of the drains it was horrible - especially as our new kitten thought they were a new toy for him!

Before I was allowed home I was visited by the hospital physio who gave me a chart of exercises to do.  To be honest, the ones you can do with drains in, I found so easy they weren't worth doing as I had more mobility than I perhaps should have.  When the drains came out, it was another story - the exercises then are designed to stretch everything and oh boy did I feel it.  On the first day of doing those, I lay on the floor trying to get my arms above my head and on the floor.  It was so painful and I got stuck and then couldn't get up!  Luckily hubby was at home and between us we managed to get me on the sofa!  Not being able to pull somebody up with their arms or under their arms is problematic!  LOL!

My other visitor was a student nurse who had observed the whole 6 hour operation.  She was full of praise and admiration for my surgeon.  She said he was so meticulous and that it had been a real eye opener for her.  I of course felt duty bound to show her the results of how they were now looking and, like everybody else she was in awe of his work.

I went home on day 3 (could have probably gone home on day 2) but I was pleased to be comfortable in the hospital (something I've never felt before)!  I was given pain medication but I found that by day 4 I didn't need anything apart from the occasional painkiller at night after staying in one place for a long time - but that was more the pain in my back.

Twice a day I had to empty the drains and record how much came out.  I'd read that drains won't come out until they are under 30mls each time and maintain that for at least 2 or 3 days.  As it happens, my drains drained very little even from day 1.  I think the most one drained was 40mls.  By day 3 I was under 30mls each time on both sides so I was very impatient to have them taken out.

I found that sleeping sitting up was problematic and uncomfortable but I'd bought some V shaped pillows (like the ones you have during pregnancy and they made me more comfortable than pillows on their own).  We only have double beds in our house so having a drain over each side of the bed wasn't going to work so I put one across my body and on the floor with the other one.  I was always conscious that I'd pull that one and it is actually the one that did bleed. 

In terms of pain, it was all do-able.  I won't lie, it does ache quite a bit from where the muscle was pulled up (my implants are under the muscle) and it all felt a bit tender with the odd shooting pain but much much better than I thought it would be.  It was sore and I would get the odd shooting pain (interestingly, my non cancer boob gave me more pain than my cancer boob which didn't hurt at all!  Bending forward was the worst feeling as I got a shooting pain so I quickly learned not to do that!

By day 6 you can see that the breasts were settling down and there was definitely less swelling.

All the dressings were in tact and in place - especially the foam dressings over my nipple area.  My surgeon had left me with strict instructions that NOBODY should touch the dressings until I saw him in a fortnight.  For the nipple graft to work, they have to have time to grab onto the underlying skin and attach to a blood supply so they had to stay in place.

On day 7 I had my drains out.  A fairly painless process and best if you relax.  The stitch is cut on either side and then the nurse literally pulls the tube out.  It feels sooooooo strange coming out - not painful - but the thought of it is worse than it actually is!  Within a minute, both drains were out and a small steri strip and dressing put over them.  So I had added dressings but no drains - woohoo!

Despite the swelling going down, I was still very swollen at this stage and all the post mastectomy bras I had bought didn't fit me.  So after having my drains out I went straight to the bra shop and exchanged them for ones that fit.  I wore one out of the shop and for about 30 minutes until I got home.  Within another 30 minutes I had the most excrutiating pain in my non cancer boob.  All around the nipple area I had horrible shooting pains as the bra was pressing too hard on them breasts.  I got it off quickly but to my horror the following day, I had broken capilliaries all around the foam nipple shield.  I was convinced I had done some damage but there was nothing to be done and I had to wait a week until I went back to see the surgeon.

Day 14 and the ache/pain is minimal although sleeping on my back is still problematic.  When I lie flat I feel a pushing on my chest and it's uncomfortable so I'm still propped up.  I think the bandages under the breast area weren't helping.

Anyway day 14 is the day when I saw my surgeon again AND the great unveiling and removal of dressings.  I was apprehensive, worried, concerned, scared and also frightened as to what the lab results would show from the best tissue that had been removed.

Taking the dressings off was a relief but a bit sore - like taking off any plaster, it's not the greatest of feelings and I kept looking up because I didn't want to dare to look at my nipples.

As the surgeon stood back, he said "WOW" and I wasn't sure that was a good WOW or a bad WOW - it turned out to be a good WOW thank goodness (and interestingly is what most people have said when they've seen my new foobs (false boobs)!

I looked down and the nipple on my non cancer boob I recognised immediately as my own!  I didn't expect that.  It looked great and this was the one that I had worried was damaged by the tight bra.  The right one was 75% ok but there was an issue that was probably not going to take and was looking a bit black.  You could still see it was my nipple and the shape was there and honestly unless you knew, I don't think you'd realise that anything wasn't 100% right.  IF that area doesn't take (and apparently it looked like blood had got underneath it at some point which may have hindered it "taking), then I can either leave it alone and it'll be a slightly different colour to the rest of the areola OR I can have that area tattoo'd.  I'm going to wait and see what happens.

What absolutely floored me though was that the scars leading from the nipple to under the boobs were non existant.  I mean I really had to squint to see them.  It was nothing more than a faint line.  The scar under both boobs was the same although slightly more red but plaed so that they wouldn't be seen and in all honesty, how they look now, I'd expect them to disappear very quickly.

The icing on the cake?  None of the breast tissue showed any signs of cancer.  Now that's the biggest present ever!

Dressings were popped back on to protect them for another week.  The steri strips will probably come off next week and the foam pads the week after but we'll see how they're doing.

Regrets?  None at all.  I'm delighted beyond words.

So here we are with an update at day 21 after surgery.  You'll see that the swelling is slowly going down although the most annoying bit for me is just under my arm (you can't see in the photo) but it's still a bit bulky there and annoying!

The steri-strips have now been removed from the vertical strip (from nipple down to under boob) and also from the scar line under the boob.  From a distance you can't even see the vertical scar line (but you can see it up close - see photo below).

The nipples are still covered by foam pads to protect them.  The left nipple (right in the photo) has taken exceptionally well and there are no areas of necrosis.  It might stay covered for another week or two.  The right nipple has been a little more naughty.  When my surgeon looked at it 2 weeks post surgery, he thought that about 25% of it had failed (due to blood collecting under the nipple).  However on inspection at day 21 he was delighted to see that actually it might be "taking" and the black we're seeing might just be a scab.  We won't know for definite for a while but it's encouraging news.

As you can see in the photo, the vertical scar line is hardly visible.  I'm pretty sure this will be invisible in a few months - it's just amazing!

In terms of pain/healing, by day 21 I'm almost laying flat to sleep but I can't wear a bra when I'm sleeping.  It's just too uncomfortable.  I'm not sure why.

I've actually had trouble finding a bra that's comfortable.  Most have felt too tight and made my breasts ache even ones that are too big for me!  The area that is hurting the most (and by that I mean a dull ache), is the area under my arms to the side of my breasts.  This is still swollen and probably why it's not as comfortable as other areas.  I'm occasionally getting short shooting pains around the breasts but this feels like nerves are reconnecting and it's definitely not enough to take any pain killers.  The aching is the most annoying part - but again, not enough for pain killers.

The most comfortable bra I've found so far is from ASDA at £8!  I've spent a fortune on mastectomy bras, trying to find the right one and then ASDA come up trumps with a cheap one! 

I've been driving (short distances) for about a week and initially it was sore especially when turning corners but it's easier now.  The one thing I still can't do (and don't want to do at the moment), is lift a saucepan of water.  Any lifting like that I'm avoiding at the moment. 


So here are the twins at 8 weeks/2 days post surgery!  At about 5-6 weeks I was allowed to take the covers off the nipples.  They still had some scabbing but this quickly was rubbed off by my bra and to my great surprise, both nipples have "taken" beautifully.  The one nipple that we thought might suffer from some necrosis, hasn't and is the same colour all over.  At some point during the healing process though, it's become slightly oval in shape BUT I don't care!  They're my original nipples, although not functioning ones, but they look great (to me)!

At about 5 weeks I was able to sleep on my back comfortably and by 6 weeks was able to sleep on my side.  That was an enormous relief. 

Apart from a tiny bit of cording under my right arm (where the original SNB was), I don't have any pain at all.  The breast area is softening up and so feeling more natural as well and the scars are definitely looking better.

One (surprising) thing I've found is that wearing a bra (even mastectomy bras) can be a little painful.  Where I have the cording to the side of one breast and just under the arm) it feels really sensitive and any bra seems to press on it.  Inside mastectomy bras you often find it has a pocket to slip in a prosthetic is you need it.  This means that there is an edgin inside the bra and I think this is what is uncomfortable.  I do have one that doesn't have a pocket but that's not comfy either.  So I've actually stopped wearing a bra!  I've never ever ever gone without a bra and it feels very odd - a bit like I'm going out naked or have forgotton to put clothes on.  I can't decide whether it's strange or liberating!  It's a lovely plus though because I can wear lots of summer clothes without worrying about a bra showing!

Did I mention I love my new boobs?  I do mourn the loss of feeling BUT they look so much better than my old knackered boobs and (hopefully) they won't try to kill me again!

I won't downplay that this is an enormous decision to make but I haven't for one minute regretted it.  It was so important to me to do this and I'm very very very pleased with the result (which is an added bonus).