Switch-out Surgery Explained

A little "present" I left for my plastic surgeon.

Lately I've been fielding questions like What's next? and What's this next surgery all about, anyway? Rather than press rewind and play a few more times, I thought typing and sharing on this blog might be a good way to inform everyone of what's happening at my surgery late this month.

First off, nothing is "wrong" - this is a reconstruction-related surgery. I'm under construction and this is a major step towards piecing me back together. During my double mastectomy surgery last year, expanders (which are basically like thick, ribbed plastic bags with magnetic ports in them) were inserted between my pecs and filled to 150cc. I went in for regular saline injections to fill the expanders which, in turn, stretched my breast skin. To learn more about that, read about my expansion process and filling them up. 
Now that my skin is stretched, radiation is over, the clinical trial is complete, and I am healing well from all of that...it's time for the switch-out surgery.

There are two main goals for this surgery:

1. Take expanders out; insert implants. These thick, stiff expanders have a one-way ticket outta here! Although useful and necessary for the reconstruction process, I'll be happy to not have these things in me anymore. Dr. B, my plastic surgeon, will use the same incision line left from my mastectomy surgery (in the middle of my breast) to take out expanders and insert implants. He may also remove scar tissue that's built up if he feels it's necessary.

2. Remove my port. I had the port inserted on June 17, 2011 to aid me in receiving chemotherapy treatments. While it makes me feel bionic, it kinda (still) freaks out Joshua and it's time to say goodbye to this trusty piece of technology. Thankfully, I never had a blockage or clot while the port was inside of me - I know several other women that have had issues with theirs. I've had it flushed every 4 weeks when it hasn't been in use and it's behaved nicely. I've also appreciated nobody having to fish around for a good vein in my arm. The port made things nice and simple that way!
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Other FAQs related to this surgery:

What's this surgery going to be like for you?
A piece of cake, 'cause I won't be an active participant. :) OK, but really...it'll be approximately 2.5 hours long. No drains and no pain med balls to tote around my waist afterwards. (Hallelujah!) I will most likely spend a night in the hospital, given my challenges in the past with coming to and getting my system up and running.

What is the recovery process going to be like?
I have heard that the recovery from this surgery is easy compared to the first one. Talk about glorious news to hear! I'll wake up with a surgical bra on. I will be able to shower 2 days after surgery. I should expect to be out of commission for about a month. Same lifting restrictions as the first surgery for 4-6 weeks. Then gradual stretching and strengthening to rehabilitate. -->I'm already finding this to be a mental hurdle to overcome. Starting "over" with the arms and rehabilitating my range of motion and muscle power again.

What cup size will you be? 
While that's getting personal, I get it and am not afraid of sharing. The short answer is: I don't exactly know.

Longer answer: Early on, I let Dr. B know that I was hoping for smaller breasts than I had naturally (like a cup size smaller). Because I needed to have radiation soon after surgery, there was a finite amount of time in which we could expand and whatever I was expanded to - that was it. (There's no further expanding post-radiation.) So...I was stretched to what I could handle within that time frame and am trusting everyone in the operating room to decide on an implant size that fits in the pockets we've created for them and "goes with" my body size/shape.

Silicone or saline?
Not sure yet.

What should I expect to see?
The outward projection should be the same for both breasts. Dr. B will do his best to get them closer together (right now they seem like they're miles apart). I may still have concave areas to the side of my breast bone. I'll have more natural looking curves (right now, I could practically sit a coffee cup on the expanders - my profile is pretty humorous). I should expect to see breasts that about the size I am now or a bit smaller; not bigger.

Are you all done after this?
For me, yes, I am choosing to be "done" after this surgery. Right now, I don't find the elective additional procedures to be necessary. For those that are scratching their heads: additional procedures can include surgery to reconstruct nipples ('cause I don't have them), and medical tattooing to color the created nipples (a.k.a. tit tats!).

When is it going to happen?
July 31. This year.