I’m not a decisive person.

Wedding dress shopping, for me, was kind of a nightmare.

I named my youngest daughter ‘Stella’ for a night, woke up the next morning all like, “Nah Josh, I don’t think she’s a Stella. Let’s go with Alice,” and then it took us the rest of that day plus another to settle on a middle name.  But my husband is pretty used to how I roll.

“Well, I better call my mom,” he joked that morning after Stella/Alice was born, “before anyone has anything monogrammed.”

Josh and Alice Jolene
Josh and Alice Jolene

This is why I’ve never wanted a tattoo.  I just know that two months later I would hate it.

I buy shirts that are *so me* for, like, three weeks before I hate them forever.  “Were my eyes closed when I bought this?” I think to myself.  “Who am I?”  (But I have to continue to wear them because WHAT AM I MADE OF? MONEY?)

I tell you this so you will understand my struggle right now.

I’m 99 percent sure that I’m going to go ahead with reconstruction (Always leave a little wiggle room, no?), but now I have to decide how to go about it.  Like what kind of boobs I’m going to get.  That’s a big decision for someone who clams up at the dollar menu.

I had my last Herceptin infusion last week (!!!!!) and after an emotional bell ringing — it was strangely more much emotional than the bell ringing to mark the end of chemo — I headed down one floor for a consultation with my reconstructive plastic surgeon.

Herceptin COMPLETE!  And then I hugged the nurse assistant and had a cry by the elevators.
Herceptin COMPLETE! And then I hugged the nurse assistant and had a little cry by the elevators.

I had only met him once, two days after my diagnosis, and my impression of him was probably influenced heavily by the haze that I was in.  I remember him as being cocky and maybe even a little loud and apathetic.  Nothing is further from the truth.  I mean, Dr. Build-A-Boob (let’s just call him that) is definitely confident but in a surprisingly quiet kind of way.

But first, I met with the fellow.

I had stripped down — and when your boobs are detachable, those have to go too — and covered back up with the hospital gown, and just when I started to get comfortable, in walks the fellow.

He was cute and charming and caring.

I knew immediately that I didn’t want to disrobe in front of him and hugged my gown a little tighter.

This had happened once before, at my last echocardiogram a few months ago.  The technician was a guy about my age but not as cute as this plastic surgeon in training.  At that appointment, I decided to treat it as a social experiment, and as I opened my gown for the ultrasound, I studied the technician’s face.  HARD.  In fact, he’ll probably request to never care for me again.  I don’t know if I was waiting for him to flinch or start crying or run away screaming, but I do know that I was ready to detect even the slightest amount of disgust in his eyes.   To my disappointment (but also really not), I saw nothing.

This time, Dr. InTraining didn’t ask me to disrobe (Thank the good Lord.), and instead sat with me for at least twenty minutes discussing my boob plans and options while I made slightly inappropriate boob jokes.  I had lots and lots of questions (a plus to delaying the surgery until you are past the “I HAVE CANCER??! fog), and he patiently answered them all.  By the time we were done talking, I felt optimistic about surgery and kind of like I had a new friend, and I was stoked that he didn’t ask to see the war zone that is my chest.

Then, he went to get Dr. Build-A-Boob, who definitely would need to assess my situation, which was fine by me.  Dr. BAB is a little older than me, not quite so cute, and frankly, saw what I was working with before they were gone.

What I didn’t anticipate was Dr. InTraining coming back in the room as an onlooker.

So here’s where I’m going to tell you about my two real options.  I basically have to decide between implants and a type of breast reconstruction know as DIEP, where they basically craft new boobs out of skin and fat from your lower belly.  There are pros and cons to each, but in order to give me a real picture of my options, Dr. BAB needed to also take a look at my belly fat, and when he said, “Can you unbutton your jeans, please?” I knew it was going to get real real up in there.

It is embarrassing enough having someone inspect and poke around your belly fat under FLUORESCENT LIGHTS, but to have a bystander involved is downright humiliating.

I uncomfortably muttered things like, “Yeah…haha…chemo made me gain this weight,” “I’m fifteen pounds over my normal right now,” and “I’ve never weighed this much not pregnant.”

So yeah, I was suuuper cool about it.

But Dr. BAB didn’t just, like, see if he could ‘pinch and inch’ or whatever.  He pushed and pulled and squeezed and contorted my little (but bigger than ever before) belly every which way.  At one point, he put his hands on exactly half of my lower stomach and simultaneously squished them together and pulled them out in order to get an idea of how big of a breast he could make out of it.  So I guess he was feeling me up in a way?  Jk.

Anyway, after that emotional trauma, we again went through he pros and cons of implants vs. DIEP.  I am a candidate for both, and I have to be honest, even though the surgery for DIEP is a bigger deal, recovery is much more brutal, and it just sounds kind of gross, I was leaning toward that option.

That is until Dr. Build-A-Boob informed me that he wasn’t sure if he would be able to build me back up to my natural size.

Ahh gee, well, thanks…

But wait, I’LL BE DAMNED IF I HAVE THIS SURGERY AND END UP SMALLER THAN BEFORE.  Oh, hell no.

Is that vain?  I don’t care.  It’s true.  After all this, there is no way in hell that I’m going to settle on a A or barely B cup.

“So you want me to gain twenty pounds?” I ask.  “Cheeseburgers all around in the name of bigger boobs?”

He agreed that that’s a possibility, but I’m not sure it would work.  A cup size of belly fat would, at least, quadruple the junk in my trunk.

And before you go there, my mother-in-law and husband already beat you to it.  Yes, they could use other sources of fat (my badonk), but Dr. BAB doesn’t recommend it.

So what I’m left with is my pros and cons list.

The route to implants starts with expanders — to literally expand my skin and create a space for boobs — that would have to be ‘filled’ every two weeks or so for about four months (I think?).  I imagine that hurts 50 times more than tightening braces, but I don’t know anything about either.  Then it requires a ‘swap’ surgery to replace the expanders with the implants, and surgery every 10-15 years forevermore to replace the implants themselves because implants expire.  Did you guys know that?  Weird.

Although it’s more surgery, it’s an easier surgery, taking only around two hours each time (DIEP takes 10-12 hours!), AND I can go bigger.  I’m not trying to get crazy here, but I can’t swallow being smaller than before after having to deal with so much crap.

But implants are not a perfect fit for me either.  Since they are literally just mounds on your chest — and I have no fat or breast tissue to surround them — they would be just mounds on my chest, and one of the things that currently bothers me most is the concavity of my chest, especially my upper chest.  In fact, it was this upper chest hollowing that led to me considering reconstruction because it is noticeable in a lot of clothes.

This is embarrassing for me to show, but it's the truth of mastectomies.  Check out the concavity and hey there, prostetic!
This is embarrassing for me to show, but it’s the truth of mastectomies. Check out the concavity and hey there, foob!

As far as DIEP is concerned, it’s potentially only one surgery and done.  It uses my own tissue so I wouldn’t have anything foreign in my body and the infection rates are much lower as such.  It would address the concavity and the look is more natural.  Also, the procedure includes a free (??) tummy tuck.  I mean, not that I really need it, but it’s definitely on the pro list.  On the other hand, it would leave a pretty mean scar from hip to hip.

There are lots of other pros + cons, and Dr. BAB really tried to help me nail it down.  Like, in a nice, caring way.  He tried to help me decide which would work better for me, but it was like the time I tried to choose between JTT and Joey Lawrence.  At eleven, I. just. couldn’t.

He told me to go home and discuss it with my family, but what exactly does that even mean?  I tried to talk to Josh about it, but (1) he also doesn’t really know and (2) if he even hints around the visual or tactile benefits of one over the other, I basically accuse him of not caring about what’s best for my health.  Oh Heather, haha.

So what am I supposed to do?  Call my dad?

I know for sure that my mom would support me in not being cool with having a boob job to go smaller so there’s that.  And my mother-in-law definitely has her opinions, but they aren’t usually based on what you would call facts.

It’s been over a week, and this is where I am still.  Unsure and struggling to make a decision.  And it’s not exactly like I’m trying to decide between fajitas or pizza for dinner.  This is just phase one you guys.  Wait until I have to decide what to do about nipples.

20 comments on “Boob shopping.”

  1. You are too funny! I really enjoy your writing. You will make the right decision. Go with the one that feels right to you, and don’t second guess yourself. I’m enjoying my new boobs! 🙂

  2. It’s tough enough to lose our breasts, and deal with the anguish of disfigurement, but then to be told we won’t get back our normal size is confronting and a little heartbreaking. I felt dismay about that too. I currently have tissue expander so in both sides (awful shape, but I don’t need a foob) and I have a bit to think about for reconstruction too – although I will be having Herceptin until next April so it’s not a decision I need to rush)
    Good luck with your decision. My plastic surgeon is recommending implants for me and some injections of belly fat on top to make them feel a bit more soft. I am like you in that I don’t have enough belly to make two decent sized boobs. I really don’t like the idea of putting on extra weight to do it either…so I am leaning towards implants. And as far as nipples go…we could do ANYTHING! How about a pair of unicorns on top of your new breasts!!!! Haha
    All the best, Heather.
    Xxx

  3. I did implants, my mom did DIEP. I now have encapsulation of my “cancer side”. Basically my body is trying to “wall off” or “reject” my silicone implants, by encapsulating it in scar tissue. Not all that uncommon. Just focal hard and considerably smaller and perlite than my other side, which does not have encapsulation. I need to have them redone….I can’t wear a bra, because it’s easily two to three sizes different. I just can’t make myself do this again. The length of the DIEP scarred me to death. The thought of being on the operating table for 12 plus hours terrifies me. That being said….my mom, LOOKS FABULOUS. She was 65 when she had hers done and you can hardly see the abdominal incision. Ask your BAB dr. If he will do a combination. I think that was an option if your body doesn’t have wrought to create a boob!!! Let me know what you decide. Maybe I will do it with ya!!! (;

  4. Hi Heather! I am also not a decisive person. My friends find it difficult to deal with this side of me, especially at restaurants where I end up changing things from the menu (yea, awful!).

    I have no experience with reconstruction but I want to wish you good luck with you decision. I am guessing what makes this so difficult is that it has to come from you. You need to feel at peace with it. And you will.

    Hugs.

  5. Hi Heather, I was also concave after my bilateral mastectomy and with expanders that were placed at that time. My pre cancer cup size was c/d. I elected silicone round implants. My plastic surgeon did an excellent job as I am no longer concave with the implant placement. Get exactly what you want. While the implants are just mounds on your chest you don’t have to wear a bra if you choose not to and that is a pro for me.

  6. thank you for capturing just the struggle I have been going through. I am a candidate for both too. Right now I don’t have to face the surgery/reconstruction process just yet, but I know it will be coming down the road and it helps to know that someone else is just as indecisive as I am. I say go for what feels right to you. Now if I could just decide what that is! Good luck!

  7. You should definitely consult another plastic surgeon. There are ways to increase the size of the flap after the initial surgery during stage two, specifically fat grafting. If your surgeon isn’t very experienced at that surgery he may not want to go that route. You should check out Kline and Craigie in Charleston South Carolina, or PRMA in San Antonio Texas. Both are very experienced at reconstructing breasts for women who’ve been through cancer and treatment. They are the best. DIEP is hard,but worth it, in my experience.

  8. One question I would ask your PS is about whether or not your skin would allow you to actually go bigger with implants? As it is clearly important in your decision process. I do know someone who, because of radiation, her skin could only stretch so much, so that limited how big of implants she could get …
    I did DIEP and haven’t looked back … implants were not a good option if I ever plan to move back to Canada (they get damn cold in the winter months)! Just another something that the PS forget to tell you about!

  9. I should mention that the one advantage to bilateral reconstruction is that they make you perky! So, you can choose to go braless if you want 🙂

  10. First off, I love all your stories, and you are one amazingly strong woman (I always got sick of everyone telling me that, because it’s not like we have a choice, but anyway) I had my ladies chopped off last year, and went the expander route and I now have saline implants. There are a lot of horror stories out there which had me super worried for the first few weeks, but my experience was pretty painless and easy and it kept me entertained to slowly have my boobs grow… Now I can flex my pec muscles and never have to wear a bra!!! If you or anyone else has any questions please let me know I’m more than happy to share my experience! taylashoultz@hotmail.com

  11. Wow, Heather, reading this post was like being inside my own head, my own experience– and like reading some of my own blog posts and private journal entries, in which I waffle back and forth and back again about reconstruction. I was diagnosed (at age 39) about 7 months ago, did chemo first; and thank goodness because it meant I had some time to figure out about reconstruction, because every time I thought I’d finally made a decision, I’d change my mind again– sometimes, but not always, because of new information, like learning that I was not a candidate for the tummy DIEP, either, which was my initial leaning WERE I to do reconstruction. (I went to see a doctor who specializes in some of the other surgeries using one’s own tissue, because I thought I’d be a candidate for using my butt fat (ha!) and I am… have you looked into other options?) In any case, I had a left mastectomy 2 weeks ago and in the end, decided to go with implant reconstruction (something that at one point I thought I’d NEVER do). It took me literally months, and dozens of conversations, and a lot of research to get to that decision. Now I need to face radiation which may undo the whole thing, but that’s for another day….

  12. There is no way on God’s green earth I’m reconstructing, especially since I’ve reluctantly read your summary of the options. I also make totally inappropriate jokes at appointments (told the sub-in when my doc was OOO that I was sorry he didn’t draw the straw to take off my girls and that we couldn’t all be lottery winners, could we?). You’ve gotta have some ‘fun’ with it. Your face is beautiful…see pics at the top…and love the red wig. Totally getting one! My daughter is dyed that color 🙂 You’re one brave bitch!

  13. I love your stories and out look on your cancer. The the steps you have taken throughout the healing process by telling your story. My sister Sarah is just amazed by you and your writing. Blessed be and good luck in the nipple selection.

    Mindi

  14. Oh, honey! I wish (sort of, assuming you’d even wanted to see) that I’d shown you my foobs at the conference in New Jersey. Not that you asked, but so you could see the results of my expander/implant decision to help inform yours. I’m mostly happy with the end results, but I will say expanders are AWFULLY uncomfortable. It feels sort of like having a couple of tennis balls under your pectoral muscles. I was self-conscious about hugging people, about how I looked in clothes, about just about everything while I had them in (for 14 months — ugh). And I had to take a valium with every expansion (even though they went slowly) because my muscles would twitch terribly. I don’t know much about DIEP except I was told the same thing — that I didn’t have enough belly fat to make much. This is probably so much more info than you want, but let me know if I can answer any other questions about the expander/implant option. Either way, you’re beautiful & a badass & I have so much love for you. XO

  15. Im thrilled to have found this website. What an amazing outlook you have. I too doubled down and had both removed but I was given the option of putting the expanders in at the same time as the mastectomies. Which I did. Having them expanded weekly or biweekly is not painful at all. I did however get to the point where my skin would no longer stretch to accommodate the larger size so my awesome dr. deflated me to where I was comfortable. I went from a D to a C and couldn’t be happier. No bra, no mammos, no bouncing when you run and best of all when you go in the freezer section in the food store your headlights are not on!! I did opt for the tattoos instead a 3rd surgery and they came out beautiful too. Swapping the expanders also was really no big deal, it was like having a tooth pulled. Daystay and your home by lunch. Not at all bad. It was all a fog 2 yrs ago but my decisions were the right ones. They were all made by me and only me. I have an incredible husband who I re-named my in house nurse, he did it all, changed my drains daily, my bandages, bought me a chair to sleep in a nite and even, without me asking, put newspaper on all the mirrors before I got home from the hospital. Until I was ready the paper stayed up. But even with all the support around you, ultimately it is your body and you need to do what is most comfortable for you. There’s a lot of info out there and a lot more women who have gone thru it. For me not going on the internet served me well, but I would have loved to have known about yours at the time. Good luck to you as you continue on this path and Im hear to answer any questions you may have. Take care

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