A Dress A Day

Keeps the doctor away.  Isn’t that how the saying goes?

I met with my plastic surgeon at a 3 month post-reconstruction checkup last week and was he ever not surprised when I showed up with a long list of questions.  Dr. Orman’s reaction to my pulling out said list was along the lines of (insert sarcastic — but friendly — tone here):  “No. Really?!”

Although it’s possible I’m either needlessly redundant or hopelessly hypochondriacal, I prefer to instead consider myself a well-informed patient/consumer.  Assess the situation, gather as much information as possible, and make a rational decision to best improve the situation.  Let’s start with the situation.

  1. Sore hips.  That abdominal skin incision just never quite heals, and the ends over my hips are sometimes ok and sometimes not — puffy, red, tender, and oozing slightly.
  2. Breast mound.  Whereas with some mastectomies the breast tissue is removed but shell (skin, nipple, areola) kept intact, because my MRI showed the cancer could have spread to the skin, the breast surgeon removed everything.  After Dr. Orman et al. reconstructed the breast using abdominal skin and fat (tummy tuck!), I was left with a “breast mound,” meaning a broad expanse of skin with no landmarks aside from the prominent oval scar. Given a choice, I’d like for it to look like a breast again, which requires putting a facsimile of those landmarks back on.
  3. Upper chest concavity.  For good or bad, it turns out I didn’t have quite enough abdominal fat to truly match my small healthy left breast.  Because Dr. Orman ran out of raw material, there is still a slight depression in my upper right chest.  It’s not something I pay attention to when I’m covered up with sweaters and turtlenecks, but I have a feeling it’ll be more noticeable when spring and summer roll around.
  4. Smaller breast.  When the surgical swelling subsided, the new right breast turned out somewhat smaller than the healthy left.  They’re not freakishly different, but clearly I would have had a better result if I’d started out with a rounder tummy.  I suppose it’s too late for Pringles.

Dr. Orman offered surgical solutions for all of my issues but left the use of any intervention up to me.  Given the miscellaneous neural pings and muscle soreness I have intermittently experienced following surgeries on the right side of my torso (front and back), even though I’d like to look more like Susan pre-2011, I am hesitant to go under the knife again.

  1. Re-excise the ends of the abdominal incision and resuture. He was mystified when he saw that both ends of the incision were still slightly inflamed until I told him Dr. Semien guessed that pant material rubbing against my hips caused a constant irritation and prevented proper healing.  He seconded Dr. Semien’s suggestion to wear dresses temporarily (to remove the irritation) and also recommended that I moisturize the pesky bits.  The incision is healing, but I can’t wear skirts forever.  Also, I must note that winter is not an ideal time to eschew pants.
  2. Nipple flap + areolar tattoo.  To be more precise, this would require going under the knife and needle.  A skin flap or graft would create a small profile nipple and later tattooing would restore the darker hue in surrounding skin.  Downsides include a poor match to the left side, a small probability the “nipple” would flatten completely or fail to thrive, and the need for later tattoos to rejuvenate fading color.  Fortunately, I believe I have found a superior non-surgical solution to this issue via prosthetics.  More on this later this week.
  3. Fat injection.  Dr. Orman would liposuction fat from my hips and inject into the chest area as needed.  Downsides include 50% fat shrinkage, possible formation of hard spots where pockets of transferred fat die, and new scars at donor and injection sites.
  4. Fat injection.  This would be more of #3, just injected into a slightly different area.  Frankly, I don’t think I’m bothered enough by #4 to do anything about it.  The original pair wasn’t a perfect match either.

Fortunately, if I decide to undergo any of the above work, I can have it all done (with the exception of the tattooing) within a single outpatient procedure.  Before that I will try first try nonsurgical means to address numbers 1 and 2.  If those don’t resolve adequately, I can always resort to surgery.

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