Picking out new boobs and going in for the exchange

Thursday, I wrapped up the physical aspects of my breast cancer treatment. I underwent "exchange surgery," where my plastic surgeon swapped out the tissue expanders he placed in my chest in August 2018 (during my bilateral double mastectomy) for permanent implants.

Or, as my kids have been telling everyone "Mom got new boobs!"

Picking them out

I showed up to my appointment at Specialists in Plastic Surgery at the beginning of December in full-on student mode. I was ready to learn as much as I could about my options, and I had more options than I imagined! We discussed three types of implant fill - saline, silicone and a bonded silicone gel (also referred to as water, jelly, and jello, respectively, for the purposes of my lay understanding.)

There's pros and cons to each type of implant.

The saline implant is just water. It doesn't hold quite as much shape as the other two options, but technology has improved with it over the years. The implant has to be replaced every 15 years or so, or when it ruptures, which, of course, you'll know when it happens because the implant is like a water balloon. The implant will stop holding its shape, your body will absorb the saline liquid, and you'll be well-aware that a fix is required. Like a car - you'll eventually end up with a flat tire.

The silicone (or "jelly" implant) is likely the implant most of us think about when we think about traditional breast augmentation. It can leak at a point in time, but usually the leak is so small you might never know until it gets replaced. In order to find a leak, you have to get an MRI. Replacements usually occur around 15 years.

The bonded silicone gel (or "jello" implant) is the latest and greatest in implant technology. The contents of the implant don't go anywhere if the capsule is compromised, and it holds its shape really well. It's a great option if you want a silicone implant.

But, having gone through cancer, I likely overthink what I'm putting into my body. I didn't love the idea of a pinhole leak that may or may not leach silicone into my body at some unknown point in time and while I trust that the "jello" doesn't go anywhere if the capsule is compromised, the technology is still too new for me to fully believe it isn't without its own issues.

My plastic surgeon was fantastic with this process - he said I couldn't make a wrong choice and that I had to pick what I was most comfortable with. He endorsed each of the choices; otherwise, he wouldn't be using them.

So, I went with saline. Specifically, I went with the Ideal Implant - a double-walled saline implant that offers more structure than saline implants of prior decades.

The idea that my body could absorb and expend the contents of the implant actually gave me comfort. Might I look a bit ridiculous if I suffer a flat tire? Sure. But I've had uneven expanders in my chest for more than a year. I'm perfectly fine with the idea that one day I'll likely laugh about popping an implant.

It's a lot easier to laugh about things that really don't matter that much after you've been through cancer.

The Procedure

On December 26, I reported to UNC Rex Hospital. The hospital was bustling with end of year craziness.

I was starving. My report time thankfully had been moved up two hours (from 3:00 p.m. to 1:00 p.m.), but I’m a girl that likes her food, so I felt fully deprived of every delicious leftover Christmas treat in our house.

The surgery itself lasted about two hours. My plastic surgeon utilized only a small portion of my mastectomy scar, so the incisions are much smaller than before (read: NO DRAINS!)

I experienced a post-op anesthesia issue in recovery that led to a precautionary overnight stay, but the nurses in 4 West took great care of me.

The next morning, after proving I could walk and pee by myself, I went home.

And that like - a new chest.

It's only been three days since surgery, so I'm still in a 24/7 bra in order for the implants to heal in the right place. I have limitations on lifting (nothing over 10 pounds - which makes life difficult with a toddler), but otherwise I can move around as it feels comfortable for me. It's not even close to how difficult recovering from the double mastectomy was.

Here we are - the conclusion to a nearly two year journey that we never saw coming. An end to 2019 that so perfectly sets us up to feel fresh and anew for 2020.

While we all laugh that my kids are excited "mom got new boobs!", it’s important to remind you that this isn't a boob job. Although I did get to pick out my implants, decide my size and their contents, this wasn't me on the hunt for an elective procedure (note: there’s nothing wrong with elective procedures).

This surgery was me searching for normalcy. One last step in searching for the "sanity" that I had before cancer. Searching for a symmetrical chest - one that doesn't try to kill me with cancerous tumors. Searching for me again.

While I believe I’ve gained more than I’ve lost during cancer, losing the physical aspects of the self you’ve seen in the mirror every day for your entire life isn’t easy.

My best advice for the exchange:

Be comfortable with the implants you choose. They live in you so you’re the one that needs to like them. You’ll see them in the mirror every day, and you’ll be thinking about them being a part of your body.
Have someone watch your kids (or pets). Sleep and healing are so important post surgery. Even just a day of someone watching your kids will be helpful for you. (I was fortunate to have my mom and sister watch the girls for three days).
Remember that you’re healing. The exchange recovery is vastly different from mastectomy recovery - no drains, not as much numbness/tightness. I didn’t lose any of my arm range of motion! I have to remind myself that even though I feel good, there’s a lot going on inside for my body to accept the implants.