Plastic fantastic

I have a date for surgery! I went to see the plastic surgeon today and also had my pre-op. I have to say that the highlight of my day today (and yes I am joking) was standing topless in the middle of a room having photos taken of my boobs. I think the last of my dignity got up and walked out the room, waving as it went!

I lose my boob (and more importantly the tumour) on the 5th of February. As the results of my genetic testing for BRCA mutations were negative, they won't be removing the other one at the same time. However, because I still have a 25% risk of another breast cancer (as calculated by the genetic counsellor) I am opting to have the other one removed as soon as possible to reduce that risk. It won't be done at the same time as the bad one, as the priority is treating the cancer and the more surgery I have, the greater the risk of infection, which would delay my radiotherapy.

I will be having what is called a skin sparing mastectomy with immediate reconstruction with an expander implant. An expander is essentially an empty implant which gets pumped up gradually to stretch what skin is left after the mastectomy, until there is enough skin to put in an implant equal to the other side. So instead of a titty squash, I'll now be having a titty stretch!

As my sentinel node biopsy showed one out of five nodes as having cancer in, I'll also be having what is called a level two node clearance - all the lymph nodes removed from my armpit and chest. To be honest, I'm more worried about this than having my tit cut off. The node clearance will leave me with a number of possible side effects, including nerve damage, cording and permanent lymphoedema or the risk of developing it.

Because the inside of my breast will be essentially scooped out (like a jacket potato  - eew) the expander will need to go behind my pectoral muscle and be held in by what is called a 'strattice mesh'. It's basically a sling made of pig skin, but with the 'pig' taken out.

It's very likely that the radiotherapy will muck up the reconstruction and that things are going to need tweaking and fixing. Worst case scenario I could lose the expander and /or the strattice. But it's a risk I'm willing to take. The surgeon told me to look at the expander as a temporary fix until treatment is done, something that will slightly less traumatic for me than seeing a flat scar in the mirror every day where my breast used to be.

I'll probably be in hospital for three to four nights. I'm hoping I'll get a side room where my hairless cancer face and head won't be on show to the whole ward and their families! I'll also be doing my best impression of a boiler, what with the three drains that will be hanging out of my boob and armpit. Two these will come out before I leave hospital, but unfortunately one will be staying in and I'll have to carry it round with me for two weeks like an additional body part - "we've taken your boob but here's a bottle of bodily fluid instead!".

The surgeon will start filling the expander once I have completely healed, gradually filling it with saline at weekly or two weekly intervals. Once this is complete (and it shouldn't take that long - I'm not exactly Katie Price) then radiotherapy will begin.

This is very basic account of the next stage in my treatment. As you will hopefully see, it is not quite as simple as 'getting a new boob'. It's major surgery and a long drawn out process with it's own risks. But onwards and upwards as they say - bring on that scalpel (and the morphine!)