February 25, 2010
Research Continues
I never received a call back from either the American Society of Plastic Surgeons OR the Board of Plastic Surgeons. I’ve left two messages and I guess they just can’t be bothered. So I’m going to the public sector to do my research since these people cannot be bothered to speak to a small time blogger like myself.
I have found a few places that I will mention soon once I have established contact. I need to verify things like time frame of available statistics, types of complications, if fault was established for either implant failure or failed surgical technique.
As always dear reader i will be keeping you up to date.
I may have found a niche for BoobCast The Podcast and that might be going forward later this year after all.
Implant safety is still a pretty major issue, it seems.
I also remembered something I don’t know if I ever mentioned when I was going through all this hell. For the few weeks I had the implants in, I had a rash across my chest and cleavage. Special K chalked it up to an allergic reaction to the antibiotics I had taken. The odd thing is, after the implants were out, the rash went away in a couple days. I had saline implants but the outer shell was textured silicone.
With some of the symptoms I’ve read from women who have had silicone implants, I have to wonder if I wasn’t having a problem with the implants along with everything else that happened.
February 23, 2010
Sore Flap
I have noticed over the last week or so since I started the C25K.com program that I have some problems. I have a silver dollar sized area on the outer edge of my right breast that feels like someone is boring into my breast. The spot isn’t where the wire ends on bras. It’s about an inch forward of that, towards where my nipple would be if I had one. If I probe, I can feel the edge of the muscle flap.
Now I’m SURE I definitely overdid it this past weekend. Saturday Ken and I took the “Keys To The Kingdom” tour at Walt Disney World’s Magic Kingdom. It’s a FIVE HOUR walking tour. Of course there were short breaks and 30 minutes for lunch. We’re talking about a 3.5 mile hike around the park. For me, that’s like running a marathon.
We got up at 6 am so that we could be there by 8 to check in because the tour started at 8:30. Then our lovely guide Evelyn, proceeded to take us all around the park. It was a fantastic tour and I recommend it highly. This tour was on top of the C25K.com run I did on Friday.
After a nap, we came back since the park was open til midnight and stayed until nearly closing. I was pretty worn out but I thought maybe with a good night’s sleep and some aspirin, I’d feel better. We slept until we woke up and I was sore and tender but I figured if I walked, I’d stretch out the soreness. After a nice breakfast of fruit and yogurt, we went BACK over to Magic Kingdom. As we were walking out the previous night, I found a child’s hoodie sitting on top of a covered trash can so when I dropped it off at City Hall, the woman there asked if i would like a fast pass. It was good for one attraction. Since we hadn’t gotten to go on Space Mountain since it re-opened after refurbishment in December of last year, aches and pains or not, We were GOING on Space Mountain. By the time we made our way to the back of the park, I was starting to feel like a zombie. But by damn I wasn’t going to give in.
After Space Mountain we went all the way BACK out to the car and drove over to Animal Kingdom. I wanted to milk this weekend for all it was worth since we so rarely stay over night. So we took it reeeally slooooowlyy. By the time the park closed at 6pm, I was spiking about a 4 on the pain scale. That’s the highest it’s been for a long time. I was firmly convinced that I had died some time the previous night and no one had bothered to tell me.
By the time we got home I was thinking that I might have done something to my right breast flap, i was in that much pain. So I grabbed the ice pack and tossed down some Tylenol. This morning, I was in even worse shape. I went to change my bed time top and it felt like the flap was ripping. So I called Patti at Dr. Elliott’s office.
She was kind enough to reassure me that I hadn’t done any damage to what they had done. She suggested I take ibuprofen the rest of the day and resume normal activity tomorrow. She said that getting back to my old self (or in my case, better than my old self – my words, not hers) was going to be painful.
So here I sit, waiting for Ken to get back with ibuprofen. I’m SO not looking forward to running tomorrow but I’m NOT going to skip it. I’m just shifting it to T-TH-S this week instead of the usual M-W-F.
February 18, 2010
Sports Bra Shopping
As you know, Dear Reader, this is my second week doing the Couch To 5K running program. Last week and Monday I was stuck in a sports bra that was way, WAY too small for The Twins. I also didn’t have any decent running clothes. That second part is not really a big deal. At my chest size (DDD or E cup) a good sports bra is a must. Mainly so i don’t beat myself to death with The Twins.
Yesterday DH and I went to Sports Authority. While I DID find some great, really breathable, jogging pants, the bra hunt was an Epic Fail. The largest size they carried was an XL or a 38 DD. I understand that women who are already in shape generally don’t go much higher than a D cup or a 38 inch band. I also understand that they have to cater to the largest denomination in order to turn a profit.
It’s just really rather disheartening to shop for women’s athletic clothes when you’re this chesty. And let’s face it, being overweight doesn’t help much either. I can definitely relate to Kevin Smith’s current conundrum with Southwest Airlines. We fluffy girls still fit. It’s the world that doesn’t quite see it that way.
The clerk (who was as big around as my right thigh) suggested I go over to the lingerie shop at the mall across the street. I was heartened to see that the woman there was about my size. She had several sports bras for me to try on. I finally found a 42DD that fits me like a glove. Today when I went running, The Twins stayed in place beautifully and I didn’t have a single problem.
The cost for this wonderful piece of engineering was $64.99. I know…a gasp-worthy price for one sports bra. BUT, please refer to the article I wrote on sports bras last week. A well-engineered sports bra can prevent injuries, tendon damage and bruising. So I’m looking at it as a good investment.
February 16, 2010
Boobjob Versus Breast Augmentation
Dr. Grant Stevens speaks out on the subject:
An excellent breast augmentation can look natural, feel real and have a natural shape. Plastic surgeon Dr. Grant Stevens, Los Angeles, makes a distinction between successful breast surgery and the obvious “boob job” where it’s easy to tell a woman has had surgery
“Part of an excellent breast augmentations the fact that the breasts look as if they could actually occur in nature,” he explains. “There should be a question in the viewer’s mind as to whether or not these are real or are surgically created.”
A good breast augmentation has a natural fullness and gentle sloping off the chest wall. There should be natural cleavage, without webbing between the breasts and a certain amount of perkiness. Dr. Stevens lists five basic considerations that make for a desirable breast augmentation:
*which incision to use
*what type of implant to use
*placement of the implant
*texture of the implant
*size of the implant
Before having surgery, you should go over photographic examples of the breasts you want with your surgeon so that you both have a clear, visual understanding of the desired result. “My job is to make the breasts look like the photographs,” says Dr. Stevens.
There are four choices regarding where to make the incision for a breast implant: underneath the arm, around the nipple, or in the inframammary fold (where the breast meets the chest wall). The fourth is the umbilical incision, but is not as preferred as the others. There are advantages to each incision.
“l allow the patient to direct me as to which incision she wishes to have,” says Dr. Stevens. “We know that each incision has a certain amount of scarring, but our goal is to have the scar so minimal it’s inconspicuous.”
Sometimes there are ethnic factors(in terms of skin type and color) that might encourage one incision over another. Dr. Stevens refuses to recommend any incision per se but notes that: “Of all the breast augmentations I have performed on nurses, physicians or even my own employees, none have ever asked me to do either the inframammary fold or armpit approach. I find it highly significant that women who have been surrounded by the plastic surgery industry and have seen the most results, have never asked for an incision other than beneath the areola.”
The type of implant used has certain limitations in terms of availability. Currently, there is a moratorium on silicone implants; the silicone gel implant has been limited to women who fit into specific inclusion criteria. “lf there were no moratorium I would be putting in far more silicone gel implants than saline implants,” says Dr. Stevens. “The silicone gel implants, in general, feel more like a breast and look more like a breast. However, we can certainly adjust the saline implants and in most cases are able to give the woman a natural-looking breast.”
The next question is where to put the implant. It can be placed either on top of or behind the muscle. “l place implants behind the muscle so the implants are partially covered,” says Dr. Stevens. “The muscle allows a nice smooth take-off from the chest wall. lf put directly on top of the muscle they can look like a half-grapefruit or rounded balloon the chest.”
The fourth criterion in an excellent breast augmentation is the choice of specific implant. Should it be smooth, textured, low profile, high profile or anatomic? It’s important that each implant is individualized to achieve the size and shape the patient desires. According to Dr. Stevens, that individualization should dictate the decision.
“It’s my feeling that if the surgeon is wedded to only one type of implant then all the breast augmentations will look the same. This is not cookie-cutter surgery. Cookie-cutter breast augmentations are, in my opinion, ‘boob jobs’.”
Finally, although there is a size range from which to choose, the breast implant must be appropriately sized for the individual.
“When a breast augmentation is extremely large compared to the woman’s body, in my mind, it falls into the category of a ‘boob job’ because any one can certainly spot it,” notes Dr. Stevens. “If you take a little woman and you give her size double-D breasts, most people would agree that this is inappropriate. For a larger woman however, that size may be reasonable.Mostlf my patients want to be In the C to D range but certainly some women want to be a large D and some women only desire to be B-cup size.”
“Boob jobs” are often hard, round balls on a woman’s chest. Beautiful breast augmentations have a natural shape and size. Allowing natural movement, the implanted breasts slope gently off the chest and feel soft to the touch
February 15, 2010
Why I Hid My Surgical Complications
When I wrote this post: breast-necrosis-photos I mentioned that, as the necrosis was developing, I kept the extent of the damage from my husband and my family as long as I could. There are a few reasons. They may not make much sense but if you’re going through this, I think perhaps you can relate.
1) “I don’t want to be a burden”. No one wants to cause problems for their family. As women we generally put everyone else’s needs before our own. When we’re sick or hurt we usually keep it to ourselves until it’s really bad. Even then, most of us hesitate to ask for what we need for fear of being a burden.
2) “It’s my fault. I’ll handle it myself.”. My big guilt trip for the longest time was that somehow, this was all my fault. Because of that, I was going to deal with it myself. I’m a big advocate for personal responsibility. Since I felt responsible for what happened, I was bound and determined to handle it all on my own.
3) Fear. When I was in my late teens my mother went through something similar to what I have gone through. My father had an extremely hard time dealing with it and it drove them apart. I was stark raving terrified that if my husband saw what was happening to my breasts, he would leave me.
4) Sheltering. My husband led a pretty sheltered life before all of this. I wanted to protect him and shelter him from the trauma so that only one of us really had to deal with it. I put up an extremely good facade too. 99.9% of the time he had NO idea that I was in a mental and emotional Hell.
For those reasons, I kept the necrosis hidden. He was not allowed in the bathroom during my bandage changes. He was also not permitted to see me when I showered. I gave him updates after my check ups with the plastic surgeon, Special K (see this post for an explanation on the name: talking-is-harder-than-writing), but he was never permitted to see. Not until much later when I had absolutely no choice in the matter.
Some people call this bravery. Since it was fear based, i still think of it as self preservation.
February 14, 2010
Latissimus Flap Breast Reconstruction Photos
Since I posted the necrosis photos and a description of each one yesterday, for Valentine’s Day I am celebrating the Twins by sharing with you just what a latissimus flap reconstruction looks like not long after surgery. For those not familiar with this type of breast reconstruction, please see this link for more information: living_latflap.htm#how
This is not graphic like yesterday’s post. The link above is actually more graphic and shows part of a lat flap procedure.
The first photo you see is my back. The long scar lines is where the latissimus muscle was removed from before it was migrated under the skin of my armpits. And yes…I AM a tattooed chick 
Where you see the gauze, that is protecting the entry point of my surgical drains. I have talked about those in previous posts. Just do a search for surgical drains for more information. on those.
The second photo below is of the flap itself. It is the oval-shaped inset. This is VERY soon after the surgery. Those wrinkles relaxed over time and I no longer have them.
And finally, below we have a happy pair of bouncy baby Twins! I went from a C cup with my original breasts to no breasts to an E cup. I still have nipple reconstruction when we can afford it, but right now I’m just thrilled with my Girls. I’d like to add that these results were accomplished WITHOUT breast implants. Those breasts are all my own, natural tissue.
The white tape you see outlining the flaps is to help the scars heal flat. This reduces the chances of keloid scars. I’ve talked about those in other posts too. If you have any questions, please don’t hesitate to contact me at boobcast (at) gmail.com
February 13, 2010
Boobjob Verus Breast Augmentation
Dr. Grant Stevens speaks out on the subject:
n excellent breast augmentation can look natural, feel real and have a natural shape. Plastic surgeon Dr. Grant Stevens, Los Angeles, makes a distinction between successful breast surgery and the obvious “boob job” where it’s easy to tell a woman has had surgery
“Part of an excellent breast augmentations the fact that the breasts look as if they could actually occur in nature,” he explains. “There should be a question in the viewer’s mind as to whether or not these are real or are surgically created.”
A good breast augmentation has a natural fullness and gentle sloping off the chest wall. There should be natural cleavage, without webbing between the breasts and a certain amount of perkiness. Dr. Stevens lists five basic considerations that make for a desirable breast augmentation:
- which incision to use
- what type of implant to use
- placement of the implant
- texture of the implant
- size of the implant
Before having surgery, you should go over photographic examples of the breasts you want with your surgeon so that you both have a clear, visual understanding of the desired result. “My job is to make the breasts look like the photographs,” says Dr. Stevens.
There are four choices regarding where to make the incision for a breast implant: underneath the arm, around the nipple, or in the inframammary fold (where the breast meets the chest wall). The fourth is the umbilical incision, but is not as preferred as the others. There are advantages to each incision.
“l allow the patient to direct me as to which incision she wishes to have,” says Dr. Stevens. “We know that each incision has a certain amount of scarring, but our goal is to have the scar so minimal it’s inconspicuous.”
Sometimes there are ethnic factors(in terms of skin type and color) that might encourage one incision over another. Dr. Stevens refuses to recommend any incision per se but notes that: “Of all the breast augmentations I have performed on nurses, physicians or even my own employees, none have ever asked me to do either the inframammary fold or armpit approach. I find it highly significant that women who have been surrounded by the plastic surgery industry and have seen the most results, have never asked for an incision other than beneath the areola.”
| The type of implant used has certain limitations in terms of availability. Currently, there is a moratorium on silicone implants; the silicone gel implant has been limited to women who fit into specific inclusion criteria. “lf there were no moratorium I would be putting in far more silicone gel implants than saline implants,” says Dr. Stevens. “The silicone gel implants, in general, feel more like a breast and look more like a breast. However, we can certainly adjust the saline implants and in most cases are able to give the woman a natural-looking breast.”
The next question is where to put the implant. It can be placed either on top of or behind the muscle. “l place implants behind the muscle so the implants are partially covered,” says Dr. Stevens. “The muscle allows a nice smooth take-off from the chest wall. lf put directly on top of the muscle they can look like a half-grapefruit or rounded balloon the chest.” The fourth criterion in an excellent breast augmentation is the choice of specific implant. Should it be smooth, textured, low profile, high profile or anatomic? It’s important that each implant is individualized to achieve the size and shape the patient desires. According to Dr. Stevens, that individualization should dictate the decision. “It’s my feeling that if the surgeon is wedded to only one type of implant then all the breast augmentations will look the same. This is not cookie-cutter surgery. Cookie-cutter breast augmentations are, in my opinion, ‘boob jobs’.” Finally, although there is a size range from which to choose, the breast implant must be appropriately sized for the individual. “When a breast augmentation is extremely large compared to the woman’s body, in my mind, it falls into the category of a ‘boob job’ because any one can certainly spot it,” notes Dr. Stevens. “If you take a little woman and you give her size double-D breasts, most people would agree that this is inappropriate. For a larger woman however, that size may be reasonable.Mostlf my patients want to be In the C to D range but certainly some women want to be a large D and some women only desire to be B-cup size.” “Boob jobs” are often hard, round balls on a woman’s chest. Beautiful breast augmentations have a natural shape and size. Allowing natural movement, the implanted breasts slope gently off the chest and feel soft to the touch. |
February 12, 2010
Talking Is Harder Than Writing
I’ve been writing BoobCast for so long, one would think that losing my breasts to necrosis would have gotten somewhat easier to talk about. I would have liked to believe that writing about it makes it easier to deal with at all.
It hasn’t.
Yesterday I hung out with someone I haven’t seen in about a year and a half. After we talked about the initial reason she contacted me again, she asked me what had been going on with me since last we saw each other. So I told her. Not in vivid detail mind you but enough so that I was kind of choking up.
What surprised me even more is how much anger I still have towards the man I feel is responsible for all of this. I’m still legally constrained from mentioning his name or the name of his practice…in a strip mall on Dr. Phillips Drive in Orlando. That doesn’t keep me from hoping that some day someone will break his hands with a sledgehammer so he can’t put some other poor woman through this.
Almost 2 and a half years and I’m still angry beyond belief. I think what made me the most angry has always been his manner. There was The Valium Incident, generally replying “I don’t know” when asked what was going on and insulting my practice as an herbalist by calling it voodoo even though, as part of prep for the surgery I was given herbal supplements to take. Add to that, telling me to stop screaming as he sewed cadaver skin onto my rotting breasts to try to act as some kind of bandage. The screaming happened because he was sewing it on to a spot that hadn’t been numbed. Of course I left out those details. I can write about them but, as I type, I’m choking back tears.
From this point on I will no longer refer to him as the HiQ (Hack in Question). He is now Special K. Take from that what you will.
When does this get easier??
It HAS to one of these days or I’m never going to be able to talk about this on stage. I still have hopes of turning BoobCast into a Vagina Monologues style stage show.
Do any of you know how to get speaking gigs?
For new readers, please read my earliest post in the Archives.
February 10, 2010
Fallout – The Implant Difference
If you are one of my regular readers, you know that I had implants with the initial breast augmentation and lift surgery. If not, implants are used to replace the breast volume that has been lost either over time or due to breastfeeding and pregnancy. They can also be used in the case of benign fibroid removal to help fill out the breast blGflA
My surgery was purely cosmetic. My breasts had degraded as far as they could go. According to the RN at one consultation, “they weren’t going to get any worse”. By degraded I mean that the areolaes covered the entire end of my breasts, my nipples pointed at the ground and my breasts had very little volume. They looked like a couple of pizza slices hanging from my chest wall.
It is not physically possible to put breasts back where they were when you were 18. Skin stretches far too much for that. What they CAN do is add volume. That’s where the implants come in. But there are big differences once the implants are in. Remember, these are foreign objects placed in your body. So they are not going to act like your own natural breasts.
Here’s what I’m talking about when I say “Headlight breasts”. They look like they were pasted on her.
Whether they are saline or silicone, they are not going to feel or act like your own natural tissue. For instance, with a natural breast in a 30+ year old woman, when we lay down, we end up with our breasts migrating towards our armpits. This is commonly referred to as fallout.
It’s just what breasts do after a certain age.
With implants, those puppies aren’t going anywhere. You lay on your back and they stay where they were put. They may move a little but not like real tissue.
This is one reason I advocate for tissue-based reconstruction whether it be TRAM flap or Lat Flap reconstruction for women who have lost their breasts.
The other reason is the feel of the breast. I can only speak from the point of a woman who has had saline implants. You can FEEL the implant through the skin. From my perspective it feels like you’re squeezing a warm, overfilled water bottle.When I poked at them, I could HEAR the saline sloshing sometimes.
My husband says, “They were very hard kind of like groping a hard, squishy melon. Well, something not as hard as melon but not as soft as breast tissue.”. He enjoys my reconstructed breasts much more. The reason he likes the tissue reconstruction better is that “they’re natural. They’re all you”.
The down side to tissue reconstruction is that, on a deep feel, you can feel the edges of the flap. You really have to search for it, but it’s still there. For my husband, there IS no down side now that the flap has softened.
February 4, 2010
Going Mental
Recuperation really IS a long, drawn out process. It is SO much more than physical. I’ve talked about the mental and emotional aspects before as well. It’s a convoluted aspect of healing wherein each state ties in to each of the other. It’s the Gordian Knot of Recuperation.
Here’s an example. I know that I am temporarily satisfied with the Twins. I know that I eventually want nipples. Surgery is just a four letter word right now. The idea of more surgery stresses me out to the point that I almost start crying. On the opposite end of the spectrum, not EVER having the surgery makes me tear up.
The thought of more surgery makes me fearful. I’m terrified of something going wrong and developing necrosis again. I’m also not thrilled with the idea of being cut on again even if it IS only surface work and outpatient surgery. I’m angry that I have to make these decisions in the first place.
I also own that if I had not put myself in this position in the first place I wouldn’t have to be making these decisions. Nor would I be putting my family through everything we have been through since this whole ordeal began.
Regular readers know that I am indecisive. It takes me ages to to come to a final conclusion. Usually I am anxiety ridden about a thing for months, if not years. Making the nipple surgery decision falls into that category without a doubt.
It’s also a very individual decision. I have seen a woman who bought prosthetic nipples without having reconstructive surgery. She felt that even without the mounds, what she missed most was not having nipples. Other women I have spoken to are simply happy with just the mounds and nothing else. Others don’t want to take a chance on a second surgery, so they find prosthetics and still others are so afraid that they don’t do anything at all.
Trying to make the “right” decision is enough to drive you mental. Just make sure that whatever you decide, it’s what YOU want. YOU have to live in your body. No one else does.
