Monday 25 September 2017

Expanders, foobies, frankenboobs, rocks, boulders...what do you call them?

Expanders, foobies, frankenboobs, rocks, boulders. These are just a few of the names for tissue expanders coined by other breast cancer survivors.

After the mastectomy and lat flap reconstruction, it was an adjustment period getting used to these new foobies. I felt like I was walking around like a robot at times because the circumference of my upper body felt so stiff. The incision areas on my breasts felt hypersensitive and anything that touched them, even just the touch of a light shirt, made me feel uncomfortable. My lower back still felt inflamed from where the drains once were so I continued to sleep with multiple pillows stacked around me to prop me up in bed. I’ve been a side sleeper all my life so having to sleep on my back was awkward and uncomfortable and left me with many sleepless nights.

About a week after my surgery, I was feeling so tense in my back and asked my husband if he could give me a massage to try and loosen things up. As he began rubbing my back, he noticed a big bulge on the right-hand side of my lower back. It felt like there was fluid rippling under my skin. I jumped up to take a look for myself in the mirror and was shocked at how large the pocket was which seemed to develop overnight. The plastic surgeon had told me prior to surgery that it was quite common to develop a seroma after the lat flap procedure so I crossed my fingers that it was nothing more. Once you’ve been diagnosed with cancer, it’s hard not to have every alarm bell sounding in your head when a new side effect comes up.

I set up an appointment with my plastic surgeon the next day to get it checked out. As soon as he took a look at it, he confirmed it was in fact a seroma and told me it would need to be drained. Nothing serious but more of a nuisance than anything. If there was going to be a side effect, I seemed to get it! With a quick poke of a needle, a numbing agent was used to freeze the area of my back and then a syringe was used to extract the fluid. The syringe was nearly full with just over 50mL of fluid removed from the pocket in my back. He said it would likely continue to fill over the coming weeks until the surrounding tissue healed over and filled the pocket so I would need to go back and have it drained again.

The following week after my little seroma scare, the incisions on my breasts were finally fully healed over and I was able to go in my first tissue expander fill. My expanders had already been filled to 120cc during my mastectomy and lat flap reconstruction surgery four weeks prior and I would be getting an additional 60cc fill at this appointment. I was nervous going in as I didn’t know what to expect and was worried that it would be painful but the surgeon assured me that I would be okay. As I sat in the chair, he felt around my breast for the expander port which was located near the top of each breast and then inserted a needle into it. The saline was then inserted into each expander with a syringe that held the 60ml of fluid and took about one minute to fill on each side. Once I got past the initial poke of the needle, the actual fill wasn’t painful other than a bit of pressure from the fluid going in. It was weird to look down afterwards and see that my breasts were suddenly a cup size bigger! Once both of my expanders were filled, I needed to get the seroma drained again in my back. The fluid level had gone down with only 30ml extracted this time but it would likely need to be drained again in another week or two. Once the fluid reached a low enough level, my body would naturally reabsorb the excess.
Fill 'em up!
After my first fill, I went about my day and didn’t experience any pain or discomfort other than what I had already been experiencing post surgery. Still some tightness across my chest and back which was to be expected and twinges of pain here and there in my foobies, especially in my left breast. My radiated side was quite tight however the left side had excess skin (which would be removed during my implant exchange) and was allowing the expander to move and rub in spots. It wasn’t until I lay down in bed later that night that I noticed how much bigger these foobies felt which took some adjusting to. It took awhile to find a comfortable position but I found that bear hugging a soft squishy pillow in front of me helped provide some cushion and comfort between the rock hard boulders on my chest.

Up until my first fill, I had been wearing mostly loose-fitting tank tops that I could easily step into and shimmy on from the feet up as it was still hard to maneuver a top over my head. There were also a lot of tops that I didn’t feel comfortable wearing because the incisions on my breasts were still quite pronounced leaving me with lollipop like scars which poked through my t-shirts. I was anxious though to start getting an idea of what size I was after my first fill so with my best friend in tow, I went to try on some bralettes. Because of the incision across my back, I was looking for something with a soft wide band that wouldn’t dig in and it still felt quite uncomfortable with anything rubbing on that area. Underwire was also out of the question and anything halter style because my range of motion still needed a bit of work especially on my affected side. I found myself going back to the same style of bralette including this sheer floral lace bralette from Forever 21 and this Halo soft cup bralette from Wacoal as they were the most comfortable and supportive.

Despite only being at 180cc, I was pretty happy with the size they were at. I had asked other women who’d gone through breast reconstruction how many fills they had done and what worked for them but it’s really hard to know what the “right” size is for your own body. Everyone’s bodies are different so what 250, 500, or 750cc might look like on one person may look completely different on another. I’ve always been heavy chested all my life so I wanted to go smaller and aim for something that was more proportionate to my body. Prior to surgery, I was wearing between a 30E/F and 32DDD bra and had a very difficult time finding bras and bikini tops that fit. As it was, I was trying on bralettes in a size Small or around a 32C bra which seemed to fit comfortably.

The day I was scheduled to see my surgeon for my last fill, I decided to go shopping again, this time for bikini tops. Part of me was confident that I wanted to stay at this size but part of me didn’t want to go too small either so I wanted to try on a few things to confirm. Trying on bikini tops with these new foobs was much different. Anything with an underwire or added padding was not going to work so I went for something that wasn't heavily lined and provided ample coverage. My absolute favourite were these halter style tops from La Vie En Rose. They kept my foobies intact and covered, while still giving me the look of having some cleavage. Some of the strapless styles looked great but I was worried about having “scar slips” without noticing so found having an option with a strap would be more comfortable for me.


When I went in to see my surgeon later that day, he asked if we were doing another fill and I told him I was comfortable with the size they were at. He encouraged me to spend some more time getting used to the size and to come back to see him in a month just in case I changed my mind. In the meantime, I still needed to get the seroma in my back checked which was still looking puffy. He froze the area once again and drained the fluid that had been building up since the last time I had seen him 12 days prior. Only 15ml came out this time which meant my body was finally starting to reabsorb the fluid and the cavity in my back was filling in.

I had brought a long list of questions with me to ask after my checkup. My memory is still not the greatest these days so I write down all of my questions leading up to my appointments in case there’s anything I forget…which is a lot! I was anxious to know the details about my next surgery including how soon could I get it done. We had originally discussed waiting 6 months from my initial surgery date to allow for time to do the fills once every 2 weeks and for the scars to heal and strengthen. Since I wasn’t getting anymore fills though and the scars were already looking better than anticipated, he estimated that we could do the implant exchange in about 3 months which was much to my avail.

We then discussed the different types of breast implants available with options including saline, silicone, round, teardrop, and textured. My surgeon recommended that I go with the Natrelle round silicone implants rather than the textured teardrop implants as there is an extremely low risk (but a risk nonetheless) of developing a type of cancer called Anaplastic Large Cell Lymphoma (ALCL). According to the FDA, the risk of ALCL is higher in women who have textured implants, which have a bumpy surface, as opposed to smooth implants. I was worried at first about getting round implants and having Barbie like boobs but he assured me that they will still look very natural. The silicone implants will naturally sit lower in the breast at a standing position giving it a bit of a teardrop shape and take on a flatter and rounder shape lying down. When it comes to implant sizing, a number of factors are considered including diameter and projection. In order to stay within the same diameter and have similar projection to the current expanders, I would need to go up to either a 210cc or 240cc implant to match. It sounded like quite a size difference but the surgeon advised me that the implants sit more flat while the expanders project out quite a bit more. 


Over the next month, the incisions on my breasts and back were beginning to heal more and more, leaving a thin formation of pink scars. The skin on my radiated side was starting to stretch out and drop thanks to the lat flap transfer making my breast feel more natural. And the tightness was easing up across my back. The surgeon recommended that I get the scars massaged once the seroma in my back healed which would help loosen them up even more (I still haven’t done this but have plans to do this in the future). I was also finally beginning to sleep on my side comfortably which was a huge plus although it was still hard to sleep directly on my foobies because of how hard they were (think sleeping on two hard rocks).

I started going to physical therapy a couple of months after surgery to work on my range of motion and to find some exercises that would help regain my strength in and around my lat muscles where the flap had been removed. It wasn’t until I began doing the exercises that I realized how weakened the muscles were. The physiotherapist told me to work at it slow and steady so as not to injure myself along the way and set myself back. Hard for someone stubborn like me who just wants to get right back into things. As I regained my range of motion, I tried on some of my old clothes and found that a lot of tops fit differently in the bust. They got thrown into a donation pile along with the small fortune of bras and bikinis that no longer fit.

Since this surgery, I have lost a lot of feeling around the circumference of my body, making me more aware of the potential for scar slips which may have happened once or twice already. My breasts have some feeling around the outside close to the chest wall but what I mostly feel is just pressure. And while I have regained some feeling in my back from where the drains once were, there is about a 4-5 inch band across my entire back that I have absolutely no feeling at all. It’s strange to lose sensation on parts of your body and is eerie to touch but you get accustomed to it over time. To this day, I still have a lot of numbness in my underarm where the lymph nodes were removed during my first surgery last year and am cautiously aware when I go to shave.

After sixteen months of treatments and surgeries, I just want to move on and adjust to this new body of mine. While some people think this is a free boob job, to me this is trying to regain a sense of normalcy again after having to amputate my breasts. On October 2nd, 2017 I will be going in for my third and what I hope will be my last surgery since being diagnosed with breast cancer.

One week til I'm rid of these boulders!