Is not a boob job.
It’s okay if you did not know this. I’ve heard this from multiple people in different walks of life. This is the opportunity to get perky boobs! Woohoo! Why not get implants? They’ll be perky and beautiful!
Yes. They can be perky and beautiful, but it’s a much different process. First, I never wanted this. I was ready to let the ladies do their thing as I aged. They were complying.
Second, a mastectomy is total removal of all of the breast tissue. All of it. There is nothing left to build on as you would with an elective implant process, because it’s just gone. Often, that includes all the skin as well. There are ‘skin-sparing’ options now, but again, they have nothing to build on with the tissue.
Why do they remove all of it?
When you elect for a mastectomy, that’s the agreement. There are other options available to some patients such as a lumpectomy. A lumpectomy would remove the tumor and tissue around it, known as the margin. They would ‘test the margin’ to see if any cancer had spread. If not, great! Your lumpectomy is complete. If it has spread, they’ll keep removing the tissue until they get it all.
I think waking up from a lumpectomy and realizing you’d had to instead have a mastectomy would be the worst. At least I’m able to wrap my head around what is going to happen to me and have time to process it.
So, what are the options for a mastectomy?
No reconstruction: Remove all the tissue and the skin - including the nipples - and ‘go flat.’ This option is more common than you think. You may not notice, especially if someone had a smaller chest to begin with or it’s your first meeting. Or they might be using prosthetics. Removable fake tatas. This is by far the easiest recovery from this surgery. Amputate the breasts, move on with your life after you heal. Well, as much as any cancer survivor can move on. There will still be screenings and tests for forever. Am I considering this option? Absolutely.
Reconstruction: This can happen during, immediately after or even years after a mastectomy. Let’s look at some reconstruction options, shall we?
Reconstruction with implants: If they are able to save some of the skin and nipples, great! There are times they cannot save the skin. Example: When the tumor is too close to the skin. This is an ‘easier’ surgery than with the next reconstruction option I’ll go over. But it is also more prone to issues in the future. Just recently there was a recall on breast implants. They’re causing implant-associated anaplastic large cell lymphoma in some patients. That’s cancer. And not just patients who had them put in after treatment for cancer, but in healthy women.
Back to information: Implants can be filled with saline or water, or a combination of the two. Or apparently vegetable oil? This information is coming from BreastCancer.org - I trust this site. But vegetable oil? Really??
Anyway. If you get implants and they’ve had to remove all the skin and stuff, guess what? You get to stretch your skin back out! This takes time and involves ‘expanders’ - they’re like balloons you put under the skin and they fill them over time until they stretch the skin to the correct size.
Sounds fun? I will not go this route.
Reconstruction with ‘flap’ surgery: Autologous reconstruction. Basically, they take fat from somewhere on your body - most commonly the belly, but can also be the back, derriere or inner thighs - and use this to make you new tatas. Sounds great! Except… it is a longer recovery time than either going flat or implants because, well, you have giant wounds to recover from in various areas now.
The good? Unlike implants, there does not appear to be any additional maintenance over time. And it’s your own tissue.
The bad? The recovery time, of course. But also that this surgery is not available everywhere to everyone. It requires a skilled plastic surgeon. I do have this as an option because of where I live. I’ll think about it.
I’ll go into more detail of different types of flap surgeries sometime, but for now let’s end today’s lesson. If you take away nothing else from this, please accept that while I’m happy for you getting your boob job, it’s nothing compared to a bilateral mastectomy.
Homework: Google mastectomy scars.