Cancer log 174: Reconstruction surgery fat transfer details.

To recap briefly for those who missed it earlier (the rest of you can skip this paragraph), about a quarter of my left breast got scooped out when they took out the cancer. Yay, cancer gone. My emotional state shifted over time: Sept / Oct / Nov were mostly yay, cancer gone. Dec / Jan / Feb were pretty distressed about the appearance of my healed breast — it had healed somewhat poorly, with a big puckered scar (fortunately the cancer was in the lower quadrant, so the scar wasn’t visible even in cleavage-y clothes). In a swimsuit or tight-fitting shirt, if you were really paying attention, you could see that one breast was missing a big section, but overall, it was only really noticeable without clothes. I could have lived with it (and I definitely didn’t want to bother with prostheses; no patience for that), but insurance covers reconstruction, so after much thought, I decided to explore it. The procedure they recommended is fat transfer, where they suction out some fat from my lower belly and insert it into the breast. The process needs to be done in stages — one surgery every 3 months, 3-4 times. They don’t move any skin — the skin should expand slowly as needed, since they’re just inserting a little bit of fat each time.

So, yesterday was the first surgery. I took a Xanax in the morning, which I now do as a standard before procedures like my chemo infusion, because it makes me much more chill about the whole thing. You can’t drive yourself home, and they require you have someone there the whole time, so Jed came with me and Kev stayed with the kids. I got there at 8, much paperwork, and answering questions from nurses, anesthesiologist, doc. Stripped down and changed into robe, they took some photos and the doc drew on my breast with a marker. I brought my iPad mini and played video games while waiting at various stages, nicely distracting. Around 9:45, they finally had me lay down, inserted an IV needle (tiny prick), and I was quickly conked out.

While I was out, they did the procedure, also intubated me, which meant that I woke up with a sore throat and not much voice for the rest of the day. I tend to react somewhat poorly initially to surgery — for the two c-sections, the breast reduction, and the lumpectomy, I always ended up super-cold and woozy, for about an hour longer than they seem to expect. This time was better, though, because while they added a second warm blanket first, when I was still cold a few minutes later, they brought over this fancy device, some sort of inflatable blanket they put under the other ones, and then attached to a machine that made it toasty warm. Much more comfortable. Plastic surgeons have fancy stuff, I guess. My breast incision was somewhat painful, maybe a 4-5 on the pain scale, which I told them, and they used the IV to push some painkillers; after 15-20 minutes, the pain was down to a minor ache, around a 1 on the scale.

I went home at 1, with a whole host of restrictions — no lifting anything heavier than a glass of milk, no shower or bath for 72 hours, no spicy food (why?), etc. and so on. Also a prescription for pain meds, which I took every four hours yesterday, and which kept the pain at 1. They also made me super-drowsy, so I napped and watched tv much of the day. (Project Runway, which I don’t mind fading in and out of.) Around dinner time I got up and did some stuff, as I was getting restless — after a few hours of light activity (cooking something, walking around the garden, etc.), I suddenly got really woozy. I also totally overreacted to something Jed said and burst into tears. Back to bed for the rest of the day.

Today, I feel fine. Oh, a small ache at the incision sites, but I haven’t taken any pain meds at all yet; I’m planning to take some ibuprofen, which should cover it. I don’t like being drowsy. The real challenge for me now is not over-doing it. I have some suspicions that my original lumpectomy healed poorly because I was too active when I was supposed to be resting. At least in part. I was pretty mad at myself about that yesterday, but I was really over-emotional for much of the day; today, I’m much less inclined to beat myself up. But a lesson to try to implement for this time around, maybe. I have to spend most of the day writing, so that should keep me nicely immobilized.

The most frustrating thing right now is wanting to see what it looks like, and of course, it’s got to stay under dressings for days. I have a follow-up with the doc Monday, when he checks the site, so maybe I’ll get a look then, though it will be swollen and misleading, so perhaps not much help.

I feel somewhat ambivalent about the whole thing; we’re spending a noticeable amount of money, even with insurance. More importantly, every surgery carries risks, especially with anesthesia — I had a moment where I was furious with myself for risking death, even a tiny chance, risking leaving my children motherless, for pure aesthetics. But the risk really was very minor. Hopefully this will end up feeling worth it.

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