Category Archives: Plastic Surgeon

Switching Plastic Surgeons

I have listened and responded to my gut instincts, setting in motion actions to acquire my first-choice plastic surgeon, Dr. S. after traversing this breast-cancer-reconstruction-passage with a plastic surgeon who was picked for me due to her availability and Dr. S.’s unavailability.

I first learned of Dr. S. in speaking with another local breast cancer “sister”. I asked for the names of her team of doctors since she raved about them. Having the names in hand, I diligently researched each of these specialists online, coming away feeling impressed and that I would be in good hands.

Having never experienced medical drama of this magnitude, I was not certain where to begin but chose to make an appointment with the breast surgeon as my first step. My life would be in her hands before anyone else’s, as she would dig out all of the cancer and interpret the sentinel node biopsies. It was during my visit with her, she informed me that Dr. S. was no longer affiliated with the hospital, therefore would not be able to perform my immediate reconstruction surgery; he moved on to focus his roles at the University where he serves as Chief of Plastic Surgery & Program Director, Surgical Director of Plastic Surgery and Department of Surgery. My breast surgeon left the room, made a quick call to a different plastic surgeon and upon her return, the surgery date was set. Insofar as arranging the surgery, all I needed to do was meet with the plastic surgeon.

As I recall, I liked the plastic surgeon. Of course, I would rather have preferred Dr. S., but I was in a hurry to get the cancer out of my body so I convinced myself that I would be in good hands with this substitute.

Since that first meeting with her, she has placed the tissue expanders, filled them, replaced one of them as it was defective and leaked and finally, we set our date for the exchange surgery and suddenly, I stepped on the brakes.

Post-bilateral Mastectomy Expanders

EXAMPLE OF: Lumpy, Uneven
Placed Too High
Breast Expanders

During my last office visit with her, which was the pre-op visit prior to the exchange surgery, numerous pieces of incorrect information were passed on to me. It began with the reference booklet I was to take home. Informational sheets explaining pre-op and post-op care, medications and emergency situations were printed for me to read and initial as having read and understood the contents. The pages were then photocopied and the photocopies were placed into a binder; the nurse reviewed each page with me before giving the binder to me for home reference then left the room.

When the doctor came into the room, she looked at my chest and began explaining her plan of action for the exchange surgery. This ‘plan of action’ was nothing like her initial plan of action which had included cutting out the existing, jagged scars with clean, straight incisions, leaving a hairline scar. She had also spoken about using silicone strips to aid in healing. Her new plan of action, revealed a week and a half before surgery, was in direct opposition to what had originally been explained to me.

When I asked about the new incisions for the scars, she brushed it off, “…your scars will heal in time…”

I did not feel confident in that blasé answer.

My discontent did not stop with the new plan of action. As the doctor explained that I would be going home with JP Drains, a pain pump and steri strips, I wondered if I had blacked out or something. Only moments before, her nurse reviewed the booklet with me that explicitly stated (and in print) that I would NOT be going home with drains but some new disc-type contraption, steri-strips would be replaced with some new glue, and the pain pump would be replaced with a new one-pill drug. I felt that I needed to change something too, change doctors!

I was not certain where to start nor how to do this. I did not want to cancel this surgery until I knew that I could see Dr. S. I sent him an email at 7:30 a.m., explaining that he had been my first choice for this surgery but Dr. T. had to pick someone else since he was no longer affiliated at the hospital. He personally responded to me within half an hour, copying his staff with his response as he told me that he would gladly see me.

While I waited to hear from Dr. S’s staff, I phoned Dr. T. ’s office to ask if she would share my surgical records with him and officially send a referral to him. Things moved swiftly and within a few hours, I had an appointment set up with Dr. S., had filled out the required paperwork and faxed it all back to his office. He was correct, he does have a wonderful staff!

Not wanting to burn my bridges, I still needed to deal with my current plastic surgeon. I phoned her office and explained that I would not be healed from my sinus infection for next week’s surgery and needed to postpone it. The girl on the phone explained to me that she would just cancel the surgery and I could phone her back when I was feeling better. What? How easy could that be?

Now that I will be in super-doctor hands, I am anxious to see if he can make my existing chest, with lousy-looking expanders, actually resemble something that looks like breasts. I have been googling post-mastectomy reconstruction photos, copied them to a Word document and will print the pictures out as I ask him if there is any possibility that my chest might resemble any of these photos. I want honesty. I don’t want smoke blown up my as*.

I need to know the truth. I need to know if beginning with Photo #1, exchange surgery can ever come close to resembling Photo #2. I am not talking about size, I am referring to symmetry and placement upon the chest wall. I just want the truth.

Expanders

Photo #1

TissueExpndrs1

Photo #2
© Concannon Plastic Surgery

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Did you hear the one about…

ComeHellHighWater

Hell or High Water

Did you hear the one about the plastic surgeon who said “come hell or high water, we’ll remove that JP Drain on Monday”?  Well, we did have some rain, but no fire and brimstone, maybe that’s why she couldn’t remove my drain?  Sigh, my output readings were still too high, averaging around 50 cc/day, too high to safely remove the drain.  I knew my readings were too high, but, I didn’t re-schedule the appointment and wanted to keep that scheduled appointment strictly because of the ‘hell or high water’ claim and her positive attitude, I thought she might have some trick up her sleeve.

Of course, when she met with me and told me it would be too dangerous, I admit, I felt my hopes deflating, like a loosed balloon.  She questioned me on what types of activities I had been doing, emphasizing that a lot of movement will irritate the healing process and contribute to high output to the drain.  I did not think that I was being overly active.  I had just been cleaning up the kitchen, not scrubbing floors or walls, just loading and unloading the dishwasher, wiping down the counter tops, doing laundry, folding and putting away clean laundry… what I would say are minimal house-keeping chores.

She instructed that, “For the next two days, I don’t want you to do ANYTHING other than sit in your recliner and read a good book or watch movies.  NO  ACTIVITIES! And then we should be able to take the drain out on Friday, but call first with your readings.”

There was nothing more to discuss regarding the drain, so I turned to my trusty notepad where I had some questions for her.  The first two questions were actually answered by the receptionist, I had asked for my operating room report regarding this portion (plastic surgery) of the original bilateral mastectomy with immediate reconstruction.  I also asked for a copy of my “cards” for the tissue expanders.

TissueExpanderCardMy doctor’s office typically does not issue identification cards for the tissue expander medical devices because they are only temporary, but I will receive identification cards for my permanent implants when they are finally set in place sometime in February…. but just reading this card, I can understand why I would need an identification card for the expander because it contains metal, what would be the purpose to have one for the implants since they don’t contain any metal?  Maybe just as an f.y.i. for recalls or the like?

Back to the doctor – my next question was what brand of implant will she be using?  “Natrelle 45”  is what she likes to use.  We talked about the tear-drop style and she said that she is not a fan of that type of implant and there have been problems with them shifting and looking unnatural.  In my case, she would be using the round type of implant.

breastimplants400ccvs500ccI also asked about projection.  My tissue expanders are filled to 500 cc now and have 250 cc more to go until this portion of reconstruction is finished, but, where I’m at now, I look extremely flat-chested; an “A” cup would be too big for me to fill.  It looks like the saline-fill has ‘spread’ to the sides.  The Doctor reassured me that the implants will look and lay entirely different than the tissue expanders.  Ok, I sure hope so, I don’t want under-the-arm-boobies.

I’m overweight and my breasts were large and saggy, I don’t even know what size bra I should have been wearing, I was wearing a 38C, but, I could never get a bra to fit comfortably, so I typically opted for sports bras.  This whole reconstruction event is to replace what cancer has taken from me, not to try and turn my new breasts into porn-type decorations, but, to make me feel and look more like the woman I was before cancer started carving on my body.

The doctor told me that as I lose weight (I told her that I am anxious to be active so that I can start walking for exercise) my breasts will appear larger as my body shrinks because these new “breasts” will not change/diminish in size.

I have a way to go before this year of overcoming breast cancer is behind me;  time is beginning to move more at the pace it was prior to breast cancer – faster and faster but I’m not so sure I want things to move so fast.

Breathe and savor life!
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