Pre-op #5: body-building, the Limbo, and tattoo removal

Today is my last day with the old newbie boobies. Tomorrow I will get my new rack, my new girls. It still hasn't completely sunk in, I suppose. Maybe it's because I have had so many surgeries in so short a time, it feels like just another day in the life. Or maybe this one isn't affecting me as much because it isn't treating or preventing cancer. It is really just cosmetic - which I hate, because it makes me feel so vain. So I have to tell myself instead that it isn't so much cosmetic as it is about quality of life. My surgeon assures me that these will look and feel more real and comfortable, and that lying on my stomach will be easier. Still, I'm not very convincing to myself... I still feel vain for having what amounts to a cosmetic surgery on my breasts, which is exactly something I would never have done if said breasts hadn't threatened to kill me.

I was reminded at my consent for surgery appointment how much I enjoy the doctors I am working with. They are helpful, compassionate, kind and funny. The resident today, in a wonderfully full circle turn of events, is the very same resident who accompanied Dr. Skinner in one of my very first appointments with her, who was there in case I had any questions about the possibility of a mastectomy (at that point, I believed it would be prophylactic). He is the same guy who sewed me up after my first procedure that required stitching up afterward. I liked him so much, both times. How appropriate that he will be there for my last surgery as well. I asked him a whole bunch of questions - all kinds of things you never knew about implants and didn't know to ask. For example:

I used to be strong and could do a bunch of push-ups - the real kind. But now I can barely do ten girl push-ups. And it is uncomfortable to do things like open jars and slice bread. Will I ever be strong again, now that my chest muscles have been repurposed as boobs?

There was actually recently a grant for $25,000 given to research this very thing: strength and muscle in post-reconstruction breast cancer survivors. I can't be in the study because they need to start before surgery, and I'm at the end. But they are working on learning how women can regain strength. After 6-8 weeks, I can begin trying to rebuild those muscles, but need to avoid anything like push-ups or over my head strength exercises for now.

If I do regain some strength, will my boobs get bigger or differently shaped?
Probably not too much. A strengthened muscles may push the implant in a different way, but it probably wouldn't be to bad effect. After those few weeks have passed, there isn't really anything I can do to mess up the implants. Since I'm not planning on doing any sort of major body building (really, I just want to be able to open a stinkin' jar again!), this is probably fine for me.

If there is stray breast tissue that didn't come out at the time of the mastectomy, would it be affected by pregnancy?
Probably not noticeably. There is so little left, it is negligible.

How do you get the old implant out and the new one in?
Open the old scar (actually cutting it out and making a new, better scar), and possibly cutting through the muscle, but they would cut with the grain of the muscle, not against it. Sometimes they can slip the deflated implant out the side. Dr. Langstein tells me they will cut through the Alloderm (the cadaver skin they used with the initial reconstruction), not muscle.

How long until I can drive?
Depends. Maybe a couple days.

There were some other questions, but those were the most pressing.

I also spoke with Dr. Langstein. He took some before and after pictures, and drew on me so he would know where we started. He asked if I was pleased with what I currently look like, and I said I was fairly pleased, as far as fake boobs are concerned, and he said, "Because I think this turned out pretty well. What you have is some of my best work!" So he doesn't plan to do any adjustments, besides of course swapping the implants and cutting out the old scar (which, by the way, they send to pathology, just in case - but don't expect to find anything).

He did say that with the new, anatomically shaped implants, I will "lose some projection" because of the different distribution. I chimed in, "So you're saying I will be better at the Limbo..." He chuckled, a little thrown off, agreed that I will indeed be able to stay in the limbo game for longer, then said, "I forgot, I need to be on my game with you." He smiled and said "hold on" while he tried to think of a snappy response, but then said, "Nah, not today. Too tired. See you tomorrow!" I love him.

One other interesting thing about this appointment. Dr. Langstein said he could remove my radiation tattoos for me, specifically the one that is at the bottom of my sternum. There is a new laser technology that makes this very easy, and he could do all five of them for me if I wanted. I was surprised how resistant I was to this. I'm not sure if I want them gone. They are part of my story, like scars. I would lose the shock factor of telling people, "I have five tattoos!" (although I will gain the shock value of, "My boobs are tattooed!"). I always sort of liked that my particular tattoos almost make the sign of the cross (but I have one on my chin instead of my forehead, where the sign of the cross would actually start). This has always served as a sort of reminder that no matter what trials I may endure, I remain a child of God, marked by the cross of Christ. One last silly reason, which I told Dr. Langstein, is that I used to use that dot at the bottom of my sternum as the indication that my shirt was too low cut - if you could see the tattoo, the shirt was too low! The resident suggested I could just ask my husband, but I'm not sure he would give a very objective opinion on that matter... ;)

But joking aside, I am playing with the idea of having these removed, and I honestly feel like something would be missing. I earned those tattoos. They are a part of my story. It feels like they always have been. Although I am ready to move on from cancer, I'm not ready to deny it ever happened, and somehow doing away with all scars seems dishonest to something that has been so important to me and my formation. So, it seems a little silly, but I think I want to keep my radiation tattoos. But I'll keep considering.

Well, after a day of doing things I won't be able to do for a couple weeks (exercise, chores requiring lifting, some yard work), my husband is home. I think I will relish some time with him. See you after (my last!) surgery!