Thursday, 25 July 2013

Mr S and My "Boob Job"

Good evening :) 

I promise, there will not be many more of these...! 

At 16:30 today I found myself sat in the waiting room in Outpatients 1, Subwait 2 with my husband holding my hand. 

He held it in a way that said so much. We were quiet, wondering, hoping and praying that all this would be over soon. As we sat in silence, I started to think back over the last 2 and a half years. The moment we found out we had a defective gene running in our family, the day we found out my sister had it, the day she had her operation, the day I made a decision to be tested, the day I found out I was positive, the day I made up my mind to have a PBM, the day I had a mammogram, the day I had my MRI, the day I met my consultant and today. The day I would find out the date of my operation. Each one of those days has dramatically affected my life and led me to that waiting room this afternoon. Luckily, we were not waiting long and a poor elderly gentleman was left alone in the waiting room - we had reassured him that he would definitely be next, poor soul. 

My consultant is called Mr Soumian and today would be the second time we would meet. A smile on his face and a good firm shake of the hand made me feel confident that I was in good hands and that all this would be just fine. 

Mr S, started to go over my options again to make sure I had made the best possible choice for reconstruction. He was very thorough and, after drawing a very lovely picture of my breasts and nipples on a piece of paper, it was agreed that what I had chosen would be the best choice for me.

So a little bit about the procedure I will be undertaking and why I have come to the decision that I have.

After having all your breast tissue removed, your first decision is whether you want reconstruction at all and if so when? You can have immediate reconstruction or wait a few months and then have another op where they re-create your boobs. I have chatted to many women who did not want reconstruction at all – viewing their boobs as their enemy and not at all bothered by being completely flat-chested. For me, I know I definitely want immediate reconstruction (I want to wake up with boobs of some sort) but I was unsure how this was going to happen.

The options for me were:

Implant (pretty straight forward) Although contrary to what a lot of people think I won't have bountiful breasts that resemble a Pamela Anderson or Katie Price. Due to the reason of the operation, every bit of breast tissue has to be removed (some will remain) so the implant is inserted behind my chest muscle. The results will not look like your typical "boob job" and more than likely they won't be completely symmetrical. With this procedure I can either keep my nipples or lose them.

A flap of tissue from my back - In this procedure the muscle is transferred to the breast area by "swinging" it around the ribcage so that it lies at the front of my body. I would need an implant with this also. This will give a more natural result but will result in a larger scar.

Flaps taken from the tummy - This is one chosen by a lot of women because a large amount of skin and volume can be replaced to achieve a very natural look and feel. Removal of excess skin and fat can also be a lovely surprise,  resulting in a "tummy tuck"  There are 3 types of abdominal free flaps, TRAM, DIEP and SIEA. This reconstruction will result in large scars.

Believe me, this decision was very easy to make. I knew I wanted implants purely on the recovery time. I have two young kids and I don't want to spend weeks recovering when I could be cuddling and playing with them instead. At the end of the day I just want the awful nasty tissue out, the reconstruction is just a bonus. The reconstruction is just psychological for me.  I did toy with the idea of no recon, but I thought about going to the opera with my husband at Christmas,  playing on the beach with my kids, going to work wearing every day clothes,  doing all that with no breasts would make me very self-conscious. 

So today, at approx 16:43 I confirmed to Mr S that I will be having the implants. I am still undecided whether or not to keep my nipples, but he said I can decide that as late as operation day, so I will sleep on that decision a little longer. 

The nipple dilemma - When they cut around my nipple to pull the flap of skin down and remove my breast tissue, they can either sew it back together after the surgery or remove the nipple all together and pull the skin up to cover where the nipple would have been. If I decide to keep the nipple, there is a chance that during the op, the blood vessels die off and once in recovery, the nipple itself could die (Which would involve another procedure to remove them) the other bad point is that the nipple will still have attached, some breast tissue, which in theory will raise my chances again, not by much at all but if I'm willing to go through all this, why bother with a nipple that may contain one little cell that screws me over...? 

The most interesting part of the operation is that the UHNS has recently been able to do part of the reconstruction using, wait for it..... 

........................ Pig skin!

Although the posh doctor wording is Strattice Tissue Matrix. Basically, it provides a scaffold or framework which helps the natural growth of new cells and formation of new blood vessels. The piece of skin is designed and processed in a unique way to minimise the risk of rejection and will be placed under the bottom of each implant to create a type of hammock!

How unbelievably clever is that?! It is just incredible what these surgeons can do now. My new boobs will not have a web like mass of scars either – in fact the only scars will be around the nipples or minus the nipples, across the front of my breast. 

My pre-op will be within the next few weeks and then I'm on the home straight. A year ago, nearly to the day I found out I was carrying the defective BRCA2 gene and although there's been some tough, teary times, I am SO ready to jump and and get these damn things off. My boobs or my life, right?!

I have the BRCA2 gene mutation.

You would think that after all these months, after all this writing, that that simple fact would feel normal and acceptable by now. 

But it doesn’t you know.

I spoke to one of my dearest friends this evening to tell her my operation date. Well….she picked up the phone and the conversation went something like this:

“It’s me. I've just come back from the hospital and my operation is definitely going to be on the 28th August”

“Crikey. How are you feeling?”

“Scared titless”


…….oh did we laugh……

Laughter really is the best medicine.

So all that is left now, is to plan my "Good-bye Boob Party!" I am so very excited about this and can not wait to have my nearest and dearest with me to celebrate!

In the short term, I am easy to spot…I’m the blonde who is looking happy.. The one running/crawling when she gets the chance and the one who still squeezes her eyes shut every night and whispers “thank you” to the  big man in the clouds. 

Thank you for reading, this post especially.

I love you.

Bex xox

BRCA2 Information
Breast Cancer is the most common cancer in woman in the UK, making up around 30% of all cancers in women. By far the majority of cancers occur by chance and only 5-10% of cancers are thought to be inherited.

Three genes have been identified that carry a high risk of breast cancer: BRCA1, BRCA2 and TP53. A fault in one of these genes can confer with a lifetime risk of up to 85%

If you are worried, remember that if you have just one relative who has breast cancer you will NOT be at increased risk. However,  there are many specific characteristics that may indicate a gene mutation. Don't panic but just be aware of your risk so that you can personally make an informed decision about how to handle your situtaion.

Family histories are usually considered significant if there are:
1.     Two cases of breast or ovarian cancer under the age of 40 - especially a case of breast cancer in both breasts
2.    Three breast or ovarian cancers under the age of 50
3.    Four breast or ovarian cancers occurring under 60
(N.B 1-3: the ovarian cancer can occur at any age)

The Macmillan Cancer website has a useful  tool called OPERA which can guide you through your possible risk.

However, I can not stress enough that this is not a medical site and if you have any concerns please visit your GP.

It is also important to recognise that even if you are worried that you may have the gene, you do not have to be tested and may prefer to just have annual mammograms or MRI's. Similiary if you are found to have one of the genes you do not have to have surgery and instead can
be screened on an annual basis.  Having the test does not alter anything - you are the same person that you were from conception - but it may give you a sense of control.
For advice you can visit

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