Penny and Clover 2.0

WARNING!!! There ARE photos in this post. If you don’t want to see them…turn back now!

Hi there!  If you have been following my blog, you may remember me mentioning in my last post that I was heading back to surgery in September for another round of fat grafting and scar revision.  Well, in late August at exactly the 90 days post Covid point, I along with several others in my tribe tested Covid positive (for the second time this summer.)  The day my nasal swab turned from negative to positive was exactly ten days prior to my scheduled surgery.  I quickly called my PCP to reschedule my surgical clearance.  Certainly, I would be able to squeeze it in after 5 days of isolation, as long as I masked in the office.  Right?  Nope, not even close.  After a disgruntled conversation with the office scheduler, who informed me my doctor was not available for this kind of appointment in the next 10 days and the NP’s were not permitted to do surgical clearances, I reached out to the surgeons office directly.  Nicole (my favorite) took my call, asked me one simple question…..”are you positive right now?” and squashed my tenacity in less than a nanosecond.  Per their guidelines, I needed to wait 6 weeks after a positive test to have surgery.  Great!  More waiting, my favorite!

Since October is a crazy month at work, I used my time in September to effectively coordinate and organize chaos for my day job at the local YWCA.   I also spent as much time as I could with my nieces and nephew, oh and in an effort to work on downsizing my life in general, I packed numerous boxes and bags to be hauled off to either the auction or Goodwill.  I also managed a weekly call with three wonderful humans at a company called HelenHealth.  HelenHealth is a digital health platform that strives to connect people with the best cancer prevention resources in the world!  I am hopeful this relationship will continue to open doors and that I can be a small part of this company’s mission.  ~ Stay tuned for more on this front…..AND if you or someone you love are at high risk for any type of cancer, check them out at: https://www.helenhealth.co/ 

As is common with any upcoming surgical experience, the closer the new date got, the higher my anxiety rose.  To combat the effects of uncertainty, I downloaded my first podcasts.  Throughout the summer, I read the book The Gifts of Imperfection by Brenè Brown.  In just one book, I was hooked and wanted more.  So, Brenè Brown podcasts, seemed like a good place to start.  Let me just say…..WOW!!!!  Each episode filled my heart with admiration for whomever she was interviewing AND each one had me searching a little deeper within myself.  Searching for what you ask?  Well, hell if I know, BUT after some long hours of soul searching and truth finding….here is what I ultimately discovered.  I very much disliked my original foobs.  Sure, Penny and Clover were full and could be perceived as lovely.  My nipples had been saved and life should have been the tits, right?  Unfortunately, that was not the case.  I tried really really hard to adjust and accept what they were.  I told myself, I was going to give them ten years and then reevaluate.  BUT, somewhere in the depths of my being was unhappiness.  Carrying the literal weight of implants that were simply too big for me left me edgy and feeling like a fraud.  As for the nipples, sure some feeling returned, but it was a feeling that brought flashes of pain and acute insecurity instead of pleasure and self-confidence. 

In this crazy world, we often live by the mantra “it’s good enough, move on.”  The more I tried to convince myself to continue the “it’s good enough” tune, the more the voices inside my head spoke up and shouted….. NO!  This is NOT good enough.  It is okay to not be okay.  It is okay to NOT be happy with these results.  Find a way to speak your truth and allow a new plan to unfold.  I finally got tired of all the shouting in the space between my own ears and scheduled a virtual appointment with the Physician’s Assistant. 

I need to mention that I like to live in a really rad place called Gina Land.  Others often try to pull me out of this delightful destination, but it is quite lovely here, I like it and when forced to vacate the premises, I do so by kicking and screaming on the way out.  Therefore, it was no surprise when I pitched my perfect plan to Nicole (smaller implants with a decent amount of fat transfer…..to happen all in the same surgery) she was quick to shatter my dream and trump all fantasy with reality.  She confirmed my suspicion that the original implants were chosen to fit my “pocket” after the mastectomy.  If you think of it like a pillowcase, you can get a pretty good idea of what I mean.  If you stick a standard pillow in a King sized case, you will be left with a lot of extra fabric.  That fabric would need to be folded over, altering the design on the case, potentially leaving a less than desirable look.  When it comes to a mastectomy, the skin is the pillowcase, the implant the pillow and the nipples are the design the doctor tries to keep intact.  No one wants wonky looking nipples that point different directions like an outta control Mad Eye Moody. 

Thank goodness for virtual visits!  Nicole, Jim and I were able to talked at length from the comfort of our own home.  Nicole helped me see and understand that we were dealing with more than one issue.  Not only were the OGs too big, over time, the “pocket” was starting to stretch, causing the implants to shift slightly.  This was noted by the ever growing amount of side boob appearing under my armpits.  She explained that we could put in a smaller implant, but the nipples would be compromised.  ~ If a woman (who has not had a mastectomy) chooses to do a breast reduction, they will often do a lift prior to the reduction itself.  During the lift, they use what is called an anchor incision to remove and reposition the nipple.  Once healed from this surgery, the woman can move forward with the reduction. ~ Unfortunately, the anchor incision is a complicated pattern and when used after a mastectomy, presents a high percentage of failure.  There is simply not enough blood flow left to successfully heal the tissue, leaving nipple necrosis a strong possibility.  Nicole’s ability to listen and gently guide, left us ending the conversation with this as the leading approach:

• Remove the nipples, tighten the pocket, revise the scars and replace the larger implants with smaller ones. 

Nicole asked me to take a day to mull it over and get back to her by the next day.  New implants needed to be ordered (if necessary) and she hoped the date would not need to change again.  After the call, I literally laid on the bathroom floor and had a good cry.  I know I have said many times, I wasn’t happy with how big the girls were, and I hated having to continue wearing a bra, in fact I wore one more frequently than before surgeries.  But it doesn’t mean making the decision to actually remove my nipples was easy.  Nothing……let me say it again…..NOTHING about these decisions is easy. 

I took the day to allow the new approach to sink in, confirmed with Nicole this was what I wanted and secured my time in the OR for early morning October 4^th.    All aspects of the surgery were successful, time in recovery was short, and we headed for home early that afternoon.  As is standard protocol, I could not shower for 48 hours.  As dawn broke on the morning of October 6^th (my 49^th birthday), I released the Velcro from the pink surgical bra, removed the oversized gauze covering the incisions, took in the first full look of my new reality and wept.  I can’t lie.  The visual is rough.  This heavily cut and sewn canvas of my chest area looks like it came straight out of a classic Frankenstein movie.  This revised image carries a new set of insecurities.  In time, I will acknowledge, conquer and embrace this new version of myself.   I find comfort knowing Jim won’t mind adding a little addition to one of his favorite uplifting sayings.  He reminds me regularly that he didn’t marry me for my hair, boobs (or nipples.)  Funny he likes to tell me what he didn’t marry me for…..maybe one day I will get the courage to ask him why he DID choose me!  LOL!   

At this point, I am only a few days into healing and can already tell the size is going to be a better fit for me. Even with swelling, they are substantially smaller and lighter.  Full recovery is going to take me a hot minute though.  I don’t have much feeling in front, but there is plenty of feeling around the periphery.  In all the places where scar revision took place, it feels like a hot iron is being pressed on my skin.  A regiment of Tylenol and Ibuprofen takes the edge off.  It’s the look that will take the longest to heal from, but I am hopeful that as the scars fade, the insecurities will fade too.  As for today and a few tomorrows, I am going to allow myself some grace and a little room to be sad. 

If I can relay some advice to anyone new to this journey (and even to remind myself)…….It’s okay to not know what you want.  What feels like a dream, as you wade through research, conversations, increased screenings, tests, and possibly surgeries, can leave you with a result that is not ideal for you.  Yes….erasing the threat of breast and ovarian cancer can feel like a huge weight lifted from your shoulders.  But, that doesn’t mean you have to live with a reconstructed result you are not comfortable with.  Keep reaching out, keep having the conversations and keep fighting for yourself.  This approach is challenging for me, but in time, I plan on it becoming something I am proud of! 

I have two songs for today. The first one: Scars to Your Beautiful by Alessia Cara. What a beautiful message delivered through these lyrics!

As always, THANK YOU for taking time out of your day to read what I have to say and allowing me a safe space to chronicle my journey. If you are embarking on your own path to prevention, keep your chin up.  Please reach out if you have any questions.  You are NOT alone.  This wonderful community of mutants got you! 

Peace and Love,

Gina, Penny AND Clover