First of all, I think this is the most misspelled word of my blog. A word that I never thought my five year old twins would be saying or even know the meaning of. What is their purpose anyway? (And by that, I don’t mean my twins. That’s a whole other blog, one I actually started two weeks before I discovered my lump but never published.) Areolas – I mean, they don’t have any biological function, not that I know of. I barely remembered what they looked like, I mean at all, and I would find myself comparing them to the only ones that I would see on a daily basis – my husband’s, who by the way has some pretty nice areolas. I would stop myself from rewinding when watching TV so that my cat wouldn’t think that I was a pervert. And no, it’s not a reason as to why I’m such a big fan of GIRLS. Areolas …. Why are they round, and so pinkish? Why doesn’t hair grow on an areola, like it doesn’t on the palm of a hand? And why is the nipple color a tad darker? I imagine a day and age when areolas actually were of some use, or a time unto which we evolve for the areolas to have some purpose. Headlights? Beacons? But I digress. I should start where I began, at the reconstruction surgeon’s office.
When I met Dr. Samson and his assistant Sam (hereafter referred to as S&S), I never could have thought of the long and harrowing road I’d have to undergo to simply feel as if I’m a woman again. I know that I say that intermittently throughout my blog but it’s true. It’s as if each procedure is a step forward. And as I talk with more and more cancer patients, I realize how lucky I am. As in all aspects of life, each person’s journey is different and unique. And it’s not the experience that defines you but how you deal with it. So I take each step as its own. I stay in the present. With that, I’m able to revel in the little accomplishments of each and every step along the way.
When I had my mastectomy, my implants were temporary tissue extenders. Now, I do in fact have pictures and video of all of this, but I’d rather let the anticipation linger until we produce our documentary. Until then, you’ll have to deal with my drawings. My first set of scars looked like an upside down ‘T’ like this.
The implants were saline filled and silicone lined that S&S would inject more saline into the hardened port (which started at the top and rotated to different positions as time went on) to stretch the skin and tissue to the size I wanted. For the most part I didn’t feel a thing. At the worst of times, a tiny pinch. Once we got to the size breast I felt comfortable with (which was considerably smaller than what was infected with cancer), we stopped. This was mostly prior to chemotherapy, but once or twice between chemotherapy and radiation. As time went on, they would grow, so to speak, to be somewhat uncomfortable.
Once radiation had started its deconstruction, the breasts started to harden and truly become uncomfortable. I began to realize why women rushed to have the exchange surgery. But it was better to wait. The damage radiation causes is pretty extreme, on the surface and below. The skin gets burnt literally. I had pretty aggressive treatment focused on 6 areas of my right breast and armpit. (FYI, having a burnt armpit is pretty much the worst type of sunburn ever!) The skin and tissue would tighten on my right side, while my left temporary implant began to slide. All of the scar tissue damage below the surface not to mention to the implant itself, my genius of a doctor would be able to repair when he opens me up and gives me my permanent implants. So I waited through six weeks of radiation and then for another 3 months afterwards for my burnt skin to heal. And for those three months, I would beat on my rocks in jest to friends, creeping them out a little. The pain was so uncomfortable that I couldn’t do any stomach lying positions in yoga. I would give extra long hugs to people just to freak them out, to get my rocks off. That’s right. I said it.
I ended radiation on April 17th and on July 26th I had my exchange surgery, a one hour out-patient operation that would take a mere couple of days to fully heal. The scar? Only a small horizontal line across each breast, giving each breast their own ‘T,’ like this…
Now, through all of the research, there truly isn’t any ‘safer’ choice of silicone vs. saline. If they should ‘pop,’ you simply know sooner about the saline as it deflates pretty quickly, while the silicone takes some time but does no harm to your body. The lifespan of both is about the same (10-15 years, and yes I may have to get them replaced). As for the feel? The silicone feels more natural. So I decided to go with silicone. After going through all of this (MRIs, PET scans, surgeries, saline inflation, chemotherapy, radiation, minor bouts of lymphodema) I want them to feel as real as possible.
After a couple of weeks, I could totally feel the difference. They’re squishy like my breasts use to be, soft and natural feeling. But minus the nipples and areolas. I start to get resigned to the fact that I don’t have to worry about nipple coverage. That for the first time since fifth grade, I don’t have to wear a bra. That I could be ok with my nippleless breasts. But then there’s my husband. Hardly anyone ever talks about the toll that it takes on the spouse and caregiver. Now, anyone in a relationship knows what it’s like to be completely unencumbered with a partner. Before all of this, Graham and I had been together for 15 years, married for 8, and now closing in on 10 years of marriage I was a different woman. Now I would never question his devotion, love and loyalty towards me. But you gotta admit, sex is not the same after a mastectomy. Not only could I no longer have kids, but I felt as if I couldn’t please him as I had in the past. So in all honesty, the nipples and areolas are gifts to him. As he’d say, ‘c’mon you gotta give me something.’
My scars healed enough by 12/12 for S&S to work their magic yet again. An in office procedure, I’d lie down, and after about 12 injections of anesthesia in each breast, they were completely numb. For an hour, they cut into each breast where the scars came to meet, and in a tri-folding stitching pattern they sculpted me nipples. I didn’t feel a thing except for a bit of tugging. Amber and Elizabeth who joined me afterwards were amazed. As for me? Well, it took some getting used to. They were pretty big, but S&S swore that they would go down in size and if any adjustments were necessary it was easier to make them small rather than make them larger. So now I looked like this……
Weird right? I would wear bandages for about a week. Luckily it was actually winter and cold outside because now I looked, well, …cold. On 2/26 I went in to have Sam tattoo me some areolas. First, Dr. Samson took a clear plastic template, like I was being scanned for an overhead projector, that had a central point and then varying sizes of circles. He placed the template on my nipple, and we agreed upon a size. He took a dry erase marker, outlined the size and then pressed it onto the center of my breast, leaving behind the circle. Now all Sam had to do was color in the lines. There we go again, the color. How do we determine it? Sam opens a folder and there they are. Photos of my old breast. I don’t even recognize them, but there they are. Sam compares the color and chooses the dye. Another round of anesthetic injections were in order and this time? I could feel every bit of it. That’s right. No matter how painful it was, it felt good to be able to feel it at all. After both breasts were numb, Sam starts her art of tattooing, making the nipples a tad darker. Like with any tattoo, it takes a few days for the skin to heal.
Now, a month later? Well, I do in fact stare in the mirror a bit more. My girls say that my breasts are pretty. As for Graham? I’ll leave it to your imagination. As or me, I do in fact feel different. So maybe doing the final reconstruction was just as much for me as it was for Graham. I saw S&S for the last time on Tuesday and we were all a bit overwhelmed. I’ll go back once a year for check-ups, and do MRIs every three years. I never thought I’d get teary eyed saying goodbye to these two, Dr. Samson and Sam. What they’ve given me, my family, words can’t completely describe. In the end, it was definitely worth the wait.