Lead plastic surgeon had warned me that my mastectomy and reconstruction would likely lead to several more surgeries. I wasn’t a believer. Or maybe I should say I refused to believe. I am a get in get out kind of girl. One time around. 2 measures 1 cut. Or at least settle for less than perfect if you find yourself with a mistake. Considering I am all into neatness and structure and organization, it’s really unfortunate to admit I settle for less than perfect in my appearance. I rush through make up application each day in less than 5 minutes, I marginally match my attire (Ron is way more in tune with style and fit than I), and I may or may not look in the mirror before leaving the house and more often not. I have absolutely no qualms about running to the mailbox or even the grocery store in my PJs or gym attire. Knowing all of this about myself, I was very surprised when I had been noticing and also bothered by a quadrant of Imposter #1 and a much smaller quadrant of Imposter #2.2. I think they were worried I had forgotten about them. Tossed them aside after all we had been through together. I guess in many ways I had. And I didn’t feel an ounce of guilt about that. Not all relationships are intended to stay in the forefront, but I guess Imposter #1 felt differently. He was mourning my relationship with him. He felt….overshadowed. Imposter #2.2 (formerly Imposter #2) had already one-upped him with an extra surgery. He declared infection and worked his way back into my every day thoughts last April. But what Imposter #1 didn’t know was that the extra surgery made me a little bitter towards #2.2. #1 was in my favor! ..... Until now.
How shall I describe what he has gone and done? There is a gully? A trench? A line? A rippling? A dimpling in the form of a line. Yes, that is a very close visual description. There is a line of dimpling that extends from midline to under the armpit across Imposter #1. It’s not the Grand Canyon, but it could easily be the Cape Fear River with aspiring goals. He looks tired and worn out. He looks to be imploding on himself. He most certainly needs a sick week to recoup and get his implant back under him. He appears marginally deflated (though not possible with High Profile Smooth Round Gel Implants). But he’s doing a good fake out all the same. It’s minor. It’s trivial. It’s pathetic to even consider. But it’s noticeable to the gal who leaves for work without looking in a mirror and goes to the grocery in rather unflattering attire.
I’ve been told it’s not uncommon. In fact it may be more common than not. My surgeon had warned me that this day would most likely come. I had warned him “no, not me, not ever!” in return. I have no problem at all pointing out where he is wrong. To which he said “well, we can hope”. In fact, the last time I saw him I had made a convert out of him. It was a year ago exactly -can you believe that?- that Boob #2 went rogue and picked up cellulitis requiring emergency surgery and replacement thus introducing Boob 2.2. In an appointment following that surgery Plastic Surgeon said I may in fact defy the odds and never require “upkeep” since otherwise they were visually doing so well. Score one for Sally! Well, a year later I have been robbed of that score and now found myself scheduling an appointment for his input on the dimpling. Twice I almost cancelled the appointment. Even the night before, I went back and forth. “Is this silly of me?” “Have I suddenly lost all sight of common sense?” “Am I worried about something when I should just be grateful I have a boob at all?” I sought the consult of a friend who had only a month ago experienced a similar out lash from her own imposter. I sought the consult of family. I felt petty. I felt vain. Yet every morning when I look down at Imposter #1 and he looks up at me, I felt unsettled. I knew something was up.
Well, the good news is I went to the appointment a few weeks ago, and I no longer feel petty. I no longer feel vain. Lead Plastic Surgeon took one look and said “yep, we absolutely need to fix that and if you don’t fix that it is only going to get worse.” Thankfully, he didn’t gloat. He put on his cheer me up smile. I think he thought I was going to tear up right there in his office when he said we needed to fix it. I wanted it fixed, but I didn’t want it to NEED to be fixed and to go through the actual process of fixing it. I simply wanted a visit with the magic eraser. Scuff up, scuff down, dimpling trench gone in 3.5 seconds, head back out of the office and call it a wonderful day. I didn’t want a “procedure” or an operating room time slot. But in the end I got both. As he explains it: this dimpling, this rippling, this trench of the Cape Fear is being caused by the lack of fat and good blood flow under the skin. Basically, the area and skin over the implant is thinning and losing blood supply. You’ll recall that during the mastectomy itself they scrape out every ounce of breast tissue and fat under the skin. During reconstruction the surgeon either refills the area with fat to make a new boob (I wasn’t a candidate for this procedure because of all of my radiation exposure) or they place an implant in a sling under the skin envelop (my procedure). Because I only had an implant (no fat), once the implant settled into the new home gaps began to appear between the skin and the surface of the implant. Dimpling, rippling, trenches. Also, because there’s no tissue inside the imposter other than the exterior skin and the gel implant itself, there isn’t a great blood supply to the area. Well, the great news is this procedure (I refuse to call it surgery) will help rectify this and should be easy cheesy in the whole scheme of things. All I have to do is lie on the OR table for an hour or so and take the best nap known to man - and he even said I might be able to get by with just localized anesthesia and then I would be awake for it all. We will decide that day. Get in, liposuck some fat from somewhere in my body, place some stitches, inject the fat over the imposter (maybe more stitches???), and get out. Go home to recover for a few days with the help of some pain meds. No drains (can you hear the angels singing!?!?!?). Minimal scarring. Improved blood flow to the area as the recycled repurposed green-way-of-doing things fat (maybe I will get a tax break?) will provide a surface for blood vessels to regenerate in the area. We will show Boob #1 who is boss and hope he takes the hint for this to be a one-time occurrence. Let him feel the love he evidently needs then move on, and at the same time hope Boob#2.2 doesn’t feel left out. Lead Plastic Surgeon warned me the dimpling is starting there as well so this time when he said “you will likely need to do this again in the future for either or both imposters” I gracefully backed down and simply nodded a “yes sir”. I guess I can’t be right all the time.
Well, it turns out that what they say is true. A mastectomy may be a one-time occurrence, but the reconstructive process can be (and appears to be for me and evidently many others out there as well) an ongoing event. While my vanity and a twinge of worry took me into the appointment, I left knowing there was in fact a need to investigate remodeling and boob design tips for medical reasons to increase blood flow to the area and lessen ongoing dilapidation. “Flip This Boob” coming to a station near you in April. Slap in a little spray on insulation and watch the value sky rocket! Boob #1 will be back on the market good as new!
(By the way, don’t give me a second thought. This is so very minor. But in my desire for transparency for those reading during their own journey, it needed to be told for full disclosure. You might want to think about Ron though. Boy does he win the award for For Better or Worse. )
