From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…It appears that the next event is breast reconstruction!
It’s been two years now since the double mastectomy and shortly, it will be two years since chemotherapy began. My wife now has an appointment to begin the next phase: breast reconstruction.
As is my wont, I am going to ONLY cover the medical side of reconstruction. I WILL tell you that the ultimate choice is your own. We discussed for nearly a year the different types of reconstruction, we researched, my wife talked to dozens of people both online and face-to-face. We consulted half a dozen doctors, changed clinics and changed clinics then went back to the second clinic again. Breast reconstruction is not a decision to be made lightly nor is it to be made quickly. There are ramifications, risks, and considerations; soul-searching and God-seeking. All of these should be part of the decision to yes or no as well as the decision of which or what.
So…I am not endorsing or advising any of the methods I will write on here. I will translate the doctors – as I’ve tried to do all along. This week: Implant-based reconstruction, step one.
First, a clear definition: “Breast reconstruction is a surgical procedure that restores shape to your breast after mastectomy (surgery that removes [one or both] breast[s] to treat or prevent breast cancer).”
The first step after the mastectomy – which may also happen during the mastectomy itself or years later – is that the surgeon lays down a device called a tissue expander.
http://www.allergan.com/assets/images/US/products/tissue_expanders.jpg
The expander is basically a balloon that the clinic will fill with salt water a little bit at a time. The surgeon puts it under BOTH the skin and the muscle and leaves it there. After the surgery to put it in, the person visits the doctor for an appointment where some salt water is injected into it and then left there. It stretches the skin and muscle a little bit. Then the person waits while until the next appointment. Obviously, there will be feelings of the skin being stretched; I IMAGINE that the feeling would be similar to what happens when you get a sting of some sort and your knuckle swells a bit.
In my wife’s case, the surgeon will add something fairly new to support the expander – a “donated human skin scaffold” which will go along the bottom side of the expander.
“Lab-made skin and soft tissue substitutes (in this case) is made from donated skin but it has all the living cells taken out. What’s left is collagen – the same stuff that makes up tendons, ligaments, cartilage, bone, and intervertebral discs (as in “I slipped a disc!”)…Tissue-engineered skin...can be used as either temporary or permanent wound coverings. Other situations in which bio-engineered skin products might substitute for living skin grafts include certain post-surgical states such as breast reconstruction…”
“AlloDerm is a soft-tissue implant fabricated by a proprietary method...”
The surgery to place the expanders and the AlloDerm will take two to four hours and includes new drains to reduce uncontrolled swelling.
In the interest of keeping the posts readably short, I’m going to stop for now and continue next week!
Resources: http://www.mayoclinic.com/health/breast-reconstruction/MY00207,
https://securews.bsneny.com/web/content/dam/BSNENY/Provider/Protocols/B/prov_prot_701113.pdf, http://emedicine.medscape.com/article/879007-overview
Image: http://www.conlab.org/acl/images/secondbank/1942_reconstruction.jpg
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