Boob Surgery 101 (warning talk of boobs)

Spoiler: That thing all women have always said “I wish they could move my belly into my boobs” IS A THING…

Knowing October will quickly be upon us, I’ve started my search for the Plastic Surgeon who will rebuild my new boobs. I was quickly disappointed when I realized all the Atlanta Plastic Surgeons are in Buckhead and Alpharetta. The first doctor I met with was eye opening. Here is my summary.  Disclaimer – while I can rock a white jacket, I’m not a doctor and nothing here should not be used as medical advice.

• Surgery 
  1. Mastectomy – My surgical oncologist will perform the mastectomy and remove all breast tissue and cancer, hopefully sparing skin, nipples and putting the incision in the crease of the boob.
  2. Tests – During the Mastectomy they will test the tissue and look for traces of cancer. If there is a cancer then radiation is needed (go to #4). They will also see if conditions and blood supply looks good, if they do look good go to #3, else go to #4.
  3. 1 Stage Reconstruction (aka Direct to Implant) – if all looks good, they can rebuild the implants during the mastectomy.  The plastic surgeon will jump in and rebuild.
     – OR –
  4. 2 Stage Reconstruction – If radiation is needed or conditions aren’t right, the plastic surgeon will put in tissue expanders, which will be filled with saline over the next months during radiation while we wait to do the reconstruction.
  5. Touch Up Surgeries – Apparently there are often more surgeries after the reconstruction to get the boobs right – tattooing nipples on, adding fat etc.
  6. Replacement Surgery – If you have implants, they will likely need to be replaced every 10 years.
• Types of Reconstructions
  • Implants – This is what we normally think of – putting in a typically silicone filled implant with some options:
    • Silicone – This is a different silicone than the ones you may know. They are more like gummy bears  liquids e.g. you can cut it in half
    • Saline filled – feel less natural
    • Tear drop – shaped for a more natural feel
    • Rough or smooth – I forget why they recommend rough
    • Size – you can pick a size
    • Placement – They can be placed behind or in front of the chest muscle. Apparently, people are cheeping out and it’s becoming quicker to put them in front, but they don’t look as good so it’s recommended to insist on going behind the muscles
  • Flaps –  This was new to me.  If they have to do radiation, they may need to get a blood supply or you may choose to do a flap rebuild instead of implants. There are two types:
    • Back (LAT FLAP) – They can borrow a piece of your back muscle and “bring it around front” to use. This leaves you with a gnarly scar across your back and possibly a diminished tennis career – though they say for the most part you don’t miss the muscle – OR –
    • Belly (DIEP FLAP) – This was probably the biggest shocker – Apparently that thing all women have been praying for – “I wish they could take my belly fat and put it into my boobs” IS A THING! They basically give you a tummy tuck, and can then use that belly fat with it’s blood supply and make you new boobs! It’s a micro surgery and they have to reconnect each blood vessel, but in the end you get a tummy tuck and new boobs.  Apparently, this has a lot of benefits and has become very trendy but if you don’t have enough fat you aren’t a candidate.  And sorry ladies this isn’t an option for regular boob jobs, just reconstructions.

So what to choose…

So overall it was a mind blowing experience.  Here I was expecting to pick if I wanted B’s C’s or D’s and they now present me with a whole new set of options. I have months to research and present my case (sarcastic yey).  This tummy tuck option was super intriguing; flat tummy and new boobs.  But man they should have talked to me last year when I was 33lbs heavier – I could have had a set of DD’s. We’ll see…