Well, I must say it’s been nice. By the time I submit my beleaguered breasts for inspection in a few weeks, it will have been six months since I’ve had to expose any private parts to physicians. I had a sinus infection recently that required my primary care doc to look down my throat and in my ears, but that doesn’t really count. If disrobing is not involved, you can at least maintain some sort of dignity.
In two weeks, I will be interviewing a plastic surgeon about lipotransfer. I say ‘interviewing’ as if I were researching a magazine article. I wish. I do plan to mention to her that I write a blog about breast cancer and that I will be taking careful note of all her answers so that I might share them here. But this interview will involve exposing my breasts for the umpteenth time, to yet another stranger, and possibly having them photographed, which is a thing plastic surgeons do. The requisite ‘Before’ photo. She will probably also have to poke, prod and squish, and read the dimensions of the surgically-excised tissue formally known as my right breast from the copy of the path report which I will provide. Those dimensions are etched in my brain: 10.5 cm x 5.5 cm x 2.5 cm. Also known as my ‘slabectomy.’ Shortly after my surgery, I made some comparison measurements to other objects just to help me conceptualize how much breast I’d lost. Of course I’m not quite sure if my slabectomy was a perfect rectangle or more of a lopsided wedge. But the dimensions about equal my cell phone, if I had two of them stacked one on top of the other. Or a fresh bar of French bath soap. Or a couple of packages of chewing gum, in the economy size.
I’ve eschewed serious consideration of flaps, grafts and implants thus far, for many reasons, chief among them being all the damage caused by radiation. But apparently, there might be another option that doesn’t involve scars or 14-hour surgery. It might not even involve a hospital. Seems that plastic surgeons have been getting quite good at removing adipose tissue via liposuction from one part of one’s body and re-injecting it into breasts that have had slabs removed from them. In other words, recon by lipotransfer. One of its advantages is that prior radiation is not as problematic. In fact, this seems to help soften up adhesions from radiation. Another point in its favor is that breasts end up looking more natural, still possessed of their normal droop, which doctors insist on calling ‘ptosis.’ Personally, I prefer a little droop. I just don’t see myself as the ‘perky’ type.
There is a clinical trial being conducted by Dr. Joel Aronowitz, of the Breast Preservation Foundation in California, of a slightly more complex lipotransfer technique. This involves separating some of the adipose stem cells from the fat that is liposuctioned from the donor site — yes, adipose tissue has its own stem cells — then concentrating it, and injecting it with regular adipose tissue into the breast. The idea here is that the stem cells will help preserve the transferred fatty tissue to help create blood vessels nearby that will help the transferred tissue survive. Even without this stem-cell boost, there are stem cells in all ‘good quality’ fat, which can in turn help keep the transferred tissue healthy, but the extra boost may improve that outcome. This stem-cell boost technique has been used successfully in Europe and Japan for some time now. Most of the research findings have been published by a Dr. Yoshimura. But the technique has not yet been approved in the U.S. Hence, Dr. Aronowitz’s clinical trial.
In any event, I did some research on plastic surgeons in my area who specialize in breast reconstruction and checked out their web pages. The woman I made the appointment with made the semi-finals for the simple reason that she did not have one of those noisome ‘aesthetic’ websites that some plastic surgeons are wont to have. You know what I’m talking about. Those sites splashed with ‘tasteful’ soft-lit photos of perfect female bodies, artfully arranged in semi-erotic poses, that are certainly Photoshopped and thus do not resemble any body I’ve ever seen nor would especially want to have. Dented, divoted and tattooed though my right breast may be; a body that’s certainly not as buff as it once was, and carrying a few more pounds than it did before I started down this miserable road; still and all I actually like my body. Which is a startling revelation at this juncture. I’ve gotten rather used to my morphology over the years, even fond of it. I’ve learned, through trial and error, how to dress it up or down, and what assets I’ve ever possessed have never involved cleavage anyway, but have tended to attract admirers of legs and long hair. Which is just fine. Not a thing wrong with looking good in a short skirt and high heels now and then, nonchalantly swishing my locks over my shoulder.
So, really, it’s quite encouraging to hear myself say that I still like my body, after all this. And I’m not interested in consulting any plastic surgeon with an agenda, shall we say. I have no desire to look younger than I am. I look ‘young’ enough already, thank you very much, thanks to keeping out of the sun, my mother’s genes, and the judicious application of hair color now and then. Restoration I’m open to. Correction of my so-called deficits and imperfections, as defined by some knife-wielder making payments on his BMW, I’m not.
Thus I was pleased to find a surgeon with a website that was business-like, medically-oriented and informative. The one I’m seeing made the finals based on the person who answered her phone. I do not suffer front-office morons. I deal with enough of them in my job, which often requires me to call doctors about my patients. And I certainly don’t want to consult a doctor who doesn’t have the wherewithal to hire someone with adequate brain cells to serve as her gate-keeper.
When I called this particular office and asked if the good doctor performed lipotransfer for breast recon, it was quite refreshing to be told, “Hang on a second, I’ll ask her right now.” Which was done, with dispatch, and I wasn’t even placed on hold. The answer was, “Yes,” whereupon we booked an appointment.
So, dear readers, I’m asking for some help here. I have a few logical questions in mind, but there is that haze that comes over me when I have any doctor’s appointment involving breast cancer. I get a little fuzzy. I forget to look at whatever list I’ve brought with me. I’ll take a Provigil that day — if I remember to — which might help. But tell me, those who’ve never had recon and those who have, what would you like to know about lipotransfer? If you help give me an assignment, I’ll do a better job. Thanks in advance.
If I do this, I admit I might miss my prosthesis. It’s been an endless source of amusement over the last few years. But I can still wave it around in public now and then. Just for fun.