Kate's Breast Reconstruction Surgery with Breast Implants

My name is Kate Watts.  I am 44 years old.  I live in East Tennessee on a horse farm with my husband and border collie (Emma Smudge). 
 
 I went for my yearly mammogram on April 15th, 2002.  I have been having mammograms yearly for approximately 10 years due to having fibrocystic breasts.  The radiologist department called me as soon as I arrived home from the mammogram and asked if I could come back sometime that week for more pictures.  I, of course, was stunned as I had never been asked to return in the past.  I made an appointment to return on the 19th of April.  They kept taking more and more x-rays of my right breast so I knew they were seeing something that was unusual.  The radiologist took me into a room and showed me the results of the mammogram and compared it to the one a year ago.  It was plain to see that there was something different this time.  He described it as microcalsification clusters and said they usually are surrounding cancer or independent of cancer.  He suggested a biopsy.
 
 I went for my biopsy the following week (April 24th).  They did a needle core biopsy.  Even thought they numbed the area, it was slightly painful and very uncomfortable.  It took about two hours for them to complete the process.  They took 12 small tissue samples from my breast.  On April 26th, they called with the news that it was cancer.  Of course, I was devastated as there is no history of cancer in my family.  I was given an appointment to see a breast surgeon on May 1st. 
 
 My husband and myself went to the breast surgeon and learned a lot about breast cancer.  We took a list of questions that we had and he (the doctor) answered all of them before we even had to ask them.  He showed us diagrams and made us feel very comfortable.  We gained a lot of trust in him that day.  I found out that the cancer was 1/2 of a centimeter in size, hormone receptive positive, a tubular cancer, it was just behind the nipple and at a very treatable stage.  He explained that, in my case, a lumpectomy vs. mastectomy would have the very same outcome as far as a success rate in removing all of the cancer.  He said I would need to have my lymph nodes checked for possible spread of cancer.  He gave us a book to take home.  It was written by the American Cancer Society and detailed the treatment guidelines for women with breast cancer.  After reading the book and realizing that with a lumpectomy, I would have to drive to Knoxville everyday for 6 to 8 weeks of radiation treatments (an hour and 1/2 drive one way), I opted for a mastectomy followed by reconstruction.
 
 A procedure called Sentinel node mapping was scheduled for May 17th.  This was an all day event at the hospital.  This procedure is only performed by a team of doctors who are experienced in the procedure.  The department of nuclear medicine brought a radioactive dye into the room where I was waiting to be injected.  My doctor injected the dye into the tumor.  This was very painful, but only took about three minutes.  Once the dye is injected, it takes several hours for it to reach the Sentinel Node (the Sentinel Node is the first node in which tumors leak into).  I was then taken to a room where they took constant pictures of the dye going into the nodes.  I had to lay very still for hours.  Once the dye reached the nodes, they took me into surgery for the removal of the Sentinel Node and three surrounding nodes.  This surgery was more painful than I had expected.  I was sent home to recover the same day.
 
 One week after the Sentinel Node mapping, I was told that no cancer was found in the nodes.  I was ecstatic beyond words.  The surgery was then scheduled for the mastectomy.  It was scheduled for June 3rd.
 
 On June 3rd my mastectomy was performed by my breast surgeon and the reconstruction process was started during the same surgery.  My plastic surgeon took over as soon as the breast was removed.  He inserted a tissue expander and drain tube and I went home the following day.  The breast surgeon called about three days later and told me that all margins were clean......meaning there was no cancer found in the outlining tissue of the breast.  He then told me that I would not have to have chemotherapy or radiation and that I would just take Tamoxifen (20mgs) once per day for the next five years to prevent the reoccurrence of breast cancer.  I was thrilled.  The drain tube stayed in for two weeks and was very uncomfortable as it really limits the use of your arm.  In other words, you are very aware of the drain tube....even in your sleep and are constantly shifting your body to compensate for it.  The drain tube drains fluid from around your breast area into a small plastic c bottle which is at the end of the tube (I carried mine in a fanny pack).  The bottle has measurements on it and you are instructed on how to measure and log the amount of fluid each day as well as how to empty the fluid.
 
 
 Two weeks later I went to my plastic surgeon for the removal of the drain tube.  That was painful for about a minute.  He just pulled in out really quickly and then let me adjust to the pain for a minute and then I was fine.  He also began my saline injections that day.  He injected 3 ounces of saline into the expander.  I would then go every two weeks for the saline injections until the expander was filled to capacity.  I would experience pain for about two days following each injection as a result of the skin stretching.  In most cases, the plastic surgeon will over expand your tissue to give the end result a more natural appearance.  My last saline injection was August 22.  I was so glad for it to be the last one.  I then went 5 weeks with the expander fully expanded to allow for my skin to adjust to the new size and for the skin to soften. 
 
 Five weeks later my plastic surgeon was very pleased with how everything looked and was ready to do the next surgery which involved an augmentation of the "good" breast (a lift, an implant and moving the nipple up) for symmetry.  The expander would be replaced with an implant also.  This surgery took place on Oct. 4th.  I went home the same day.  As I type this, I am still recovering from the implant surgery.  It has been 8 days and I am feeling better each day and am planning on getting on my bicycle today and going for a ride.  I am to go back to the plastic surgeon on November the 7th to discuss the nipple reconstruction.  I am almost at the end of the reconstruction and am so glad that all is going so well.  I am very pleased with the outcome thus far. My breasts really look better than I could have ever hoped for.  I am now a C cup (I was a B cup).  As for the Tamoxifen......well, I have hot flashes and night sweats quite often, but am learning to live with it.  I am truly lucky that the cancer was found so early and that I have such a supportive and loving family, great friends, a job with great benefits and God in my life.
 

 

 

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