... And so, the countdown continues.
Only nine more sleeps until I will finally be walking into London's Royal Marsden hospital in Chelsea, for my preventative double mastectomy operation, due to my BRCA1 gene mutation (check out my first blog post for more info on that). I am ready. In my head, heart and body, I feel prepared for it... but I have a sneaky little suspicion that as the day draws closer, I might be headed for a slight roller coaster of emotions... so, be prepared, people!
As you well know, what I currently consider to be the greatest 'silver lining' of my whole genetic mess, is the chatting and reconnecting with all my much-loved friends and family across the globe... as everyone has been getting in touch to send me love and well wishes (again, thanks so much! Love you guys!). I noticed, however, in all these conversations, that there is one specific question that seems to pop up every time: "What happens during the operation?" ...and so, I thought I would sit down and outline this procedure for you guys today, just so you know what I'm heading in there for.
I'm no doctor, so excuse the layman's language, but here goes:
After being placed under general anesthetic, my surgeon (Dr. Gerald Gui) will make a long incision under the fold of my breast. This will allow him to 'flip open' the breast (bleh! sorry, if you get squeamish), so that he can remove ALL breast tissue. Luckily for me, as I do not currently have breast cancer, I am able to keep my nipples... as new research demonstrates a minimal difference in the occurrence of cancer with/without nipples, post-this preventative surgery. Dr. Gui will then scrape the underside of the skin and nipples (Ugh, bleh, sorry again) to ensure that the only breast material left is the skin and outside portion of the nipple; all glands, tissue, nerves will be removed. Leaving the breast 'sack' completely empty for the surgeon to refill immediately... so, the removal and reconstruction all occurs in the one operation. I have chosen to go with a similar-sized implant to what I am already. I am a small-breasted gal, so will be increasing by just 1 size, b to c... coz why the hell not?! I should allow myself to get some joy out of all this crap, right?! ...(Thanks to my ladies who have convinced me not to be so boring, and to go a tiny bit bigger, you know who you are...and I love you!)
Since my implants aren't going to be hugely different, they can be inserted immediately, no need for expanders. Ladies who choose to go significantly larger or who have had a double mastectomy due to a breast cancer diagnosis (so their nipples have been removed, leaving the remaining breast now considerably smaller), they will often need expanders to be put in first. This enables the doctor to slowly stretch the skin over a few months, before performing a second operation to fit the permanent implants. However, this is not the case for me, so I will be getting my implants put in straight away.
Based on the recommendation of my surgeon (and after ample "umming" and "ahhing"), I have chosen for my reconstruction to occur UNDER the muscle. This was a really tough decision for me. It is incredibly difficult to make a choice about something as complex and overwhelming as surgery. As knowing once I'm under the knife, my choice is final and I have no idea which I am really going to prefer or want without seeing or feeling it on me. I was given the option of over or under the muscle. Both have pros and cons. But in the end I have chosen under, as it is the more tried and tested method. This type of implant maintains a longer recovery time (an obvious con for me, being a yoga teacher, as I will be 'out of action' for a lengthier period)... but it seems to me that there is less wiggle room for aesthetic complications in the future. So, I'm going for it... UNDER the muscle.
To get the implant where it needs to be, the surgeon will lift my pectoral muscle and slot the implant in underneath (check out the diagram to see what I mean). He will then use either a piece of synthetic material or pig skin (which has been stripped of all of it's genetic elements, so its basically like leather) and he will create a mini hammock for the implant to sit in. Without this, the implant could pull or slip out of position, as my breasts will have no tissue to hold it in place. Once that is complete, he will stitch me up... et voila! One boob done!... and he will swiftly move on to boob number two, to do the same thing all over again. The full procedure will take approximately 4 hours.
So, there you go. That is what I will be doing in 9 sleeps time. As I said, right now I feel calm and collected.... lets hope it stays that way... watch this space!
Luv, Emma xx
Diagram credit: https://www.novanthealth.org/