BRCA2 – Expanders to Implants 7.6 – Empowered Mastectomy

Double skin sparing mastectomy
Double skin sparing mastectomy

 I’m BRCA2 positive, so I didn’t have cancer when I had my mastectomy. I found out I was BRCA2 positive February 4, 2019, after my OBGYN had suggested I was a good candidate for the testing. I never had heard of BRCA, so I didn’t think anything of it, so when I was called in and she told me I was positive I was completely floored. I called my mom, who just had surgery herself to remove cancer from her breast, and she was in shock herself. Then a week later she also found she was BRCA2 Positive and then we had my grandmother tested, and she was positive as well. I had had a hysterectomy back in 2016 (not cancer related) but they kept my ovaries and tubes in during that surgery, but once I was positive, that March I had my ovaries and tubes removed. I waited until 3 October 2019 to have my mastectomy because I wanted to make sure I was 1) really wanting to do this 2) if I did, was I going to have reconstruction, or flat and 3) if I was going to keep my nipples or not and 4) I wanted to be in the right mindset. Because let’s be honest. It’s a lot to deal with. 

mastectomy tissue expanders and "JP" drains
tissue expanders and “JP” drains

  My mom suggested that I go talk to her doctors, since I went to others and it didn’t feel like they understood what I was going to be going through. Almost like it was a done deal I was to have the surgery, and I should not keep my nipples. I was so undecided and felt like I was pushed just one option and one direction. So I went to Chevy Chase Breast Center in Chevy Chase, MD and talked to Dr Marie Pennanen, and she was amazing. For the fist time I felt like I had someone who understood my fears, and wasn’t going to push me one way or another. She was very honest with me, and told me all the good and bad things that could happen, but did ultimately make it totally my choice, and no matter what that choice was, I had all the information and I knew it would be a right decision for me. The plastic surgeon was Dr. Ximena Pinell, and she was amazing. She works at DAVinci Plastic Surgery in Georgetown, MD, USA. Her and her staff really made me feel at home, and she was always there to answer my questions, and to put my fear at bay. She is truly the best, I can’t say enough good things about her. 

JP drains Mastectomy surgery
drains are usually removed 1-2 weeks after surgery (or when the output decreases)
Tissue expander fill injection
To increase the volume in a tissue expander, you go in for a “fill” every week or so until your desired size is acheived. There is a port in the expander, under the skin, that can be injected with saline. The port is magnetic, so it is easy to find with a magnet. This may look painful, but directly after a mastectomy, most all sensation is gone. The fills are usually painless and just feel like pressure.
Mastectomy expander separation
expanders tend to move farther apart as volume is added

 Advice for newcomers: I don’t know if I can give advice since it’s personal and different for everyone. My mom struggled really hard with her surgery, where I was both mentally and emotionally ok with my decision. I was told by everyone that I was the poster child for a double mastectomy. I don’t regret anything of it, but I will say EVERYTHING about my chest is different, and, since I am single, I struggle still with putting myself out there to even go on a date. I can’t imagine anyone touching me, because I have no feeling, and they are always cold. I didn’t know that would happen lol. So I still struggle now, two years later. They are these foreign things on my chest. I went bigger (itty bitty titty committee here) so I figure that I had 40 yrs, with my little girls, and now I gotta get used to the bigger girls and it’s only been two years. I’ll get there. I didn’t know, or maybe understand fully, the aches and uncomfortableness that still happens every once in awhile, so that’s something I wish I understood more, but also I guess you can’t really get someone to understand what you are going through until it happens. Right? 
IG: @sshields9779

Expanders replaced with softer implants, fat-graft
During the exchange surgery, expanders are replaced with softer implants. Fat grafting is common, when liposuction removes fat from areas of the body, and the surgeon transfers the fat to create a layer over the implants. This can prevent “rippling” or being able to see the variations in the implants surface under the skin.
Mastectomy front closure bra
Front closure bras are KEY