Surgery Wrap Up

The view from the exam table at my plastic surgeon's office
At the plastic surgeon’s office. Yep, that’s an implant on the sink. Because you know you want to touch it.

One week after surgery I headed back in for my post-op appointment. The one week appointment isn’t too eventful.  I won’t go through my whole outfit, but you need to be sure to dig out those good panties again.  Bonus points if you have two good pair, just in case the doctor remembers that you were wearing that same pair before.  And don’t forget, if you’re wearing spanx for compression, you need to toss those panties in your bag because you’ll have to ditch the spanx when you put on the paper gown so that the doc can check the liposuction incisions, and I’m betting that you’d rather not stand open-gowned to be examined– and have a full conversation– commando. (Which reminds me, I need to dig those panties back out of my purse so I don’t accidentally fling them out when I’m pulling out my wallet at Target…)

OK, now that we have the panties situation out of the way, on to the appointment.  My surgeon was pleased with the results so far.  The places he put the fat look much better.  He was very optimistic, though cautiously– but that’s just his character.  He’s a very conservative doctor, but he gets great results. He warned me that we can’t really judge until all the swelling goes down.  The six week appointment (the camera comes back out for that one, so all the panties and grooming talk applies again) will give us a very good idea, but he reserves all judgment for the three month follow up.  By that time, all the swelling and bruising should be completely gone.

And now for the big news: I still had good fat in my flanks! He was so sure that I wouldn’t, he made incisions in my abdomen and prepped it for liposuction before he started suctioning my legs. As it turns out, though, I’ve got some quality fat in my thighs. I’m so proud. He decided not to take any fat from my abdomen after all. Because he thought we should save it. In case I need it later. I wonder if anyone else has ever decided that they should save their fat for later?  I think he thought I’d be disappointed. But after three or four days above ninety degrees, my only thought was to ask whether I could ditch the super high waisted spanx. The prep work could leave me with some abdominal swelling, so he said I should stick it out for another week, but I’m thrilled to be able to switch to the low waist girdle in a few days. Plus, I got to keep my belly fat in case I need it later.  A win-win, right?

Post Surgery Update


A friend texted me yesterday to admit to facebook stalking me to find out how I was doing.  Perhaps she wasn’t the only curious one…

I’m doing fine. This morning, I woke up feeling much less sore, so I think I’ll be going without pain pills today.  Wednesday and Thursday, I was definitely pretty sore, but still functional.  My plan had been to avoid percocet since it makes me itchy, but I was apprehensive about taking Vicodin, as at least I knew percocet wouldn’t make me nauseated.  The good news: Vicodin didn’t make me itchy or nauseated.  The bad: it didn’t help with my pain.  So yesterday I switched to percocet, and thankfully the itching wasn’t as bad as before, though that stuff totally throws me into a haze.  Glad to be going med-free today!

I’m also about to take my first shower in an embarrassingly long time. (Though it was doctor mandated, I’m not just gross!) I’m looking forward to that special first shower clean, and to ditching the foam pads that are adding an extra layer on my thighs.  The big question is whether I’ll be able to get all the little purple “x” marks off my chest so that I can wear a regular shirt.

I’ve enjoyed my two days as a patient, spending most of the school day in bed, either resting, on the computer, or watching bad tv. But my days of leisure are over– it’s a good thing I don’t think I need those meds anymore, because today I’m headed to school to learn all about colonial life from the fourth graders.  A little time to relax is nice, but two days is probably all I can hope for at the end of the school year.  So I guess I’d better go hop in the shower.

And for the record, for those who are following my car saga, I do not get a new car.  But the dealer is honoring the just expired warranty and rebuilding the transmission.  I’m supposed to get it back by Monday.  I suppose a week when I’m all drugged up is as good a time as any to be without a car.

What to Wear | Post-Surgery

photo 2 - Copy (2)

I hadn’t planned to do another what to wear post, but after chatting at the bus stop, I decided to take another picture in my dirty mirror.  We were discussing all the compression garments I was wearing– yes, I was complaining.  Again. There are foam pads a quarter inch thick on the outside of each thigh, another one on my stomach.  I’ve got on a lovely, lace trimmed compression bra, a super tight abdominal binder, and of course, the girdle that goes down nearly to my knees.  I decided to share the outfit when one friend mentioned she had no idea all the “business” I had going on underneath. Oh yes, there’s a lot of business going on up under there.  A dark skirt that’s not too clingy hides the girdle and foam pads on my thighs, and the high collar and boxy shape of the tee hide the compression bra and at least most of the bulkiness of the shoulder strap flaps.

The abdominal binder means that he did end up using my belly fat for the fat grafting.  But he was a good sport, so tried my flank first, since it was my first choice.  Which means that I have double the compression, double the pain.  But maybe half the fat?  Let’s go with that.

What to Wear | Surgery Day

what to wear surgery

Today’s the big day– hopefully the last surgery day.  And you know me– what I’m wearing is deliberate and planned out.  Of course, I need the maxi skirt for the compression gear that comes later.  This hoodie has become a surgery staple for me.  When you’re having breast surgery, you aren’t allowed to raise your arms over your head, so something that buttons or zips up is a necessity.  This one is great because it’s light weight and loose fitting. Flip flops are easy, and the glasses (ugh) are a must.  I think I need some new glasses.

surgery bag

I’ve got my bag all packed too.  Less is more.  I might add a book or single magazine, or maybe my little computer.  But really, there are so many people coming and going, asking your birth date and why you are having surgery in your own words.  (Maybe I’ll have to be creative on that one!)  But there isn’t a lot of free time, so you don’t need a lot to fill it.  But with surgery at 2pm and no food after midnight, I’m already starving, so I hit up the Rite Aid this morning so that I had a couple of favorite treats waiting for me as soon as I get the green light.  (Will update on my facebook page this evening.)

Pre-Op Checklist and a Physician Mandated Trip to Nordstrom

pre op tubesThis week I needed to head back to the hospital for another round of pre-op questions and tests.  I decided to combine the stop at the pharmacy (to drop off the heavy antibiotics and narcotics scripts for post-surgery) and the trip to the hospital with my morning run.  The whole trip would only be 3-4 miles, but I failed to realize that the first mile and a half was almost completely uphill.  I think I’ve been spending too much time on the nice flat parts of the trail– I’ve forgotten what a workout those hills can be!

Between the hills and the fact that it is June, I was pretty sweaty by the time I got to the hospital.  Everyone kept offering the empty chair next to them, but I was too sweaty to sit in a chair! So I hung out with my Spotify tunes and water bottle on the floor. The woman who pre-registered me for surgery has pre-registered me at least once or twice before. It’s always a little strange when someone at such a huge place recognizes me. And the woman doing the blood draw was also a familiar face.  Next time (though let’s hope there’s not a next time!) I’m going to have to remember to ask her not to use the tape that they put on after the blood draw, a band aid would be fine.  It left a much bigger mark than the needle!

I also had the requisite 30 minute nurse phone interview where I had to recount my entire medical history. I can’t imagine what that phone call must be like for someone who’s older and has lots of meds and decades of surgeries to recall.  Mostly, after I went through my surgeries list, I just said “no” a lot. I’m apparently as healthy as a horse. Except for that pesky cancer.

So surgery’s coming up next week.  I’m hopeful for an easy recovery.  I’m not supposed to run for six weeks, but I did get my surgeon to concede that I could ride a bike, so I’ll have to do that.  I don’t have to wear a compression bra, but I wasn’t in love with the compression gear he suggested if he does lipo on my tummy. This would be a good time to point out that it never hurts to ask if you have a question. While the high waist girdle with suspenders (so wretched for July!) was the best option from the company whose brochures they have in the office, a quick chat with Cami let me know that a pair of high waisted spanx from Nordstrom would provide just as much compression without the waistband issue that they’d had with the non-suspsender girdle.  And since the Spanx don’t have zippers down the side, they can go in my regular Spanx rotation. Win-win.  One more trip to Nordstrom, a few last runs, and I’ll be ready to head back to the familiar confines of outpatient surgery.

What to Wear to the Plastic Surgeon | Fat Grafting and Liposuction Edition

wntw plastic surg

Today as I was getting ready to head to the plastic surgeon’s office for my pre-op appointment, I went, yet again, through the long process of deciding what to wear.  It was hot, a perfect day to wear a dress.  Only, once you have breast cancer, every doctor wants you to undress from the waist up before you don a paper gown.  So no dress or you end up wearing nothing under that lovely paper gown.  So jeans maybe.  Only, no jeans that are too low rise, remember you’re sitting on a table sans shirt, and well, you know.   Also no jeans that are too tight at the waist. Nobody wants to show off a muffin top. But after choosing just the right jeans/short/skirt, you’re not done. If it’s a visit involving liposuction (which mine was– for the fat grafting) you need to wear the good panties.  You’ll have to be able to drop trou to show off your “donor sites.” Which means you get to show off the parts of your body that you think are the fattest. Awesome. Tummy as a donor site means just unzipping, but if you’re considering the flank (yep, that made me feel a bit like livestock) you have to shimmy down those shorts all the way to show off your outer thighs.  Which is a good time to point out that you should consider doing all your <ahem> grooming before this appointment.   Not only is this important for the part in the office with the surgeon, but also the part later where pictures are taken.  No paper gown, pants around your ankles, and someone takes pictures of you in your panties (I told you to wear the good ones!), zooming in on your breasts and your fat parts. I mean, donor sites.  So when I said you need to be comfortable with your plastic surgeon and the staff, I really wasn’t kidding.

The good news from my appointment today is that my surgeon said that I don’t have to wear the compression bra after the surgery. That’s huge.  His real concern is that donor site, which, let’s face it, could use some compressing anyway.  So I’ll have four to six weeks in that compression gear. The not so good news– while he said that there is “ample volume” (thanks) to use the flank as a donor site, the fat might not be quality fat.  Apparently, all fat is not created equal, and since he already did liposuction in that area, it might have compromised the quality of the fat for future use. So we chose my abdomen as a back up donor site. I’m not thrilled with that prospect because it means wearing the high waist girdle, which will be pretty hot in the summer months.  You know you’ve reached some sort of low when you’re hoping to just wear the low waist girdle for six weeks.  So fingers crossed that my flank has some good, quality fat. At least I only have to wait a couple more weeks until I know whether my fat is quality fat.  And until I can begin the countdown to the “this is really the last time I wear compression gear” day.



I felt so poetic last week, talking about how Vinnie’s tattoos were the “The End” to my cancer story. Of course, we all know there are only really two things that come after the words “The End,” an epilogue and a sequel. Luckily, we’re not here to discuss Cancer: Part 2. But I was hoping not to have an epilogue to write. Certainly not a week later.

I have been faithfully wearing my silicone scar sheets since January, when I also had steroid injections to help flatten out my slightly bumpy scars.  Of course, before the injection, we discussed the risks, among them: bruising, skin atrophy, fat atrophy. My doctor said these were rare, and he uses the lowest dose available, which he then dilutes again, to reduce any risks.  I had some bruising and as it faded, the scars have completely flattened and smoothed out, but the skin has retained a pink hue in the area. Wearing the scar sheets except when I’m in the shower, I haven’t spent a lot of time worried about the redness because I never really see it.  But I ditched the scar sheets for my trip to Vinnie’s, and he commented (several times) how thin the skin was in that area. It wasn’t where he was going to tattoo, so it didn’t change my plans that day, but his concern gave me something new to obsess over. Just what I need.

I managed to keep my emotions in check for a day or so, but by the end of the second afternoon, I was somehow convinced that my skin was going to burst apart it was so thin, and then after my implant popped out and landed in the floor, I’d need a skin graft to hold it back in. (Yep, a little dramatic. Cancer has trained my brain to eschew the logical and jump right off the deep end. Stupid cancer.) Luckily I was able to get in to see my surgeon the next morning, and he confirmed that the skin was definitely thinner than he’d like, but I was in no danger of losing an implant if I wasn’t wearing a sports bra to keep it from falling out.  While I was dreading the idea of a skin graft (which I’d completely made up in my head, that probably isn’t even close to an option), I was secretly hoping there was some sort of collagen cream or something (also completely made up) that I could slather on once a day to fix everything.  My surgeon’s suggestion was somewhere in the middle.  More fat grafting. At which point my brain sort of turned off. More liposuction from one site, then injecting the fat under the thin skin near my scar. It won’t grow back any skin, but it would support the skin and make it less susceptible to trauma and leave me with a better cosmetic result. Oh, and that probably won’t take care of the redness.  So then he’ll send me to someone to laser it.

Good grief. I was done two days ago. I. Was. Done. I could not comprehend the idea of more surgery. More compression gear.  More restrictions on my activity. I’m sure it wasn’t a crazy reaction. But I told him I couldn’t make the decision that day. I wanted to be done. He agreed, there was no need to rush, we could watch it indefinitely, and make any decisions later. I knew in my heart that I’d likely agree to it, but that day, I just could not.

I gave myself some time to consider my options, and really, I needed to come to grips with the fact that I needed, no, I wanted, more surgery. Yes, I want to be done. But I want to to finish well. And so I called the office and asked to schedule the surgery sooner rather than later. I’m still waiting on the final date, but am hoping to do it within the next couple of weeks. It will be outpatient surgery, and I’ll be in compression gear (super glam spanx-y bike shorts and the wretched ugly compression bra) for probably four to six weeks. I’m hoping not, but betting it will mean more pain meds and more time on the couch than on the trails.

I remember pre-cancer, thinking how great it was that now women can have a mastectomy and reconstruction at the same time. How cute and naive of me. I knew a lot about breast cancer, but didn’t realize that even in the simplest scenario, there are two surgeries and several procedures involved. Many women who opt for a lumpectomy have multiple surgeries to make sure that they’ve gotten all the cancer, only to end up with a mastectomy, either out of medical necessity or for their own peace of mind.  I didn’t mean for this post to be a downer, but I guess this is just a glimpse of the fact, that even under the best circumstances, breast cancer isn’t easy. I’ll be fine physically, and that’s the most important. And though it will take longer, I’ll get over the fact that I have to go through another round of surgery and restrictions.  Because while I’m not thrilled to be writing an epilogue, I’m really glad I’m not writing a sequel.

A Road Trip to Little Vinnie’s | Nipple and Areola Tattooing with Vinnie Myers


OK, guys, just so you know, we’re talking nipples today. No graphic images, but if it’s too much information for you, then tune back in later this week.

I’ve talked about my surgery before, but I’ve mostly talked around the details– like they were somehow too private to put in such a public forum. Yet, I’d tell anyone who asked, and it’s not like you can’t figure out the details with a little googling if you really want to know. So I’ve decided to let it all hang out, as it were.  Like most women facing breast cancer, I had several options when it came to surgery, but I definitely went the more aggressive route. I figured if I was going to survive this and live another forty or fifty years, I didn’t want the anxiety of dreading the annual mammogram. I just wanted to be done with it, once and for all.  Given my age and the aggressive nature of triple negative breast cancer, while my surgeon assured me it wasn’t necessary, she also agreed that a mastectomy wasn’t an overreaction. I chose to have a bilateral simple mastectomy. I now have scars across each breast (strategically placed to be hidden by even a pretty skimpy bikini top) and all of the breast tissue, most of the fat, and even my nipples and areolas were removed. I wasn’t the best candidate for nipple sparing surgery, and it didn’t sound like a great option to me, anyway, so I decided to go the “simple” route and get rid of it all. After my skin was stretched out to accommodate what was lost to surgery, silicone implants were placed under the muscles of my chest wall.

My plastic surgeon is awesome and did a great job, but the obvious downside is that I was left with nipple-less breasts. I have to admit that I’m pretty happy with how I look when I’m dressed– I can totally rock strapless dresses, halter tops, and even a sports bra like nobody’s business!  But it’s pretty hard to think of your shape as “normal” when you step out of the shower if you’re just staring at nipple-less mounds of flesh.

I realize that any story that’s mostly about nipples hardly needs a good hook. But I’ve got one anyway. So, there’s this guy in Maryland named Vinnie, and he has a tattoo shop… (One hundred percent all true.) Plastic surgeons can do a few procedures and even some basic tattooing to replicate the idea of a nipple, but a nurse at Johns Hopkins thought that perhaps a bona fide tattoo artist would bring a little more artistry to the table. She asked Vinnie Myers if he could essentially tattoo a picture of a nipple on her reconstructed breast.  Years later, Vinnie has given up traditional tattooing and has become THE go-to guy for nipple and areola tattooing worldwide. He sees seven to ten women a day, and over three quarters of his clients fly in from across the country and around the world. (Expect to wait up to six months for an appointment!) I feel so fortunate that he’s virtually in my backyard, and I was able to score an appointment right away because I could fill the spot of a cancellation. I managed to get there, tattooed, and back before my kids got off the school bus. That’s a good day.



So for the details:

  • Yes, it hurts. But because of the nature of a mastectomy, most of the nerve endings in that area are pretty messed up, so it’s not nearly as painful as a traditional tattoo.  It hurt some while he was doing it, but any soreness wore off quickly.  After just 24 hours, what can only be described as discomfort is barely noticeable. (If you take a friend along, she’ll likely be in more pain watching than you are!)
  • It was quick. Including the before and after pictures and the prep and post-procedure instructions, I was in the office for an hour. The tattooing took maybe half that.vinnie-116
  • It’s in a real tattoo shop, complete with a motorcycle out front and a neon “TATTOO” light in the window. But the office where Vinnie does nipple and areola tattoos is private and reflects his love of art and travel. It is clean and feels hygienic without the sterility of a medical facility, something most breast cancer patients are so over by the time they get to this step. Vinnie is professional and friendly, and his wife is the one who takes the pictures and does all of the care instructions at the end.



  • You have to pay out of pocket. Insurance is supposed to cover it, and they give you a form with the appropriate codes to be reimbursed. I’ll still have to submit it to my insurance company, and I expect I may have to do more follow up than with something done in a medical office, but it should be covered like all my other reconstructive procedures.
  • Eat before you go.  We made the mistake of thinking that we’d eat once we got to town and made sure that we had time. But it turns out that Finksburg is a pretty teeny town, and since we weren’t tempted to eat at the gas station/Subway, we ended up eating from one of the only other places we could find.  Also a gas station. It’s a good thing Sally and I are so much alike, not everyone will consider a lunch of cheetos, pringles, and twizzlers as acceptable. So if that doesn’t meet your standards, you might want to stop at the Chick-fil-A on the way.                 vinnie-102
  • And yes, it looks real. Even though I’ve looked at more pictures on his website than I care to admit (WAIT– don’t click that link if your kids are reading over your shoulder!), I was surprised by how real the tattoos looked in person. Unless you knew they were tattoos, you’d never even imagine that they weren’t real. And even knowing, I bet you’d still be shocked. While plastic surgeons use only a few pigments, Vinnie uses as many as necessary to give a full, three-dimensional, tromp l’oeil effect.  And since he uses standard tattoo grade pigments (different from those most plastic surgeons use), his tattoos won’t fade over time.



It was a good experience.  It’s amazing how a procedure that takes a half an hour can make such a big difference.  After my final surgery, I struggled with whether I thought my breasts looked normal. I’ve come to really hate that word– what is “normal” anyway? But I did struggle. Being the last surgery, it felt so final, and I worried that I wouldn’t be happy with how I looked. Over the months since then, I have grown accustomed to how I look and am fine with it.  But remarkably, with the tattoos, the reconstructed breasts that once gave me pause instantly looked like, well, real breasts. A trip to Little Vinnie’s Tattoo Shop definitely lends a sense of closure to the whole breast cancer thing, as one friend calls it.  Of course, I don’t ever expect the thought of breast cancer to be too far from my mind. But it’s as if with every stroke of his humming tattoo machine, Vinnie was writing the final words in my cancer story. They definitely look like nipples. But it felt like he was writing “The End” across my chest.


Thanks as always to Sally Brewer for these poignant images.  These images are copyright protected and are not for sale.

Scars, scars, go away | Scar Management after Breast Surgery

scar sheets


Obviously, with surgery comes scars.  I’m pretty lucky and heal really well– the part of my scars that have remained untouched since March have faded. They’re not invisible, but they’re hardly noticeable.  The scars from my swap out last fall are another story. Granted, they are newer. But I think the fact that they’re on top of the old scars (he used the outer portion of the old scars to swap in the implants– didn’t need to use the entire scar) might be making the healing a little tougher.  When I went in for a check up last month, I asked about it– they were just pinker and not quite as smooth.  Again, I know it’s not a matter of life or death.  But I love how sensitive my surgeon is to what I need, what I want.  I’m sure there are women who wouldn’t care if their scars were pink and noticeable.  He might suggest options for improvement, but I’m sure that many women would just want to be done with doctor’s visits, interventions, reminders of their cancer.  And that is perfectly fine.

Me on the other hand? I’m looking at the big picture, the long game.  I want to take the time now to do things right so that I’m not unhappy for years and years to come.  Thankfully, reconstruction is done by a cosmetic surgeon who knows not just how to do surgery, but how to make sure it looks pretty when everything is done.  He suggested I use these silicone sheets for six months (will this ever be over??) and it should help the scars fade and flatten.They’re pretty easy to wear, they just stick on top of the scar and don’t go anywhere.  I currently have two pair in rotation. When I get into the shower, I take off one set and put them on the outside of the (included) case. When I get out, I dry off and put on the clean pair from the inside of the case. Then I take a minute or two and wash off the other pair with warm water and a little soap.  I stick them on the inside of the case, use a clean towel to absorb most of the moisture, and let them dry before snapping the case shut.  They don’t bother me at all– I don’t even know they’re there.

But the real question: do they work? Well, the scientist in me knows never to introduce two new variables at the same time, you’ll never know which one is causing your reaction.  But the “just want to get on with things” part of me decided I’d rather be done with everything faster than know exactly how effective these scar sheets are.

The second suggestion my surgeon made was steroids. Ahh, the wonder drug. They gave me boundless energy and kept the nausea at bay when I was on chemo.  Apparently when injected directly into a scar, they also help it fade and shrink faster.  So in addition to the scar sheets, I’ve had my first of two rounds of steroids (mixed with a little lidocaine) injected just under the skin into my scar. I know it sounds awful, but I only barely felt it on one side, not at all (and I’m not even kidding) on the other.  There was a little bruising, but the scars really do look a lot better. I’m sure the biggest part of the improvement I can see is due to the steroids, but the silicone scar sheets really aren’t a problem, so I guess I’ll be wearing them for the next five months or so.  Every little bit, right?

This Will Be the Year | Nike Women’s Half Marathon


Last fall, as I sat in the initial consults with my doctors, I imagine they were surprised by my questions. I wonder if they thought I was in denial as to what I was about to go through. In fact, maybe I was in denial. I remember asking my oncologist if she thought I would be able to run a 5K with Emma Clare days after my second chemo infusion. I didn’t ask whether my hair would fall out, how severe the nausea might be, or whether my immune system would be so compromised that I shouldn’t go to the kids’ school on occasion or to church every Sunday. I wanted to know if I could run. Emma Clare and I had planned to run that race, and it was (frankly, probably inappropriately) important to me that I run it. Breast cancer was not about to take that experience from me.

Earlier that fall, Nike had teased the announcement of their inaugural half marathon in Washington, DC. Sally and I had decided we would enter the lottery to run that race in the spring. Having met the authors over the summer, I had my autographed copy of  Train Like A Mother already dog-eared to a training program and was looking forward to the race. In my initial consult with my surgical oncologist in October, I was already asking whether the prospective surgery dates would allow me to be recovered in time to run the half marathon. And I remember standing outside Ray’s Hell Burger, while my parents and brother ate inside with Sally, talking on the phone to Cami from my plastic surgeon’s office. I listened to her lovely French accent as she informed me that I would not be ready for a spring half marathon.

I’ve been having a hard time getting my mojo back when it comes to running, I’ve gotten a little too used to sleeping until 7! But perhaps making the cut for this year’s Nike Half Marathon is just what I need. I am now officially registered to run the race.  Breast cancer took away my 2013 half marathon goal, but this is my year to make sure that breast cancer doesn’t steal that goal completely. Perhaps I need to look at this race the same way I looked at last year’s Girls On The Run race. I planned to run this race, and I will run it.  Breast cancer may have delayed my plan, but it can not take this experience from me.

And so I’d better finish this post and get to bed. I’m going to need to get up early tomorrow. I’ve got some running to do.