Too many damn choices

Who knew picking out breasts could be so damn stressful? And I thought making my appointments for mammograms, MRIs and ultrasounds was a pain in the behinds. It doesn’t even compare to scheduling consultations with breast and plastic surgeons. I thought I was pretty educated on this whole thing but I only skimmed the subject matter.

I am still really leaning towards the surgery in Chicago but Chad is really against it. I came home from class last night (did I mention I am getting my MBA part time?) and Chad and I opened a bottle of Nickel and Nickel, sat on the couch in the living room and had a real heart-to-heart.

His two sense: a guys point of view

He told me point blank, I can have whatever surgery I want: whatever size I want; shape, filling (ie gummy bear, silicone or saline). What he is most worried about is what happens in this 8-hour surgery and the 2-4 week recovery period. He doesn’t know how to prepare and what type of help he will need to call in. He will be very embarrassed that I am sharing this with the world (and maybe we will blame it on the wine) but he totally teared up when talking about this whole recovery period and the thought of a long surgery where anything could happen. Again, I am so lucky to have someone who is there for me… and thinking about these things with me. For the women out there that have to do some of these things alone, I don’t know how you do it. You are much braver than I am.

My two sense:

It does amaze me how ready I am to get this surgery over and done with. I am at a far different place than I was ever several months ago. The 3-4-hour surgery doesn’t phase me. What worries me is the MULTIPLE phases of surgery is something goes wrong or if I chose to go the expander route.

So just to go back a bit, I am leaning toward the direct-to-implant also known as the one-step surgery. This is the surgery in Chicago. I am learning that some of the physicians in DC will do this surgery but they suggest not doing it and have much less experience in it. Their reasoning is because of the following:

  1. risker
  2. the nipple can die
  3. greater chance for infection
  4. greater chances that you have to go back for a second surgery (redo)

The benefits of the surgery:

  1. ONE surgery
  2. Recovery time
  3. Immediate reconstruction with actual breasts

For the expander surgery (which is your typical implant surgery) the negatives are:

  1. MUCH longer recovery time (3 months)
  2. 3 months of not being able to sleep on your stomach
  3. won’t have your physical breast for 3 months; have harder alternatives

The benefits are:

  1. Less margin for error/redos
  2. Less opportunity for infections

My hair is about to fall out over all of this:

So I feel like Chad is about to kill me with all these appointments but July and August are filled with appointments with both breast and plastic surgeons. My thoughts are, if I am not in LOVE with anyone here, we will be off to Chicago since I have already met with the Dr. there and know his work is fabulous.

I am hoping a lot of my emotions and questions will be answered at the FORCE conference next week in Orlando Florida. I was fortunate enough to go last year with my aunt and it was such an amazing experience that I asked my husband to attend with me this year. One of the plastic surgeons that I have scheduled a consultation with is actually going to be presenting there and this will give both Chad and I an opportunity to see the latest and greatest in both research and surgery techniques that are available for women like myself. I was also extremely honored to be asked to co-facilitate a session for young women at risk and Sue Friedman, the founder and executive director of FORCE, has asked me to monitor two sessions as well (This means that I basically introduce the speaker but what an honor!)

Also, because of this blog, I have been able to recently connect with other BRCA+ women that will also be attending the conference next week and am so looking forward to meeting them! I had no idea what to expect from writing and am thrilled to have the opportunity to meet other women who are finding themselves in some of these same damn predicaments and to be able to discuss their thought processes on the choices we have to make going forward.



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6 responses to “Too many damn choices

  1. Are you considering tissue transfer? Because, if not, your surgery will be way less than 8 hours. I was done in under four. My husband had similar fears– I’m sure he and Chad can compare notes at the conference. We’re looking forward to meeting you!

    • Sarah Hartley

      Allison, I had the saline one with expander and ws noit laid up for 3 months. However, I did eventually have to go back and get the permanent one put in. The one-step sounds so nice! How likely is it that the nipple would die?

      By the way, permanent does not mean a whole lifetime. They told me it is like tires on a car and they need to be replaces after so many years. You are so well informed that you probably already know this.

      Anyway, I can come and help you a few days and would love to do so. XO

      • Hey Sarah, yes, the expanders from what I hear are just so uncomfortable and can be very painful. Also they don’t look the same so for meeting clients and such I won’t be able to wear the same clothes so just weighing the options I guess…

  2. Sue

    Do the one-step. You (and your husband) will be so happy. The recovery is 6 weeks, and I mean that in 6 weeks I was back to a full time job AND the gym 5 nights a week. It was amazing because I remember at 3 weeks telling my niece that there was NO WAY I could even imagine going back to work AND going to the gym all in the same day!! I had a wonderful BS (from a Breast Center where that is ALL he does) and he referred me to my PS. I thought as you did that I was pretty up on everything and I have only come to find out after my surgery that finding someone to do a one-step surgery is quite rare. I was truely blessed and most of all lucky (I call it dumb luck) that I surounded myself with a greast BS & PS. My research was how I found my BS. I could not and would not do surviellence for the rest of my life. Worth a trip to Dayton, OH if you are interested. I have had to have NO revisions–they are perfectly even and I have NO complaints.

  3. Hey,
    I had the one-step, and although I have to go back for revision I am still happy I went this route. I was able to return to work at 5 weeks, and the gym at 6 weeks. I feel like my old self again! I did the one-step because I couldn’t afford taking a longer amount of time off work. When I go back in for revision I have to be off work for 2 weeks, due to that fact that I am a bartender and use my upper body. If I had a desk job he said if my surgery was a Wed. I’d be back to work on Monday. My surgery was also only 2hrs. 🙂
    Good luck with meeting all the doctors, I hope you find what you are looking for! Wish I could go to the conference 😦

  4. hey,
    here is my 2 cents. and btw…megan above had her surgery 1 day before me. we’ve been tracking together and corresponding before and leading up to our surgeries and still keep in touch. FORCE was amazing by providing the opportunity for us to connect.

    my gut instinct tells me to tell you to do the surgery in Chicago. your outcome/results are going to be for the rest of your life, and if your insurance covers it i think you should jump on it. the inconvenience of it will mean nothing once you are on the other side of the surgery and recovered with hopefully spectacular results.

    as for your Chad…have you been able to direct him to the men’s section of the FORCE forum. there is one. i don’t know how helpful it is because i have not visited it but i know it exists.

    and for a different perspective than megan’s blog (she had one step with implants)…if you visit my blog, i have documented my journey too…with graphic photos of my nipple sparing pbm with tissue expanders. i am still currently undergoing reconstruction/expansion.

    i also had some complications which you can read about but they seem like minor blips at this point…and i am only 10 weeks out.

    go with your gut instinct,
    and good luck!

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