I'm back from meeting the plastic surgeon. I'm not sure how I feel about it just yet.
Let's start with her office. While it was clean and tidy it absolutely reeked of cigarette smoke. Overwhelmingly so. If I didn't know better I'd say someone was smoking in the office itself.
When we got into her office she asked me the standard questions about my cancer, my treatment, my previous surgeries, my age, weight etc.
She then examined my scar. The one good thing she said was that the surgeon who did my mastectomy did a great job, she left a nice scar and lots of tissue to work with.
Now the shitty part.
Here's my options.
Implants. She can put a tissue expander in, fill it with saline to expand the tissue and when that's done she can put an implant in.
Why this isn't a good option for me: I've had radiation. She noted that I didn't seem to have a lot of skin changes with the radiation (some people do?) but that this affects the tissue underneath. There would be a 60% chance of me developing a certain kind of scar tissue, hardening if you will, that would turn my breast into a hard, melon like mound (it gives a whole new meaning to calling your boobs melons) It's not dangerous or anything, more of a "wow you've got rock hard tits" kind of thing.
Taking a flap of muscle and tissue from my stomach or back and moving it up/over to create a new breast.
Why this isn't a good option for me: The recovery for this is about 6 months. It's not aesthetically pleasing - the scar on both the stomach and back is substantial. And again, because I had radiation she's not sure of the quality of tissue she has to work with.
The last choice is the most appealing option. She can put a tissue expander in to expand the tissue and then graft fat from other parts of my body to put into it.
Why I won't be getting this one: OHIP doesn't cover it. You see, part of this procedure requires liposuction. Liposuction is cosmetic surgery. Cosmetic surgery is not covered by OHIP. Ever.
Having said that, she did say she was petitioning to have that particular surgery included. She encouraged me to call and do the same - unless I want to travel to Miami and pay out of pocket for this surgery to be done. HA, fat chance!
Anyhow, I came out of my appointment feeling shitty. I went in with the hopes of having an answer - a plan, and idea of how I was going to proceed in order to get my new boob.
But all I'm left with is more questions.
So, I think I'm going to explore three options.
I'm going to ask my radiation oncologist for a referral to a plastic surgeon at the hospital out here, just to see what a second opinion give me.
I'm going to talk with my family doctor about how I go about petitioning for this surgery (the fat grafting) to be covered.
I'm going to seriously consider the implants. Of all the shitty choices this seems the least shitty. She did say that if the scar tissue were to develop that I could just leave it as is or I could remove the implant and do the grafting (though I'd have to pay out of pocket for the grafting)
The second option is not an option as far as either of us are concerned. I'm not willing to commit to a 6 month recovery and be left with a nasty scar on my stomach or back. And the surgeon herself said she didn't like that option for surgery at all. Oh, and I'd have to loose more weight for that surgery to be an option anyway and well, we know how that's going.
So, I went in feeling enthusiastic and I've come out feeling pretty low.
A lot to think about.