I’m going to preface this post by saying, I’m probably going to make you feel slightly uncomfortable.  If surgery talk or nipples make you uncomfortable, x out of this post and don’t continue reading.  But chances are, now you are totally curious as to what I’m possibly going to say.  And if you are married to me, gave birth to me or you are related to me… you are most definitely eye-rolling with your phone in hand about to send me a text saying “WTF were you thinking?”

I feel like this post is important for those of you that have asked questions about my surgery.  Technology and technique have changed a lot since you first heard about mastectomies.  Let’s talk nipples, cup sizes and implant texture!

So first order of business, wait, hold the phone, I get to keep my beloved nipples!  Never in a million years did I think I’d be posting this on any social media platform. But before I go deeper in context about my nipples, I want other women who are like me to know I am sensitive to all situations and decisions.  This post is to provide an explanation of how I came to the conclusion this surgery was the best surgery option for me.  My whole life I’ve been made fun of for having larger areolas so if they had to go… well that some major breast real estate gone. (Mom stop blushing, let it happen).

Let’s get down and dirty to discuss the specific surgery I have elected to have and what it was like to come to this decision. There are several techniques toward a mastectomy (to learn more click here).  All of the options were presented to me with their pros and cons.  In the end I am choosing to keep my nipples (click here to learn the specifics behind the nipple sparing technique).

First let’s talk about the cons! Why would keeping my own nipples be a con?  Well by leaving behind my original nipples I am leaving behind more original breast tissue.  The more breast tissue left behind, the more risk.  Not all breast tissue can be removed by having a mastectomy so my breast cancer risk will never be 0%.  My breast surgeon told me leaving behind my nipples is strictly for aesthetic purposes.  I will never have sensation in my nipples again.  I told her I’m not interested in keeping them around for sensation.  We had a candid dialogue about what my nipples mean to me and why/if it’s worth it.  I told her that if I was told my nipples absolutely had to go, I would deal with it.  But knowing I have the option of keeping them for a surgery I’m electing to have to reduce my risk… makes me want to keep them.  She said to reduce my risk the most, I could have nipple reconstruction and a tattooed areola.  I said “It sounds like you really feel like I should remove my nipples. If I were your sister what would you say to me?”

Let me tell you when I say you would have thought my breast surgeon and I were having this conversation over cocktails the way we were going back and forth while I’m vulnerably topless.  “Geez that’s tough because I’m a surgeon so I’m going to tell my sister all the reasons why more surgery is better.  But I can hear that you want to keep yours so if my sister really wanted to keep her nipples I would do what I could to save them.”  BAM YOU ARE HIRED.

I stopped her right there and said “First I want to thank you for being the first candid and honest doctor I’ve ever talked to.  I feel like you understand the entirety of what I’m experiencing.  I’ve done my research, I’ve thought a lot about this.  Removing my breast tissue and replacing it with an implant will never look like me again.  But everyone has nipples.  I mean… my nipples take up real estate on my skin…   It took me years to not feel upset over my scar post melanoma.  I would get out of the shower and cry.  I would hate wearing shorts.  I know everyone sees my leg and no one sees my nipples (aside from if I get really crazy and decide to take my top off).  It’s just that one on one time with myself.  When I get out of the shower and don’t see nipples, I don’t want to throw myself a daily pity party.  I know myself well enough to know my nipples matter more than I realized.  (long pause) I don’t know, nipples…well, they make my breasts look like breasts.  I don’t know if I could look in the mirror and feel confident in my decision.  I think I would have to permanently wear a bra.”

She heard me and said “I understand completely. By removing your nipples it does draw out this process for you, but it’s still something to think about.”

So for those of you that don’t know the breast surgeon and plastic surgeon work as a team.  The breast surgeon will remove my breast tissue and the plastic surgeon will begin the two step reconstruction process.  After the breast surgeon is done removing breast tissue, the plastic surgeon inserts chest expanders under the pectoral muscle.  During a typical breast augmentation you would have breast tissue to hold the implant, since I will no longer have breast tissue an expander needs to be put in place.  Drains will be placed to deal with post surgery fluid.  Word on the street is that if I’m really low key during recovery they should be out in a week to 10 days.  Each week I will have to make a trip to my plastic surgeon for him to add fluid to my chest expanders until the area is large enough for the desired implant size.

I’m not looking to come out of this looking like Pamela Anderson.  My goal is to come out of surgery with a matching set.  In order to get them to match I might become slightly larger than I am now.  Once the expanders are at the desired size I will have a second “exchange” surgery where the plastic surgeon will exchange the expanders for implants.

Choosing implants is a weird experience.  I went through images of women along with holding different textures trying to determine which foreign object will be placed in my body.  I can confidently say I would never elect to have a breast augmentation because I’m proud to be a card carrying member of the itty bitty titty committee.  There is nothing wrong with getting a breast augmentation, it just would not be for me.  Yet here I am, choosing my implants.  I have chosen to have a “gummy implant”.  They have the most “natural” looking result.  The only con is that I can’t tell if it has leaked unless I were to have an MRI.  So every 5 years I’ll need to check on my fun bags to see if they are still in tact.

Ladies and gentleman to conclude this boobilicious post, there was an 87% I’d be needing breast surgery in my lifetime.  But now surgery is booked according to my schedule and the outcome of the surgery is the best I could ever hope for.  The scarring is right where the breast naturally folds.  No one will know I’ve had a mastectomy… unless of course they know me, are my Facebook friend or came across my lovely blog.  Pepperoni pizza anyone? I’m buying.