The Dream Team Part 2- Dr. Jaco Festekjian

The other half of the mastectomy/ reconstruction dream team (or the bad cop/ good cop duo as I like to call them) is my plastic surgeon, Dr. Festekjian. Let me just say now that the man is a genius and does some pretty incredible work. I honestly couldn't have asked for a better plastic surgeon. He has quite a bit of experience with preventative cases like mine and has worked with quite a few patients who are on the younger side. Again, it's like I got a custom-made surgeon. You can learn a little more about him here.

The Process of Reconstruction

During my first appointment, Dr. Festekjian explained that there were basically two options for reconstruction. The first option  is to insert expanders under my chest muscle and gradually fill them up with saline to fill up the envelope left behind by the breast tissue. This would require regular visits to the office to have more saline injected in until I reach an appropriate size and they will be switched out 2.5-3 months after that for permanent saline or silicone implants. Unfortunately permanent doesn't exactly mean forever. These "permanent" implants need to be changed out every 10-15 years with a relatively minor outpatient surgery. If a nipple-sparing mastectomy is chosen (which it was), reconstruction ends here. If the nipple is sacrificed, some pretty nifty tattoos can be used to reconstruct the nipple and areola once the permanent  implants are put in.

 The other option is to use excess fat around the abdomen to reconstruct the breasts. I've read that this option feels more natural than the expanders and you can potentially come out of the mastectomy completely reconstructed (assuming you elect immediate reconstruction). All veins and things like that are sewn together once the tissue is in its new home and the breasts will grow/shrink accordingly with gains or losses of weight. Nothing has to be replaced either. I think the process of reconstructing the nipple is the same as with the expanders, but don't quote me on that one. The only downside to this option is that it does mean a longer surgery and another scar which means a slightly harder recovery (but you basically get a tummy-tuck out of it, which I guess is the silver-lining). This option is also not available to everyone. The surgeons have to asses age, size, and other variables to determine who would be a good candidate.

 One look at me and both Dr. Karam ad Dr. Festekjian were convinced that the second option wouldn't be available to me (apparently the freshman 15 didn't go as far as I'd thought), so expanders it is!

 

This is basically what the expanders look like. Note the little pump-like thing through which the saline is injected. Don't worry, this is all inside after surgery.


This is basically what the second option looks like