sex and the city | OldDogNewTits

My fifth (and potentially last first round) appointment was Thursday morning. My friend, Melissa, had recommended the doctor and came along for the ride. And I want to point out immediately that this place as well as this experience was different from the others.

What better month to bring up this topic.

My friend, Melissa, has been battling breast cancer now for the last few years. And she’s been beating the hell out of it I might add. You know how when you’re watching some Sex and the City, Desperate Housewivesy-type show and one of the characters has cancer, but they manage to deal with it with levity and an amazing sense of calm and grace, you think to yourself ‘This woman does not exist. If it were me, I would not be able to face people every day and talk about it, let alone joke about it.’

Well, I’m here to tell you that this woman does exist and her name is Melissa.

I won’t delve too much into her personal story but, suffice it to say, she was given the sobering news twice. For the first occurrence three years ago, she opted to have a lumpectomy. After this procedure, she (like all patients) was carefully monitored for any signs of recurrence. Which is how they caught the second occurrence about a year and a half later. This time, she (like many women) opted for a much more aggressive treatment. This time, she would take on a double mastectomy so that she could live worry-free of this disease. For good.

So, the two of us spent the afternoon at the very specialized facility where she had her procedures done. And, as I mentioned above, it was a very different experience from my prior appointments. Rather than a small, private waiting room filled with others seeking cosmetic improvements of various natures, this office (really a small hospital) had a large, beautiful waiting area … a two-story, glass-ceilinged atrium that actually looked and felt more like a spa than a clinical space. There were no TVs or other distractions but rather just a setting to promote peace and comfort to all who entered. The center even offered a little refreshment area for its visitors. And on the table in front of me … where there were typically albums of before and after work … was a similar pink scrapbooking album filled not with breast photos but rather with heartwarming letters, family pictures and other amazing testimonials from women whose lives had been changed as a result of the services and treatment they received from the medical staff here.

Honestly, it was very humbling.

We were taken to a private examination room almost immediately, which is where I actually completed all of my paperwork. Melissa and I caught up a little bit while we waited and she confessed that she wore a boob-showcasing outfit to this appointment … in my honor, of course. (Coincidentally, this is the second time this week that a woman has selected her wardrobe based on its boob presentation for me. Is that weird?)

And, after waiting a little while, the doctor came in. Friendly right from the start. He gets points for that. Feeling a bit small for seeking cosmetic augmentation in a place that is largely medically restorative in nature, I nervously explained right off the bat that I was not here necessarily but more recreationally. He liked my use of the word ‘recreationally’ and said he’d be using it in the future. We talked just a few minutes about what I was looking for (you know the drill by now … nothing too big as I am a small person) and he seemed pretty in tune to everything I had to say.

He said that the biggest mistake women make is going too big or too wide.

He added that women should look to correct and improve the shape of their breasts and not just be worried about their volume. He actually said smaller breasts are “more elegant,” which I’m pretty sure makes me Audrey Hepburn. And finally, he emphasized that an implant should be used to enhance your natural breast, not become it.

In discussing my options, he said that he encourages his patients to get everything that they want done in one procedure. When I asked about the full lift and implants being done together, he said it was no problem. Remember Doctors 1, 3 and 4 all stating it should not be done? And they offered two different reasons.

Doctor 1 & Doctor 4 said it shouldn’t be done because the anchor incision involved in a full lift would be under too much pressure to heal if there was an implant stuffed beneath the skin. Doctor 5 said that the anchor incision he makes involves only a very superficial layer of skin and therefore healing and thus scarring is not an issue.
Doctor 3 said it shouldn’t be done because of complications that can occur with the patient’s blood flow and there is a possibility of losing the nipple. Doctor 5 said that blood flow concerns are only present in repeat implant patients and assured me that, while the risk is never zero with anything, I would not be a candidate for these types of problems.
Doctor 2 (in case anyone was wondering) was also pro-2-procedures-in-1-surgery but his only argument was that any accomplished surgeon can achieve the desired results with no problems.

The doctor also assured me that, if anything, he was a bit of a germophobe and he had never had any complications arise as a result of infection. He said he uses something called an implant funnel to insert the implant. He literally likened it to a pastry tube … only instead of sweet buttercreamy goodness, mine would be filled with silicone. Delicious.

When I asked about the texturized implant shells (that we learned about from Doctor 4), he said he feels they do nothing to prevent the possibility of scar tissue and hardening. Additionally, he said the texturized shells don’t slide down into place and settle as well after surgery.

When I asked about implant placement, he said he determines whether the implant should be placed above or below the muscle based on two things:

The patient’s activity level – Triathletes, for example, are encouraged to seek over the muscle placement … as putting the implant beneath the pectoral muscle could become too physically restrictive for them.
The patient’s quantity of tissue – Patients with a limited amount of breast tissue available are encouraged to seek under the muscle placement … as there often simply isn’t enough skin present to stretch and support the addition in the front.

And, incidentally, he added that under the muscle placement typically results in a more natural curvature and slope from the chest wall into the breast thus creating a more natural look overall.

When I asked about the silicone versus saline decision, he said much prefers … are you ready for this? … silicone. (The exact opposite of Doctor 4, remember?) He said he uses it almost exclusively in his practice explaining that silicone is lighter in weight than saline which is more comfortable for the patient. He added that silicone also doesn’t have the same problems with breast hardening or even possible visibility as the patient ages and her skin thins. That said, he highly recommends a new innovation in the implant world called cohesive silicone for various reasons:

Unlike the silicone of old, cohesive silicone adheres only to itself, keeping it together where it should be on the chest wall rather than leaching into other areas of the body.
The recommended MRI every 2 years for these implants has been lifted by the FDA.
The same 3.5 centimeter incision made for the lift can be used to insert the silicone implant, thus any argument to opt for saline over silicone due to less cutting would be null and void.
He’s seen many first generation silicone implants (from the 70s and 80s) come out … practically empty of their contents … with no harm done to the patient.

When I asked about the fat injection method rather than implants, he seemed to steer me away from that direction altogether. He explained that he felt the technique was best used in cancer patients who are seeking to match one post-surgical breast to another healthy one. Melissa and I were both pretty surprised. We expected this technique to be one he lingered on for a while. It was, after all, the method Melissa had chosen … though she did explain to me that, because she had undergone radiation during the course of her first treatment, she was not a candidate for implants. Her breast tissue would likely have rejected them.

When I asked about the effects that implants have on mammography, he said that so many women have implants these days that there are now named techniques for performing the test proficiently on these specialized patients. He also added that any mammogram, implants or not, can miss anomalies in the breast tissue. Apparently, nothing is foolproof. (Sigh.)

Then, he took lots of measurements of just about everything I’ve got above the waist. Which ain’t much. And he seemed very focused on the fact that I have a very narrow base width which basically means I have a narrow chest. 32 to be exact, A/B. (Lord, did I just put my bra size on the internet?) The doctor said that, for me personally, he would recommend somewhere between 280 and 300ccs of “assistance.” Which is just about exactly what Doctor 4 said. (Yay! Consistency!) He also said that he would recommend something between a full lift and a mini-lift. Rather than an anchor incision, I would need something more L-shaped, coming down from the center of the breast and turning outward on both sides. Best of both worlds, I suppose.

Oh, and they took pictures. Lots of ‘em. I was escorted to a special room, a studio if you will, with very high-tech cameras, computers, lighting, etc. There was even a little heater in the area where I was photographed so I wouldn’t get too chilly, being disrobed and all. I kind of felt like a supermodel. A naked supermodel. Which I guess would sort of make me something else, wouldn’t it?

A word of advice to all women out there who may pursue this avenue – Do not wear any identifiable jewelry, clothing or hairstyle in your headless photos. And God help you if you have a tattoo. Trust me. Your pictures WILL be recognizable. I’ve already identified an acquaintance in one of these photos with complete certainty.

With my photo session behind me, I returned to my exam room to find Melissa waiting for me. And while I dressed, she undressed and showed me the handiwork of her operations. And, I must say … Melissa, you are beautiful. Your boobs are far superior to anything I could hope for. Your doctors did an outstanding job and you deserve every ounce of it. Unbelievable. Boobs made from scratch … using only parts of your body. I am speechless.

We left the exam room and walked back out into the posh waiting area again … with me having learned (and I think grown) a lot from my visit … but not before stopping to snap an all-important picture. It’s one of the many t-shirts they sell in the lobby.

Breast cancer patients are incredible, awe-inspiring. I bow at the feet of these women.

I woke up this morning to my alarm slapping me in the face and telling me to get out of bed. My daughter had choir practice and needed to be at school extra early today. Never mind the fact that the rain and my husband, hit hard with a headache again, kept waking me throughout the night. It was time to get up, throw everyone together and out the door so my day could begin.

Yesterday morning couldn’t have been smoother but this morning was a little … bumpy. (Sooo not the ‘explevatory’ word I want to use here.) Nobody was in an especially good mood, with my daughter being the real star of that dark and dramatic show. So, once they were all off and on their way, I was left to get myself, now really not in the best of moods, ready for appointment number two. Remember to wear a two-piece ensemble again, Michele. (If I ever forget and wear a damned dress, I will have to stand there completely naked for the examination. Topless is demeaning enough.)

Fortunately for me, my friend, Vanessa, was my appointment buddy for today. And, even more fortunately, she offered to drive … enabling us to get there on time today … unlike last week when I was in charge of the driving. I Googled the address from the car and we got there without incident. All improvements from last week.

After finishing the elephantine amount of paperwork a second time, Vanessa and I were left to peruse the waiting room and all that it had to offer. The TV in the corner blared ‘The View’ for anyone interested in hearing about Danny DeVito’s latest exploits. The requisite glass cabinet of upscale Obaji skin products was on display on the wall near the exit. There was an additional glass case featuring all of the doctor’s Mardi Gras memorabilia. Clearly, he had been this organization’s king at some point in the past. And his membership was probably paid for by the many sets of beautiful new breasts that may have, ironically, been flashed at his very float for that parade.

Vanessa and I flipped through his ‘Breast Book’ – filled with page after page of impressive before and after shots. True, there were some women who either had no business being befores or were fairly disappointing afters … but most had made significant improvements in their areas of interest. There was even a before and after picture of a man who had reduction surgery. And, yes, we both thought he had made the right decision. All of the pictures were headless, including his, except for one. One beautiful blonde woman with a smile as wide as Texas wanted to be sure she got credit for her efforts. And did she ever look happy!

We were just finishing up the book when the nurse called my name and we went to the examination room. She handed me a gown and told me to put it on facing forward. Oh, and I want to mention that this room had some nude Venus de Milo-y statuettes here and there as well as a plastic resin cross-section of a boob.

Isn’t this exactly what I was looking for last time???

And, as I was undressing and putting on my gown, Vanessa took her top off … just for me to see a comparison. She promised before, remember? First of all, I want to compliment my friend (who I will point out is six years younger than me!) and say she has great boobs. Everything looked to be very much in the right place to me. Did I have that six years ago? Of course, I didn’t get to look at them long because, about two minutes after she unhooked her bra and pulled down her strapless spandex dress, the doctor walked in without warning … forcing her to throw her sweater around her chest and sit there throughout the entire appointment with her bra in her hand and her dress at her waist. Our little secret.

The doctor wasted no time with me. I kind of expected a man to be different. He got right down to the examination and was fairly physical with my breasts. He immediately said that the first thing he would recommend was a Bilateral Supra Areolar Mastopexy, which is sort of like a mini-lift. It wouldn’t lift as much as the full lift suggested at my first doctor visit but it also wouldn’t leave the anchor scar (line from the nipple to the breast base with a perpendicular c-shaped scar under the breast). The only incision needed would be made around the nipple and the implant could actually be inserted through that opening. Unlike the last doctor, he said the two surgeries could be done at the same time and that, since the only incisions made would be around the nipple (rather than the full lift’s anchor incision), scarring would not be an issue. And he seemed very confident with his answers.

When I asked about implants, he said he uses both kinds but much prefers silicone over saline. (I know. Again, different, right?) He said the silicone implants feel much more real and less invasive to the patient.

When I asked about the recovery period after the surgery, he said there would be some pain but that I could exercise after two weeks. (Woohoo!) He said the breasts are taped down a few weeks during the healing process anyway. (Sounds awesome.)

When he asked me how big I wanted to go, I looked at Vanessa and we came up with the same conservative “Not too big” (me) and “Small C?” (Vanessa). He seemed surprised with our answers and said that you want to go big C or small D to really get your money’s worth and have others notice the difference. I think he mentioned something about my husband at this point. (I really wasn’t wild about this conversation.) And then he asked to take my headless picture for my file. (Please let me know if my pictures hit the internet so I know when to file for free boobs!) Perfectly nice man. Seemed to really know his stuff. Just sort of felt a little like a number. Two lifted boobs, D, silicone, check.

Of course, he did leave us to play with his sample silicone implants – the 330cc, the 420cc and the whopping 450cc – which would translate to me being a full D. With my small frame and my just under 5’4” ‘stature,’ I looked like I was about to topple over. I might just need to take it down a notch.

They say everything happens for a reason. And I mentioned earlier in this post that he was pretty physical with the examination. It wasn’t exactly comfortable, of course. But without that literal manhandling, he would never have found the lump he found today in my left breast. Yes, lump. Which was also what I got in my throat when he told me. Remember that scene in Sex and the City with Samantha? Damn.

(I love you, Vanessa, and am so glad you were there with me today.)

So now, in the middle of this whole thing, I need to go get a mammogram to determine what the hell he found today. I would have had to do it for any of these surgeries anyway, but now I’m just going with a little more urgency … and anxiety. And I have another consultation appointment tomorrow. Sigh.