Implant Exchange & Salpingo Oophorectomy
The day finally came. August 13th, 2020 I was scheduled to have my second surgery in my Previvor journey. My hard expanders would be removed and replaced with silicone implants. Simultaneously I would also be having my ovaries and fallopian tubes removed laparoscopic by another surgeon. I wasn’t thrilled about another surgery and recovering taking up the end of my summer, but I was so ready to get these expanders off my chest! After waiting months to be rescheduled after Covid pushed it back followed by my plastic surgeon being on medical leave for an additional 2.5 months, I was ready to get these procedures done. The day before my surgery I prepped my home for the recovery process. I got my nightstand stocked with a new book to read, my chapstick, backscratcher, essential oil diffuser, and my phone charger. I pulled out my mastectomy pillow from the closet since I haven’t been using it, and laid it next to my pregnancy pillow which I still use every night. I packed my hospital bag with the basic essentials. Last time I went in for my mastectomy I had a duffel bag filled with all the things I thought I might need; a couple outfit options, a few pairs of socks, headbands, makeup, hair brush, hair ties, my wallet, cell phone, charger, a book- all of which I hardly used. Since the pandemic was still going strong I wasn’t allowed any visitors with me going in to my surgery. Since my husband and Dad wouldn’t be there this time to take my personal belongings the nurses instructed me to only bring my I.D., insurance card and the bare necessities. This time I only took a small backpack with one button front short sleeve nightgown, one pair of leggings, one pair of socks, one pair of panties, one headband and my I.D. and insurance card tucked in the front pocket. When we arrived to the hospital the nerves were getting to me. I was so nervous to go through this alone without the comfort of my two strongest supporters. Steve and my Dad walked me to the entrance of the hospital and gave me hugs and wished me the best. I put my mask on and in I went.
I walked in through those big tall glass double doors all by myself and up to the second floor to the Adult Surgery Department. I checked in and they gave me a bracelet with my name on it and I waited in the waiting room for all of about 5 minutes until they called me back. A nurse greeted me and I followed her through a set of big metal double doors that required a password from the nurse. Once back in the pre-op area they took me to a room with a bed and gave me a gown, socks and a hairnet and told me to change then put my personal belongings in my bag and place it in the chair. I knew once I got to this point my nerves would kick in, and they did. After changing in my hospital outfit I laid on the bed and waited. One nurse would come in and ask me a bunch of questions, then a few minutes later another nurse would come in to take my blood pressure and vitals then another one would come and start my i.v. After what seemed like 30 minutes of that my plastic surgeon Dr. Foster came in. I was so happy to see him, especially since it had been over 6 months since I’d last seen him due to the pandemic and then him going on medical leave. He pulled out his marker and begun drawing lines on my breasts as I reiterated our plans and previous conversations. He then drew more marks on my stomach and sides as to where he was going to perform the fat grafting and then left the room. I sat back down on the bed and after another 10 minutes of waiting my other surgeon Dr. Chapman came through the curtain. She and I chatted for a minute about how the salpingo-oophorectomy would go and I asked her a couple questions I had about the recovery, then she left and I knew it was getting close to show time.
After a few more minutes of waiting the anesthesiologist came in and whisked me out of the room and down the hallways of the pre-op department and through some more metal double doors. By the time we got there I was out, and the surgeries begun. First with Dr. Chapman performing the salpingo-oophorectomy which was done laparoscopic and left me with 3 small incisions- two on my lower abdomen and one inside my bellybutton. The surgery took about 45 minutes and then Dr. Foster stepped in and performed the fat grating using the same 2 incisions Dr. Chapman used, as well as the implant exchange. In my breasts, he removed the expanders than had been placed under my peck muscle, scraped and removed the scar tissue that had built up, and then placed in the silicone implants.
When I woke up everything was kind of blurry so I kept my eyes closed for awhile until I could see that I was in the recovery room and had a nurse attending to me. I felt tired and dizzy and lightheaded but I was on so much medication and I was still feeling the effects of the anesthesia that I didn’t feel much pain. I remember the nurse giving me graham crackers and as I tried to eat them I felt a bit nauseous. I laid in that bed for several hours trying to feel good enough to walk out of there and endure the almost 3 hour car ride home. Finally the nurse helped me stand up and I then got my bag and changed into my button front nightgown and out of the hospital gown I was wearing. I slipped my slippers on and laid back down on the bed to rest. The nurse then gave me an anti-nausea medication through my i.v. right before I was released and he warned me it might make me a little tired. I was thinking I couldn’t possibly be any more tired than I was now, but I was wrong. As soon as it hit me I could hardly keep my eyes open despite my best efforts. He told me a nurse with a wheelchair would be there shortly to take me downstairs to my husband and my Dad who were waiting with the car in the front of the hospital. I waited and waited, fighting as hard as I could to keep my eyes open but finally I gave in and just closed my eyes and dozed off. Shortly after the man woke me up when he arrived and I sat down on the wheelchair and he put my bag on the rack below the seat and wheeled but out of there. It felt like we were flying down the hallways and elevators but I couldn’t get out of there fast enough. I was so ready to see the familiar faces of family and go home to my cozy bed. Once he wheeled me out the front doors of the hospital I looked up and saw my Dad and Steve standing outside the car waiting for my arrival. I was too tired to act happy to see them even though I was. They helped me inside the front seat of the car and I got situated with my mastectomy pillow across my chest to place a buffer between my new foobs and the seat belt. Then I got my super cozy blanket and bundled up with it and immediately fell asleep. I slept most of the way and woke once we were about 25 minutes away from home. Once we pulled up to the house I was so happy to be home, I climbed out of the car and went straight to bed. I had my pregnancy pillow propped up with another pillow all set up the way I liked it and I fell fast sleep again.
Day 1 
The first morning of recovery wasn’t nearly as bad as the first morning of recovery from my mastectomy but it was still tough. I had a big bandage over my chest, a medium sized bandage over my belly button where the doctor removed my ovaries and fallopian tubes from, and then 2 small bandages over the incisions on each hip where the surgeon inserted the tools to perform the surgery laparoscopic. I was sore and tender from my breast to my hips and it hurt to sit up and stand. I laid in bed most of the day and slept on and off while my husband brought me my meals in bed and constantly refilled my water cup. Every time I had to get up to go to the bathroom it was a process. I had to remove the covers, move one side of my pregnancy pillow off to the side of the bed, use all my strength to scoot my butt back and sit up while swinging my legs to the side of the bed and then slowly reaching each leg down until it touched the floor to stand. Walking to the bathroom and sitting on the toilet was no easy task either. Since I had 3 incisions in my abdomen it hurt to use my abs to lower myself down and to push myself back up. After doing this multiple times a day it was getting a little bit easier each day. I took my first shower the day after surgery. My husband hopped in to help me wash my hair without soaking my chest bandage. That shower felt so revitalizing and made me feel so much better.
Day 3 
The first few days consisted of lots of laying in bed movie watching and cuddles with my dog Rusty. At around day 5 I started having these moments when my heart would start racing and I would get lightheaded, dizzy and uncontrollable shakes followed by multiple back to back trips to the bathroom with diarrhea. At this point I had stopped the Oxycontin and was only taking the antibiotic Doxycycline, Ibuprofen and Tylenol. I reached out to my nurses and they assumed it was a reaction to the antibiotic so they instructed me to stop taking it. I decided to cut out the ibuprofen to be safe and only took Tylenol but I still continued to have these episodes over the next several days. I eventually decided to try an Ativan I had leftover from my mastectomy to see if it would help calm my heartbeat and it just so did the trick. I stopped taking Tylenol and all other pain medication and just started taking an Ativan every 8 hours to keep the episodes at bay.
The night before my one week checkup I took my second shower and my chest bandage got wet accidently even though we tried to waterproof it with saran wrap. Since it was super wet we decided it was best to take it off. This was the first time I was getting to see my forever foobs. I was expecting to see them for the first time in the doctors office at U.C.S.F the following day. Although I knew they wouldn’t look exactly how they would end up looking due to swelling and bruising I was SO excited to take a look at them! I walked into the hallway where the light was brighter and had Steve take a photo of me. My stomach was very swollen and my foobs were covered in yellow bruises with darker bruises along the lines of my incisions. Just having the bandages removed made me feel like a million bucks. At first glance I was pretty satisfied with the way my foobs turned out. I told my plastic surgeon that I wanted them to look natural but be slightly bigger than my natural breasts and I feel like that is how they turned out. My only concern was that my right foob looked like it sloped more than the left one. I told myself it was probably just the swelling and not to worry about it for a few more weeks when the swelling would be mostly gone. The next morning I was off to San Francisco to meet with a nurse from the breast care department to check on my new foobs and my recovery progress.
Day 7 
For the first time I put on leggings which I pulled up high so the band wouldn’t put too much pressure on my sore stomach or incision areas on my belly button. It felt good to have normal clothes on for the first time in a week. My husband and I drove the 3 hours to San Francisco for my appointment where I met a nurse practitioner. She looked at my incisions under my new foobs and checked all my bruising and said everything looked just fine. I asked her about the heart episodes I had been having and she was baffled at what could be causing it. I told her I thought it could maybe be from the effects of surgical menopause I was going through after my salpingo-oophorectomy and she suggested I talk to the gynaological team and see if they can come up with any answers. I reached out to them and asked them if it was possibly a side effect from the Mirena IUD that was placed in me during surgery for the progesterone or was a side effect of the surgical menopause in general. They told me that it’s not a typical side effect and weren’t exactly sure what was causing it but that it could be my body’s reaction to all the trauma and menopause combined.
Day 14 
Put on my first bra!
A week later at 2 weeks post-op the bruising and soreness got a little better. My stomach and sides were still very tender to the touch from the fat grafting but each day it improved just a little bit more. I was surprised at how long the pain lasted from this part of the surgery. My doctor instructed me to wear a tight compression garment for the first week to help with that pain but I decided to wear it everyday for the first 2 weeks. Once I hit the 2 weeks mark I took a break from wearing it for 5 days. After the pain and bloating lingered around I decided to try wearing it again so I put it back on every other day for another week. I started to do simple tasks like the dishes, making food for myself, and even vacuuming. I didn’t lose all the strength in my chest this time like I did with the mastectomy so recovery was a lot quicker and easier in comparison. I slowly started getting down on the floor to do some simple stretches and worked my way into light yoga workouts that were 3o minutes or less. I started feeling the need to move my body and get my blood pumping a little bit. I grabbed my 3 pound weights and did some very easy exercises that used my chest muscles and got things warmed up. I made sure I did this at least every other day.
6 Week Checkup 
My next check up with my plastic surgeon was at 6 weeks when all the bruising and swelling dissipated and I was able to see the real outcome of my new foobs. I still had slight bruising hanging around but for the most part my foobs looked healed. The sides of them and my abdomen was still sore but I was able to wear jeans at this point without feeling super uncomfortable. Dr. Foster said that my incisions looked perfect and I was doing well with my healing process. I discussed my issue of the right foob being slightly more sloped and flatter on the top with him and he saw what I was referring to. He also pointed out that I was started to have crevices reappear beneath my collarbone and suggested another round of fat grafting to fill it in and a small incision under my right foob to tuck under a section of my skin flap to try and lift the implant up slightly. He told me that he could make them look even better after one more short surgery. As much as I didn’t want to go under the knife once more I was convinced that this third surgery would be able to make my foobs look a little better and that in the long run I would be happier with them. The one thing I didn’t want is to have any regrets about this process. He assured me that insurance would pay for the revision so I figured I might as well do it and get it scheduled before the end of the year when the new calendar year of my insurance starts. With all the surgeries this year I have well met the maximum deductible for my insurance payment and want to try and keep the costs as low as possible. He told me that he would put in orders for the surgery and someone from his office would be calling to schedule that. He told me they like to wait 12 weeks in between surgeries so I had to wait at least another 6 weeks before having it done.
I’m now 9 weeks post op and I just got a date scheduled for my revision surgery. My doctors coordinator informed me that they are really booked up and are already scheduling into next year and wasn’t going to give me a date at all. After I pushed a little bit and told her how long I’ve had to wait already I got her to get me on the calendar although she was reluctant and informed me that this date would most likely be cancelled if they got a more important case. I’m upset about this situation as this has been so drawn out throughout the year, but I’m glad my risk of breast and ovarian cancer is gone. My foobs have settled in nicely and they are 1,000 times more comfortable than the expanders and for that I am thrilled! I do have some ripples on my foobs and small crevices above my implants, directly underneath my collarbone but they still look better than the expanders ever did. I feel more comfortable when I sleep and recently started working out again. I’m relieved that the hardest parts are over and I feel empowered by undergoing these surgeries all by myself without anyone there to hold my hand in the hospital room. I’m incredibly thankful for my husband and my Dad who both helped me so much as I recovered. I leaned on them for support physically and emotionally. I can’t believe I did it all. No more breasts, ovaries or fallopian tubes for me! I don’t have to worry about a breast or ovarian cancer diagnosis and can live my life to the fullest!
