One of the many surreal moments during my cancer journey was when my husband and I attended the breast cancer reconstruction symposium at Charlotte Medical Center.
Sitting in the audience of women, some of whom had already had mastectomies, others who were, like me, still undergoing chemotherapy and looking ahead to the next surgery, I stared at slides of patients with no breasts and myriad examples of reconstructed breasts.
I also examined silicone implants and listened as Dr. John Michael Robinson explained all of the options available. "Some date night," I whispered to my husband.
Even though I did not have breast cancer, the genetic mutation that was detected at the time of my ovarian cancer diagnosis made my odds of getting breast cancer intolerably high. I opted for a prophylactic double mastectomy so that I could reduce my risk to practically nil.
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After attending the symposium and consulting with Dr. Robinson, I decided to have perforator flap breast reconstruction, a surgery that was not available in Charlotte until Dr. Robinson, 43, joined the CMC's Carolinas Cosmetic and Plastic Surgery practice in 2009.
Most people are familiar with implants, the silicone inserts that replace the breast tissue that is removed following a mastectomy.
Unbeknownst to me prior to the symposium, another option is to replace the fatty tissue with one's own fat... something, I might add, I had no problem supplying.
The old TRAM (transverse rectus abdominal muscle) flap procedure involved taking the abdominal muscle along with the skin and fat to recreate the missing breast. My surgery, a DIEP flap, is a more advanced procedure that leaves the muscle intact, but instead takes blood vessels that perforate through the muscle and keep the skin and fat alive for reconstruction.
It is not, as one can imagine, a simple surgery.
My breast surgeon, Dr. Theresa Flippo, who was responsible for removing my breasts, began bright and early on the morning of Dec. 15. Dr. Robinson and his partner, Dr. David Fisher, then took over the surgery, working together for the next 10 hours. (Dr. Jean-Francois Lefaivre also performs these surgeries, although he did not assist with mine.)
They cut open my abdomen from hip to hip (which Dr. Robinson described as just below the bikini line, although a bikini has not been a part of my wardrobe for many years) and removed the skin and fat from there to my belly button. Since my breasts had already been removed, they were then able to isolate blood vessels in my chest and removed portions of my ribs so that they could access them and use them to keep the fat and tissue from my abdomen (that now filled my breast cavities) alive.
Hundreds of stitches and 12 hours later, I awoke, groggily, to a brand new body.
Dr. Robinson, who received his medical degree at Philadelphia's Jefferson Medical College and worked alongside his father, also a plastic surgeon, at the University of South Carolina's Plastic Surgery Program , enjoys being able to give his patients a choice.
He is one of approximately 300 surgeons in the country doing perforator flap reconstruction surgery and he is "doing more and more each year." He finds what he does extremely rewarding, whether it's inserts or a perforator flap surgery, because, as he puts it, "I get to give my patients something back that was taken from them."
For me, the surgery marked the end of a long journey, but also marks the beginning of a new chapter in my life.
It was scheduled to fall within the calendar year for financial reasons (because I had already met my medical insurance's catastrophic cap for the year) but the timing was also good in that it marked the end of the year.
I was able to start 2012 afresh, all cancer, chemo, and surgeries behind me. I am so grateful to have emerged from all of this relatively unscathed and I am humbled to know others are not as lucky.
I am in awe of what my body was able to endure and what my medical team was able to do to it.
And thanks to Dr. Robinson and my new flat tummy, I just may have to invest in a bikini this summer.