The plastic surgeon. Why does he scare me more than any of the others? He should be the one I most want to see. As he said to me, he is the one who puts me back together.

The appointment did not start well as the doctor was an hour and a half late!! The nurse said he had an emergency that he had to check on at the hospital. The mind sort of boggles at what kind of horror is a plastic surgery emergency. Fallen boobs, botox od, nose out of joint. Anyway, at least when he came in, he apologized. That’s all I care about in that situation, acknowledge that my time is also worth something.

He was terrific. He sits down and before we start with his portion he looks me in the eyes and asks how I am doing. Chemo wise, I asked? No, about everything. Well, that would have made him another hour and a half late if I went over everything, but I certainly appreciated his caring. Most other doctors really only care about their part in the process. He made me feel like he wanted to know about my entire process.

We started talking about the reconstruction process and of course I got emotional. I thought I would be a candidate for the “tram flap” procedure that reconstructs the breast at the same time as the mastectomy. It uses a flap of skin and fat and muscle from the stomach area to sculpt a new breast. The entire procedure is done in one operation.

A few negatives are associated with this type of surgery, including the possibility of the skin flap dying, later stomach hernias and difficulty in sitting up from a lying position. I thought the positive of waking up from the mastectomy with new breasts and not just a giant hole would be worth the risks.

Unfortunately, my further course of treatment, as well as my weight do not make me a candidate for this procedure. The combination of radiation and weight makes it more likely the flap would not be successful. So back to the long established method of inserting spacers.

I was pretty upset at first. But the doctor took his time to explain what happens during the procedure and it reassured me some. After the surgeon removes the right breast and the tissue from the left, the plastic surgeon inserts a small bag that has saline in it behind the chest wall. He inflates this with as much saline as he can given the amount of skin that is left. This is closed up and I proceed with radiation. Every few weeks, I return to the plastic surgeon’s office and he inserts a needle into a port in the bag and pumps more saline in it. My body then stretches to accept the larger bag, this process repeats to make the new breasts. Eventually, those will be replaced by implants. It could take almost a year for the entire process to be completed. While I wasn’t happy about this news, I had no choice and the doctor made me feel better about the entire procedure.

Here was the not fun part. (Nick, Andrew and Dad you may not want to read this part.) The plastic surgeon had to see my body to assess what procedure would be appropriate. So there I was naked from the waist up and dropping my shorts so he could pinch and assess. Yikes. He creates the pretty people and then there’s me. Not exactly one of the Orange County Housewives. He was very appropriate and never indicated that I didn’t measure up (so to speak) to the standards of his other patients. Then, I had the before pictures. Up against the wall, boobs out, all angles. Not exactly what I will use for my Christmas pictures. Who knows, maybe the after pictures though. Ho, ho, ho.