Nipple tattoo!

 When I was initially diagnosed, I regularly attended informational sessions about different aspects of breast cancer. I remember one evening session featured my plastic surgeon discussing the reconstruction process. Nipples and tattooing were the final step. The surgeon mentioned that some women don't finish the process, but that for him and his colleagues the process wasn't complete without the nipples. Not only does it bring back some sense of normalcy, it also brings attention away from scarring.

After my reconstructed nipple healed, I was able to have nipple and areola tattooing. When I was first diagnosed, I became familiar with one tattoo artist who created the most realistic nipples I had ever seen. She works out of a shop and also used to work at a plastic surgeon's office. Because it had been over a decade since I first looked into nipple tattooing, she was no longer working at a surgeon's office. I decided to still go with her and pay out of pocket. 

For tattooing, it's a benefit that the "breast mound" has virtually no sensation. For standing in pictures and not knowing you are actually brushing up against someone's back, it's less beneficial. The process was pretty cool. The artist set up her colors and had me remove my top. Because the goal was to match my original nipple, she kept checking colors and mixing along the way. She asked questions like, would I like Montgomery glands tattooed? I was going for a natural realistic look, so why not?! She also measured and marked. I'm still in awe of her talent and ability to recreate a very realistic nipple and areola.

I followed the tattoo aftercare and haven't really looked back. I knew that seeing the absence of a nipple was something I noted almost daily. The addition of a nipple is something I barely see anymore. My brain sees symmetry and doesn't need a second look. There's nothing to note and while my original parts are not the same, they almost look the same.

Delayed Fixes

When I was diagnosed with breast cancer fourteen years ago, being inundated with endless doctor appointments was one of my biggest concerns. Cancer should have been the main priority, but life keeps marching on and cancer and its many necessary appointments are time consuming. When I was making surgery decisions, one goal was to have the least disruptions. Lumpectomy plus radiation versus mastectomy was at the top of my pros and cons list. Somehow a three day post flap hospital stay was the winner and felt easier to fit into my life than thirty individual radiation appointments.

The biggest goal of a flap procedure is to have the flap survive. The surgeon knows that minor fixes can happen later to improve the shape of the breast mound. Whenever I pictured these minor fixes, I pictured surgery with general anesthesia. A three phase plan for reconstruction was a concept I had heard about, yet my surgeon never discussed it explicitly. I would simply follow up with some regularity and then return to my regularly scheduled life when I had healed.

Thirteen years after cancer, my babies more grown and independent, I decided to look into fixing up my body. Naturally, I scheduled an appointment with my former plastic surgeon. Learning that fat grafting can occur as an outpatient procedure without general anesthesia was a happy surprise for me. Having fixes at this point in my life was a choice. Whenever I saw information about the reconstruction process, it always included a nipple as the final step. I too wanted to feel more finished, though I had an indentation that I felt needed to be addressed first.

Armed with new information, I scheduled fat grafting. Like many experience, one round of fat grafting was not enough. The decision to sign up for liposuction is not a small one and needs careful consideration and planning for downtime. Liposuction bruising in the deepest shades of black and blue is on a level which I had never seen before. A different option would have been to add a small implant, but I chose not to go this route.

Finally after three rounds of fat grafting, filling in the small dent and increasing the overall size of the breast mound, I had my nipple appointment. In many ways, it seems superficial to go back, take time, and endure pain for what may seem to be simply cosmetic reasons. However, I knew it was more than that. Years ago, I was fitted with a partial prosthesis. This prosthesis had a tiny bump on it mimicking a nipple. When looking in the mirror at Thelma’s, I could hardly believe I saw two nipples peeking through my bra. My eyes and brain immediately appreciated the symmetry that had been lost for so long. Even I would have told you that it didn’t matter, but that would be a lie. Although only as a fleeting thought, I have felt a pang of self consciousness in a locker room or at a doctor visit, always knowing the missing nipple would stand out, but only figuratively. In my nightshirt and in an unpadded swim top, I was consciously and subconsciously aware of the difference.

The surgical addition of a nipple was a straightforward procedure. Lidocaine was used, but the sensation on the breast mound is still mostly absent. As the four injections went in, I could not even feel the first two and wondered if they would be necessary at all. The second set did elicit a brief twinge of acknowledgement. After some surgical magic, the nipple was created, photographed (by my request), and bandaged. This was one of my easiest procedures. Fortunately, I don’t feel overly anxious about procedures and can tolerate having them without systemic drugs. After this appointment, I was able to drive myself home. In the days that followed, my main complaint was fatigue. Pain was not registered at all, though occasionally I was aware of a minor aching.

The next step is always to wait. Waiting is such a large part of the cancer experience. At this point I needed to wait to heal. After about three months I was eligible for an areola and nipple tattoo. I looked forward to this final step and was very hopeful along with my brain, that the appearance of two nipples would be noted and then fade away into the sense of normalcy I have long sought.

Seven years

Seven years ago I underwent surgery to remove a small lump in my breast.  The lump and resulting pathology changed the next year of my life and brought breast cancer into my health history.

It is interesting being a survivor.  I have many breast cancer sisters and enjoy providing information and support to newly diagnosed women.

In my other world, I am a mom to three children who keep growing up. My daughter who was a toddler at diagnosis, is now heading towards breast development and puberty. My post cancer baby is almost four.  My oldest hardly remembers when mom had breast cancer, but knows it's part of his history too.

Having year after year of clean scans and no evidence of disease is great and relieving. Not everyone has been as lucky.

Scares

It's interesting how cancer really changes your perspective on things.  Every new bump or pain or odd change in your body makes you think of cancer.  If you thought nothing bad was ever going to happen to you, but then it did, it's like a rude awakening.

Since my cancer experience, I've had a few "scares."  Times when something wasn't just right and my mind jumped right to cancer.  Even if I had reason to believe that it was probably not cancer, somewhere in my mind I entertained the idea of cancer.

In these instances I've even had biopsies and that made it even more real, like a repeat performance:   waiting for results, considering the what ifs...  It is not a happy place.  But as the optimist I am, I would brush off the what if's and try to go on with my life.  After cancer, I just know too much.  I have had friends die.  It's hard to forget what I know and to not be concerned.

In one instance, I even needed surgery and general anesthesia again.  I really had thought I could make it more than five years, maybe even most of a lifetime without surgery again.  A hoarseness had become apparent with my voice.  After many months of wondering if the hoarseness was here to stay and required a doctor visit, I finally consulted my doctor and also a specialist.  In the video of my throat, I was shown a small bump in my false vocal chords.  The doctor did not know what it was, but recommended it come out and soon.  She did not want me having this bump grow and obstruct my breathing.

After consulting another specialist and confirming that the unknown bump needed to come out, I reluctantly scheduled surgery...and left my nursing toddler again.

The bump still baffled the doctor even after it was out.  It wasn't until the pathology came back that it showed it was a xanthogranuloma. While these are benign growths that can occur in the body, the throat is a very odd place for them.          

In the end, I did not have cervical cancer, or throat cancer, or even skin cancer.  When I finally received the phone calls, the biopsies were always not cancer.  I could leave the waiting place and go back to living life, just a bit more of my innocence lost.

5 Years!

I'm thrilled to make it to five years since being diagnosed with breast cancer.  I have three amazing children and a still wonderful husband.  Hitting two years and planning a pregnancy was pretty special, but five years tops it.  In addition I will celebrate my 40th birthday later this year and I am excited about making it to that milestone as well.  

Life is good all around.  Around here we still know how to have fun and exercise.  I even teach hoop fitness classes once a week.  Staying connected with women who have been diagnosed with breast cancer has been nice for me too.  I stay connected on-line and meet newly diagnosed women locally as well.  Volunteering my time supporting and providing information to breastfeeding mothers still is good too.  I wasn't sure at one point if it would be too hard for me, but I'm glad I stuck with it and am thrilled to be a breastfeeding mother again.

Bras and the Quest for Symmetry

I often wonder if bra shopping will ever be the same.

After my first surgery, I noticed my breast was a bit smaller than the other.  It wasn't very noticeable in clothes and I didn't worry about it.

Then I had my second surgery and now I had one natural breast with a nipple and one breast mound.  I found that a padded bra felt more comfortable for me.  It hid any imperfections of my surgery and my one nipple.

The next bra scenario happened when I was pregnant.  All of the pregnancy hormones were headed to my one breast and it grew and grew.  The other did not.  I finally sought out a local mastectomy boutique to see what my options were.  They fitted me with a padded mastectomy bra and sold me a mini prosthesis.  It was actually more of an enhancement designed to give someone with breasts a little boost.

Finally I am even bigger, full of milk on one side, and nursing.  My bra options seem to dwindle even further.  I would like a nursing bra, but I also like the pocket on the mastectomy bras for my "enhancement."  I see what the mastectomy boutique has to offer.  We find a couple stretchy bras that will work for nursing and have a pocket.  In addition, I find some of my old nursing bras and sew in a pocket on the one side.  These options seem to work well.

As the years pass, I wonder if I can just shop in a regular store.  I know what seems to work and what doesn't.  I find a great fit and figure I can cut near the lining seam a touch to allow me to slip in my prosthesis.

As my mini enhancement prosthesis starts to degrade and lose it's firmness, I head back to the mastectomy shop.  Initially I was very much turned off by the full prosthesis.  I went through reconstruction and have a bit of a cleavage, I don't want to hide all that with a prosthesis and a full bra. But I was curious about other options.  I was happy to find a small prosthesis that is not a full one, and it has a small nipple.  I was so tickled to try it on with my bra and shirt and notice through my shirt that I have two nipples again.  My brain sees two and feels symmetrical again.  What amazes me most is that they look identical.

At some point I may consider more surgery to even things up.  I will have to wait until I am done nursing and my natural breast gets back to it's final size.  I still am not thrilled with the idea of a artificial implant inside my body.  And even less thrilled that I may need to replace it in my lifetime.  Right now, I keep the prosthesis in my bra for a couple days at a time and just put the bra on and off.  I do wear a different enhancement in my swim suit which is a mastectomy suit.  But I am comfortable around my family with nothing and in my nightshirt.

Coming Full Circle and Nursing Again

Breast cancer influenced my nursing timeline three years ago.  Having the opportunity to nurse a new baby has lessened the sadness surrounding that weaning.  Nursing was always such a large part of mothering for me.  Breastfeeding is more than food;  it is warmth, comfort, reassurance, love, and more.

As a new baby, she didn't realize that she can’t nurse on both sides.  She would try to latch onto anything and often would try to nurse though my shirt on whichever side I held her.  I am conscious that I only nurse her on one side and try to hold her and have her sleep on my other side occasionally.

I am fairly protective of my remaining breast.  Because I only have one, I had concerns about not being able to switch sides during a big growth spurt or even with sore nipples.  For the most part breastfeeding on one breast has been an easy task.  It is interesting to never need to switch sides and never wonder which breast I used last.

Chiropractic care has helped us both stay more even with the one-sidedness.  Having a sore nipple is unique in that I can't know if it's occurring on both sides or not as there's only one.  This is especially true for soreness due to hormonal changes.  With two nipples, there is confirmation that the soreness is "normal" and on both sides.  Probably the biggest challenge was developing mastitis at six months. It was rough and nursing through it was the best option.  It certainly would have been nice to have two breasts then!

Through my volunteering as a lactation counselor and my personal experience of nursing two other children, I know that breastfeeding is all about supply and demand.  I have seen twins nurse successfully.  I know nursing on one breast is possible, but seeing it is amazing.  I marvel that my body works so well and my baby thrives on just my milk.

As my baby turns into a toddler, I love that nursing is still a part of our lives.  I see how important it is to her.  She knows there's only one breast and nipple and it's just fine with her.