Double mastectomy surgery

Talking about options

I wrote about having the faulty BRCA2 gene in this post and my decision to have a double mastectomy as a result. Now I want to talk about the options related to the surgery.

The main ones I was presented with were:

1. No reconstruction

2. Reconstruction with implants

3. Reconstruction with a DIEP flap

As I mentioned in my previous post, I like my breasts and the thought of losing them completely wasn’t something I wanted, which ruled out option 1. I do want to thank all the women who did choose this and posted photos post-operation, so I could understand what the reality looked like. I really appreciate it.

After deciding on reconstruction, I had two main options: implants or a DIEP flap. A DIEP flap is when they take fat from the lower abdomen and use it to reconstruct the breast tissue. Effectively it gives you a tummy tuck at the same time as rebuilding your breasts. I’m not going to lie, it was a really appealing option, however the price tag didn’t thrill me.

To have a DIEP flap reconstruction with private health cover was going to cost about $30,000-$40,000 (in Australia). And while I like my breasts, I couldn’t justify spending that amount of money on them. I mean there are so many things I could do with that much!

I could go through the public health sector and it wouldn’t cost anything, however the wait time at the moment is 2-3 years because it’s considered elective surgery. That would take me to 49 years old and mum had her first cancer diagnosis at 50. It just felt too risky to wait.

In the end I decided on having a nipple sparing double mastectomy with implant reconstruction. Oh, that was another choice to make; keep the nipples or remove them.

It’s unlikely there will be any sensation in them if kept, and you can get tattoos and nipple reconstruction afterwards, but I didn’t want another surgery so soon.

I spoke to a couple of breast surgeons. One would cost about $3000 with my private health cover and the other would do it at cost, so it wouldn’t cost anything. The latter also operates out of the hospital where my husband works, which is convenient, so it made sense to go with her.

I am a little worried about the scars. I tend to get keloid scars which are raised and red so there’s that to consider, but not a lot I can do about it. These days there may be creams I can use, so I’ll ask the surgeon.

There’s also the recovery time. I’ve been told it can be between 1-3 weeks and it depends on the individual, so I’ll have to wait and see. Thankfully I have an amazing workplace who are flexible. I can take 3 weeks if I need to, or I can work from home if necessary, and that reduces a lot of stress.

So now, with surgery about a couple of weeks out, I need to think about things I need. The surgeon hasn’t been the greatest in communicating what recovery items I need, but mum has been through it which helps.

I need to buy a few compression bras. There’s a place around the corner which sells them, and one of the breast nurses said the Kmart post surgery bras are just as good (and about a quarter of the price), though maybe check with your own doctors to make sure.

I also need to buy some button up shirts. I don’t think I’ll be able to lift my arms above my head post-surgery, so loose fitting or buttoned shirts will be good.

I already have a full-body pillow because I don’t think I’ll be able to sleep on my side for a while.

I’ve been given some ice packs for my breasts and a pillow to go between my breasts and seat belt when I’m in a car. Honestly I’m fortunate (in an odd kind of way) that I know so many people who have gone through a mastectomy before me, because the surgeon has told me none of this.

And now I’m making a list, I am starting to feel a little anxious about it all. I think I’ll contact my surgeon this week and ask what else I might need! I’ll definitely post something after surgery and let you know what worked and didn’t work. If you have suggestions, please leave it in the comments below.