[00:00:04] Speaker A: Welcome to Start to Finish Motherhood, a podcast for those thinking or already single mothers by choice, just looking for practical advice for navigating life's relationships. When you decide to have children on.
[00:00:16] Speaker B: Your own, it doesn't mean that you're completely alone.
[00:00:19] Speaker A: I'm Aisha Jenkins and I'm partnering with you every step of your journey.
[00:00:28] Speaker B: Hi everybody. I'm back here today with Erica from last week's episode where we discuss surviving breast cancer. Today we're going to pick up the discussion with the breast reconstruction journey because I think that there are some important details that we wanted to get out there to the different communities who listen to this podcast as a PSA for some of the things that you just didn't know was available as options to you as you go through a similar type of journey. And so we are going to pick it up.
So when you were going through your breast reconstruction, is that the right term for it?
[00:01:14] Speaker C: Yes, because it's a process.
[00:01:17] Speaker B: Can you tell your story?
[00:01:19] Speaker C: The reconstruction journey, like I said before, like, that's one area where I would encourage people to take some time to think about what that's going to mean for them. My plastic surgeon, I was intentional about him as my surgeon based on the recommendation of my friend who again worked at the hospital. She said, nope, this is the doctor you need to go with. Get with him. And I did. And stay with him. Even after he left that managed care group, he left and I went with him so that he could still do my deep flap that I had three, three or four months ago. But in any event, my reconstruction, the decision I made was to get a double mastectomy, including removal of my nipples. I went straight to implants, which was intended to be temporary. I made that decision because a doctor said that I didn't need to. If I went this route, I would not need to have radiation again. The implants were intended to be temporary while I lost weight, which would make the deep flap surgery a better option for me from a health standpoint. I was overweight and the doctor did not want to do that intense of a surgery with my BMI being what it was. Temporary state ended up being longer because of COVID and I needed to have the surgery in the summertime because of the kid part. I needed my kids not to be in school so that my village could help out with caring for them while I was in the hospital for a week and unable to physically care for them for the weeks following. During my recovery. Summer of 2020 pandemic summer of 2021 still pandemic.
And then summer of 2022, I was a newlywed, and I wanted to have the surgery in summer 2022, but the doctor said, no, this is a big surgery, and trust me, go be a newlywed first. Don't put this type of strain on your new marriage. Like, just, well, I'll see you in 2023.
And he was right. I was a little bummed when he said he wouldn't do it in 2022, even though in hindsight I had not lost enough weight. But he was absolutely right because it was a hell of a surgery and a hell of a recovery. No regrets, but much bigger than what I ever expected it to be. And just a quick overview of what my deep flap surgery entailed. I went in to have my implants removed. And as far as your abdominal area, it is very similar to what an extended tummy tuck is, where I have an incision from hip to hip. So it's even much bigger than a C section scar. It is from hip to hip, and they take out any excess fat and repurpose that fat to rebuild more natural breasts.
Although I was not happy that I had to hold onto my implants as long as I did, it did give me time to be really clear on what size breasts that I wanted to end up with.
One thing to note with implants is compared to natural breast tissue, when you lose or gain weight, your natural breast tissue loses and gains weight with you. Implants, because I had no breast tissue with the implants, did not lose and gain weight with me. And during the period I was supposed to be losing weight, I gained weight and then hated my implants even more because they just again, didn't feel natural. Fast forward to being able to have the deep flap. I was able to sit down with my doctor understanding where my body was after having lost weight, knowing what I felt like when I was heavier, and come to a educated decision on what size I wanted to end up with after it was all said and done. But we've four years with this doctor, so we had a great rapport. And he would ask me questions, give me things to think about, and tell me, you think about it. Don't give me an answer now. Go home and think about it and we'll talk about it next time we come. One of the questions was what I wanted my nipple reconstruction to be. And he asked me this back with my mastectomy because I could have gotten my nipples done when I had my double mastectomy, but he discouraged me from that. If I was going to have the surgery later, the deep flap, so that he could. I can end with the most symmetrical look as possible.
Yeah, that. That was that. But the question that he asked me was if I wanted to do just a 3D tattoo, which is quite possible.
Google it.
[00:06:04] Speaker B: Okay, so. But it's still flat.
[00:06:06] Speaker C: And that's exactly what he wanted me to think about. It looks like it's not flat, right? But it is very flat. And there even. I even have a Pinterest board because I'm Spent four years looking at, like, how big I want them, how dark I want them, all of those things. And there's just so many options available. And he sent me home with that question. Think about, did I just want a 3D tattoo or did I want him to rebuild an actual nipple? And I knew pretty immediately that I wanted him to rebuild the nipple, but he would not take my answer right away. So the next appointment, he's, okay, what'd you come up with? And I told him my decision. And I told him why. Because at the time, this may be tmi, but we're all humans and adults here. At the time, I was still single. And I knew one day I wanted to get back to all of normalcy in life. And I wanted the option not to have to talk about my breast cancer.
[00:06:59] Speaker B: Right?
[00:07:00] Speaker C: I wanted things to be as normal and as expected as. As possible. And if I had just a 3D tattoo with nothing that someone might feel, what's that about? And I didn't want to have that conversation if I didn't want to. And he said, that's exactly what I wanted you to think about.
[00:07:18] Speaker B: So. Okay, so this brings me back to when I had a lump of fat on my back and I was getting surgery, and the surgeon asked me, do you want a cosmetic scar? Or I was like, what's the other option? Like a. A jagged open wound, like, so again, I'm like, okay, so then what would be the reason to get. Is. Was there a price difference between getting a 3D tattoo nipple versus getting a reconstructed nipple? And did you. Would you. What's the difference?
[00:07:48] Speaker C: For me, nothing. Because there was no difference. Cause at the time we were having this discussion in my. When in my double mastectomy phase, and I was under managed care, so I was dealing with. I was only dealing with co payments. Um, even now I have great insurance, thankfully. And so there was no. His question wasn't cost related. It was just giving me all the options.
[00:08:10] Speaker B: But why. Why would you opt for the 3D nipple? Because what you said, makes sense to me.
[00:08:16] Speaker C: There's a lot of women walking around with no nipples.
[00:08:18] Speaker B: Oh, because they might not want nipples to poke out.
[00:08:22] Speaker C: They might not want the nipples to poke out. And I can see that. And I remember having some discussions with some friends at the time and who those particular ladies may have had. Their nipples may protrude more and they're sick of having to deal with that. So they would opt for the not 3D. And that I did. I never had that experience.
And some women, it's not a thing. Just like some women just choose to be flat. It's just not a thing for them. So I think we have all these varying levels of this where you can decide what's most important to you. And thankfully he had all of those conversations with me. And until he presented it that way, I don't know that I really thought about it until we started having the conversations about. I learned about 3D tattoo nipples earlier on. I just thought that's what I had to do. I don't know if I knew that I could still have a regular looking nipple. But then he did share that that was an option. Later on, I was like, okay, which one do you want to do? And I was like, I want a regular nipple. Of course. You know, think about it, because even if that's still your decision, I want you to be clear as to why.
[00:09:26] Speaker B: Right.
[00:09:27] Speaker C: And that I knew. I was like, well, because one day I want. I wanted to have the option to not have to talk about it if I didn't want to in that moment.
[00:09:39] Speaker B: Yeah, makes sense.
[00:09:41] Speaker C: Yeah. That was a nipple conversation. Now, at this point, again, finding the bright side of it, it's been a little fun thinking about how big, how dark, how this and this. There's so many options out there in the world to help you make this decision. Whether it's prosthetic nipples to like, really, what does this look like? And know that. And I've. I've tried some of those. I'm like, no, that's too small. Or it. It. So I'm just grateful that I'm doing this now and not 30 years ago where these types of decisions, women weren't allowed to even have the option. Like once upon a time, grandmothers and great grandmothers, it was just automatic mastectomy. You don't need both. You had to take what they gave you. And there's still some of this now. We could still go. We still have a long way to go. But I'm so glad that I'm not doing it then. Like I. I can.
And that so much of it is covered by insurance to. Even though there will never be life for me before, I'll never go back to life before cancer. But now when I will get to the point where I can look in the mirror and be grateful, that. And I've always been in the point of gratitude, but not looking in the mirror. But I do feel like I'm close to the point where I can look in the mirror and recognize and see it as a. See it as a.
As evidence of the good battle scars, if that makes sense.
Yeah, I'm close. I'm almost there. One more month.
One more month. My last surgery is a month from now.
[00:11:18] Speaker B: Okay. And. Okay. So deep flat two questions that I have.
There's a difference between chemotherapy and radiation.
[00:11:28] Speaker C: Correct. Chemotherapy is the medication that you take typically via a port. Some people get it right through an iv. I had my first chemotherapy treatment through IV because they could not schedule the surgery to put my port in or the procedure. But typically through a port. And some people take all their chemo treatments right in a chemo center or in the treatment room. I know when my dad had cancer, some of his chemo, he had to take it sitting in the treatment room five or six hours at a time. And then the second part of his chemo was on a pump that he wore for three days after so he could still come home, go to work, all that. But he had just take the chemo in the pump, and mine was through a port for six months. And then radiation, while I did not have radiation, is the daily treatment where they. You go in and they radiate the area to kill any of the potential cells that may be present. I had my lumpectomy. They take the lump out, the cancer tumor out, and some tissue around the tumor. And if your margins are clear, meaning that the tissue around the tumor that they took are cancer free, then you have clear margins. That's a good thing. That means they got it all. And at the same time, I had my lymph nodes tested and there was no. It had not spread to my lymph nodes, which is an indicator that it's likely not anywhere else in my body. There still very much could have been one road cancer cell that broke off and traveling around. I was looking for a home. So even though two weeks from my diagnosis to my surgery, there was no evidence of lymph, no involvement, my margins were clear. So it seems like everything was okay. I still had to have six months of chemo to do the best we could just in case there was a road cancer cell traveling through my body. And then at the end of the process, when I had my double mastectomy and they checked, they were able to remove all of my breast tissue and check everything. There were no signs of any cancer cells there. It's just the next indicator, as best as they can indicate that there's no other cancer in my body. Now, what I know for sure is, yes, I'm four years cancer free. As what I know is, that's as best as they can tell me.
[00:13:49] Speaker B: Right.
[00:13:50] Speaker C: And while I don't dwell on that, I still recognize that as the reality. There's no 100% guarantee that even when I hit five years, that 10 years from now it's not going to come back. Even though triple negative, typically you don't see it after. Statistics are really good. I mean, five years, they're really good. But it's still a number. There's still that chance.
[00:14:12] Speaker B: Okay, so triple negative means that for breast cancer, there was no evidence that this was going to happen. Right. You cannot foresee that this was happening. So all the typical markers for someone being predisposed to breast cancer, not there. And so this is. What the hell is this?
[00:14:33] Speaker C: I believe so, yes. What I can tell you for sure, it's the worst of the worst to get.
[00:14:38] Speaker B: Okay.
[00:14:40] Speaker C: And I'm seeing it more. And I don't know if I'm seeing it more because those are the spaces that I'm in. I don't think that's the case because I'm seeing younger women with triple negative diagnosis outside of my regular breast cancer space. Like some reality TV people that are below that age range and a breast cancer diagnosed with no family history, and they've got triple negative. And it's just. It's baffling to me. And everyone that I've seen that has used their platform to talk about it, they say the same thing, that it's becoming more like they're seeing more. They're seeing it more. They're seeing the instances of triple negative in black women.
They're seeing those numbers rise. And it's like, why is that happening?
[00:15:26] Speaker B: Question is deep flat. When you say deep flap surgery. I was assuming you were talking about because of the breast tissue.
[00:15:36] Speaker C: Because.
[00:15:36] Speaker B: But is it because of where they're pulling the fat from?
[00:15:40] Speaker C: It's where they're pulling the fat from. And they can pull it from your abdomen. Definitely. This was not my story, but there's women that maybe don't have enough abdominal fat that they can pull it from maybe their thigh or their back. I had plenty to work with in my abdomen.
[00:15:56] Speaker B: Yes. Oh, yes.
[00:15:58] Speaker C: But I told him, I said, if you need any of my thighs, please feel free to take it up. There's a few different areas where they're able to pull fat to recreate the breast. But I mean, that first place that they want to take it from is the abdominal area. There's definitely women in some of my reconstruction Facebook groups that have wanted to have deep flat, but they don't have enough body fat to do. That's another side of it. They're wanting that not so much for the free gift of a tummy tuck, but to have more natural feeling breasts. Something on that end of the spectrum is preventing them from doing it. They don't have enough body fat. It's just so many things to think about during this journey of what is available from a medical standpoint but still may not be an option for you for any number of reasons. Because initially a deep flat wasn't an option for me because I was too overweight and that didn't make sense to me. You're going to take the fat, so why can't we do this? It was a matter of being healthy enough to have the surgery, which, like just take a second to talk about that. The D flap surgery in the best scenario is an 8 to 10 hour surgery. That's a long time to be on the table. So I went in with my expectation and my family's expectation that I'd be out in 10 hours or so. My surgery ended up being 22 hours unexpectedly, just because Winnie could got in there, uncovered some things that he wasn't expecting, nothing life threatening or whatever. So I won't bore you with all those details, but just some things that took much longer to get through the surgery. And fortunately, because I had lost a significant amount of weight, he didn't have to make the choice whether or not to fix things or to skip them because he needed to bring me off anesthesia. I would absolutely recommend all your doctors with cancer or not be comfortable with all of your providers. But I'm very glad that I had the relationship and the rapport with my plastic surgeon and that he knew me well enough to know that I would have wanted him to keep going. Because while it was very hard on my family to wait Almost a full 24 hours for me to come out of surgery, the things that he ran into, he knew me enough to know that I would want him to continue. And I'm very glad he did. But yeah. Gonna be a little sad when I don't have to see him anymore. It's been a long ride with him and he's done right by me and I appreciate him very much.
[00:18:32] Speaker B: And then tell me if this is tmi, but the last surgery you have to get.
[00:18:38] Speaker C: Yeah. So when you have particularly a deep flap surgery, and sometimes with a mastectomy as well, you might have to go in for touch ups because when the swelling goes down and everything heals, there may be some symmetry issues that they can correct. A lot of times with deep flap, you might get what's called a dog ear. If you imagine a full muffin top, your surgery might resolve 90% of a muffin top, but you still have a little bit of fat tissue hanging off to one side, but you're completely free of a muffin top everywhere else. Your kind of revision surgeries would resolve things like that. I ended up with a little bit of a dog flap that if I didn't have to go back in for my nipples, I probably would live with the dog flap. Maybe not, because I've gone back and forth. Oh, it's not so bad. But then I was like, I've come this far. I want it right.
[00:19:28] Speaker B: If you're gonna have to go back.
[00:19:29] Speaker C: And go under anyone, especially having lost all this weight and being able to just have this whole life experience that I wanted. Right. So, yeah. And I feel like, you know, I've been to a 22 hour surgery. What's a three hour surgery? It's nothing. And it's been so many surgeries with this whole cancer diagnosis. I'm. When they will be back for surgery, I'm like, yeah, okay, more anesthesia. Just. They said come back for some 100. Just put me to sleep. And I don't have to come back. Just go, yeah.
[00:19:54] Speaker B: All right, my dear, thank you.
[00:19:56] Speaker C: You're welcome. I so appreciate this community that you have because I'm really glad to be able to be a support to women in this intimate of a space where a woman I probably would have even within the group, I may never ever meet her in person or have a one on one conversation. But for us to be able to know as much about our lives, to be able to come back to this group with this, like, common thread that we have and ask for support in all the other areas of our. So appreciate that. And it's like when I found the original group, I would have never known that this would have been the type of support that I could get. And to be of support for someone else. So thank you.
[00:20:49] Speaker A: Thanks for listening To Start to Finish Motherhood with Aisha if you want to keep the conversation going, follow Start to Finish Motherhood on Instagram or email
[email protected] if you love this episode, please share it with anyone who's thinking of becoming a single mother by choice, anyone who's already parenting as a single mother by choice and just looking for advice on navigating it all, or a friend or family member who's looking to support someone else's single mother by choice journey. Until next time. Bye now.
