My breast reconstruction

I’ve been keen to get a breast reconstruction since I had my mastectomy in February 2019, but the global pandemic slowed things down a bit. I was officially referred by my breast surgeon in Feb 2020 as I had to wait a year after the original surgery, and then received an initial appointment with the plastic surgeon in November that year.

My breast care nurse had warned me that reconstruction was quite a ‘project’, and not something you undertake lightly. Part of that was that the centre of excellence for the south east is in East Grinstead, which is a 90 minute drive from where I live on the south coast. I would need to go there for various appointments before and after surgery, which was a huge time commitment. It also takes a while to recover afterwards, which as I’m self employed is something I had to consider. However, I’m lucky that I don’t do a physical job and can even work from my bed, so really wanted to go for it at the earliest opportunity.

Meeting my surgeon

I was over the moon to see that my appointment was with Andrew Mellington who’d been recommended by a friend. To say he’s clever is an understatement, and his CV is outstanding. Too much to mention here but here’s a summary if you’re interested! The main thing for me was that he’s hugely experienced in breast reconstruction, particularly the DIEP technique.

There are many options for creating a new boob, from an implant to using another part of your body for the breast tissue. There are pros and cons for each option. Implants aren’t ideal as they need to be replaced, don’t always look natural and don’t grow and shrink if you gain or lose weight.

Using another part of the body is better, I think, and in my case Mr M said he could hopefully use the DIEP technique, which is basically where you have a big tummy tuck and they use that for your boob. YES, I’D HAVE A FLAT TUMMY AS WELL AS A NEW BOOB! BONUS!

This diagram shows how the lower part of the abdomen is cut out and then moved up to the chest, connecting the blood vessels to keep the new boob ‘alive’.

Major surgery

Mr Mellington went through the procedure and also all the risks. The list of potential complications is huge, but most are unlikely. The new boob can die and have to be removed. He had to be sure it would work for me as firstly you need a big enough tummy to create the boob. I have surprisingly large boobs, just because they don’t look big in clothes, but are in fact an F cup. Mr M wasn’t sure if I’d have enough tummy but said he’d do the best he could with what I had! It’s the one time in my life when I was grateful for a bit of flab, and once he’d had a look at me he thought it could work.

I had to have a scan to ensure I had a decent blood supply in my lower abdomen, because they use the big blood vessels down there to plumb into the chest. It’s so clever what they do!

I was also told about the recovery, which I’d already heard about in a Zoom call with the specialist nurses over there.

He also went through future phases too, as this operation is just the start of the reconstruction journey. He would try for as much volume as possible for stage 1, and then stage 2 could be an uplift on my ‘normal’ side, an increase or decrease in size and/or a nipple reconstruction and/or tattoo. It would be up to me.

Because you have two wound sites, and the tummy surgery is from hip to hip, it takes a long time to recover. You also have to wear control pants night and day for 6 weeks, as well as a supportive sports bra. You’re not even meant to dust for 3 weeks, let alone drive or do anything strenuous. It really is a big decision to have the operation, but I was really keen still, so he put me on the waiting list.

Before I left I went for my first ever topless photo session, with the medical photographer. It was quite weird, standing there half naked for the ‘before’ shots – I’m not quite Samantha Fox, sadly!

I had no idea how long I’d then need to wait for the operation, and then in March 2021 we went into lockdown so I’d almost stopped thinking about it. It would happen when it happened, I wasn’t desperate, so was quite relaxed about waiting for the call.

A new boob for my birthday!

Then in August I had a call to say that they could perform the operation in October! I was over the moon! It was just before my birthday, and would be the best present ever.

There was a slight problem though, as I’d lost nearly a stone since my previous appointment. Knowing that I’d need as much tummy fat as possible, and the nurse had said to me that it’s a once-in-a-lifetime surgery, I did what anyone would do. I ate for England! Which wasn’t hard for me, and I managed to regain most of the weight in the following six weeks. I figured that I’d lose it again afterwards and it would be worth it.

I had more appointments over at East Grinstead, for a pre-op nurse assessment, another chat with Mr Mellington and a Zoom call with an anaesthetist.

I had to go into isolation two weeks before the big day, to ensure I didn’t get covid, and had yet another drive over to East Grinstead for a covid test. All was well and the big day finally arrived.

We made it through the rain…

I’d been paranoid that something would go wrong and the operation would have to be cancelled. So when we finally got in Lee’s van at 5.45am on October 5th I finally relaxed. Mother nature had other ideas though… It had been tipping it down with rain overnight and the closer we got to East Grinstead the worse it became. Roads were flooded and oncoming traffic was flashing us to warn us. I had started driving but let Lee take over as visibility was really bad as well as all the surface water. As we went through increasingly large puddles I just kept my eyes shut and hoped for the best. Thank goodness, we eventually made it! As it turned out, even the major routes were affected and the M23 was shut when Lee tried a different route for his journey home.

Surgery prep

As the surgery would take all day, there were no worries about where I was on the list. There was no ‘list’, just me, for my surgery team. I donned my hospital gown and those Godawful support stockings, which I was supposed to wear for the next 3 weeks.

There were three surgeons performing my operation, and Mr Mellington explained to the others about my situation and how he would try and harvest as much of my tummy as possible for my boob.

He marked up my body with a Sharpie and listened to my tummy to work out where the blood flow was, drawing spots to show where they were.

Then at around 8.30am I walked into the operating theatre. I settled on the table and I think the last thing I remember was looking at the clock which said 9am, before I was put to sleep.

Hot and helpless!

It’s always quite bizarre when you wake up from surgery as it seems to happen an instant after you’ve gone to sleep. In my case, it was around 6.30pm, over nine hours later!

I immediately took a peek at my chest and was overjoyed to see two bumps there instead of one!

But I was hot. Boy, was I hot! It turns out they need to keep the boob graft warm to have the best chance of success, so I was wrapped in blankets, foil and a special quilt on my chest. Oh, and an electric blanket. On top of all that my body chose to suddenly have a spate of hot flushes which were just awful! I had an oxygen tube up my nostrils too, which wasn’t very comfortable.

I was taken to the ward and they turned down the blanket a bit, to make it a bit more comfortable. I couldn’t move, mainly because my tummy wouldn’t let me. You don’t realise how much you use your stomach muscles, and although he hadn’t cut through mine, the trauma of surgery meant that they wouldn’t work properly for weeks or even months.

The first night

I knew what to expect during that first night, but it was still hard. I hadn’t realised how hot I’d be or that the nurses didn’t want me to drink too much water. I usually drink pints of the stuff but had to limit it to small sips for the first 24 hours.

My new boob was checked every 30 minutes – and they would have needed to wake me if I’d been asleep, which I wasn’t. I couldn’t sleep at all so ended up reading and listening to podcasts. They check that the boob is warm and the blood is flowing, using a doppler like you would use to detect a baby’s heartbeat. I had two strong ‘heartbeats’ in my new boob! If anything wasn’t happening like it should then they’d whip you back into theatre to sort it out.

I also had my blood pressure checked, which was a bit low, and my temperature, but luckily the BP picked up after a few hours.

By morning I was starving, having not eaten anything since teatime the night before the op. The hospital breakfast of scrambled eggs and mushrooms was delicious!

Care package

What was really lovely was that the nurses gave me a care package from the Restore charity. They were set up in 2010 by ex patients of Queen Victoria Hospital in East Grinstead and run ‘show and tell’ sessions for potential reconstruction patients. For someone considering this type of surgery it’s so helpful to see what the results can look like, because they’re not picture-perfect.

Although I’d packed for every eventuality, the care package included a tote bag for my drains (I had pipes coming out of my tummy and boob to drain away the fluid which collects there), a fan (yay! to cool myself!), earplugs, an eye mask and various other things. The best bit was a beautiful handmade stuffed cushion in the shape of a heart, which I used to prop up my new boob. It just needed that extra bit of support in the bed.

I couldn’t actually reach my suitcase overnight and didn’t want to keep troubling the nurses so having those bits and bobs to hand was incredibly useful.

Day 1

I did snooze a bit on Day 1 and was very sore. A nurse gave me a bed bath and helped me put underwear on. I was so helpless and couldn’t do anything for myself! She then had to help me de-robe when I needed the loo, which was an expedition and utterly exhausting.

There was a mirror in the bathroom so I took a peek at my wounds. They were only covered with tape so I could see my new boob and tummy clearly, and I loved what I saw. Like the lady in the next bed said later, you feel a bit like the Bride of Frankenstein.

I seemed to be less mobile than the other two ladies in my bay, who’d had the same procedure. I was just so tired though. Mr Mellington came to see me and said I could go home the next day if I wanted to, which was great.

I saw a physio who gave me a list of exercises I should be doing, to regain movement in my arms etc.

Although I wasn’t in a huge amount of pain, if I laughed or coughed it was agony! And standing upright was impossible. I could only stoop, because my tummy was so tight. If you imagine cutting a huge chunk out of something and then sewing it back together, it will take time for it to be straight again.

I was still being checked every hour, night and day, so at least if I was at home then I could rest properly, in theory. I cannot tell you what angels the nurses are at QVH. The care was like nothing I’d experienced before, from the most experienced ones to another who was newly-qualified – they were all just brilliant.

Day 2

Having been told I could go home, when a doctor did the rounds she wasn’t happy with how much fluid was still draining from me so said I’d have to stay in another night. I was gutted! Luckily one of the surgeons came round a little while later and said I was fine to go, which was a relief.

Packing my bag was a mammoth effort, and actually hurt my back from leaning over for too long. I then sat in the day room and Lee came to collect me after a hospital lunch of lentil cottage pie followed by sponge and custard!

I didn’t actually go home, but to my Mum’s flat which I thought would be better for recovery. There were no stairs to worry about and I’d be less likely to feel compelled to look after the family. I wouldn’t have been able to, physically, but it would have frustrated me if I’d wanted to tidy up after them.

But, much as I was glad to be at my Mum’s, it was no picnic. I had a really bad night as I couldn’t get comfortable. I had to prop myself up on pillows, have another under my knees as I couldn’t lay ramrod straight, and could only sleep on my back. It really wasn’t ideal, being so tired.

Recovery

From then on, I got a teeny bit better every day. It was frustratingly slow, but on day 3 I walked about 30 yards to the seafront and back. The next day slightly further, to the local cafe on the prom where I sat with Mum and had a drink.

I had to change my belly button dressing every few days and returned to East Grinstead after a week for a professional dressing change. I then had to change the tape around my other wounds every week until I saw the surgeon at my follow-up. I wasn’t allowed a bath, only a shower but being careful not to get the tapes too wet.

I went home properly after the weekend, when everyone would be out at work and school so I’d have the house to myself. It was actually more comfy to be sitting in my office chair rather than on the sofa, so I did some bits of work.

After 10 days we even managed a trip to London to see Mary Poppins! I’d booked it months before I knew about the surgery date and didn’t want to miss it. We had a lovely day and although I walked really slowly, I did over 13,000 steps! We parked right next to Leicester Square so I didn’t have to deal with public transport.

I was back driving after about 4 weeks. My stomach had recovered enough to feel comfortable and able to do an emergency stop. I did some light jogging after 5 weeks, but am so unfit so didn’t go far. But I was well enough to walk for an hour a day.

Results

So, am I happy with the results? HELL, YEAH!

My new boob isn’t quite as big as the normal one but you really can’t tell in a bra. My tummy is a revelation – I’ve lost my wobbly post-childbirth stomach and now have a firm one again! The muffin has gone!

My relocated belly button is like it was as a child – a cute little ‘flattie’ – I bloody love it. I show it off all the time, although I’m sure that most people aren’t as impressed with it as I am.

When I had my 6 week check with the amazing Mr Mellington he made an appt for phase two in spring 2022. We will see how the new one settles and then decide together what to do next.

So for now it’s all over and after 7 weeks I feel 95% normal. I would struggle to do too many sit-ups and can’t run a marathon, but it’s nearly winter and I’m being a bit lazy about exercise at the moment. I’ll get my act together in the new year like everyone else does. As long as I do my daily walk by the sea and get some fresh air then I’m happy.

Would I recommend it to others in the same position? Yes, but with caveats. It’s a hell of a big operation and the recovery really isn’t easy. It’s not for everyone, that’s for sure. If you get the chance then speak to ladies who’ve been through it, do some research, check out the Restore charity and then make up your mind.

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