I was looking forward to seeing this new 3D imaging camera Dr. B would use to take pictures of my boobs. When I mentioned my next visit with Dr. B, to Dr. C she had described the camera as, “a state-of-the-art-fancy.” My curiosity for the camera by far surpassed my eagerness to get a boob job.
Dr. B’s office, for his private practice, is shared with another established plastic surgeon. His office IS NOT like any other doctor’s office I’ve ever been to before, that’s for sure. There are two waiting areas when you enter the office. Both areas are outfitted with brown leather couches with glamorous black and white photographs of women’s idyllic body parts decorating the walls. The whole office is surrounded with pockets of low lighting, which I always find, is best to hide flawed make up applications. If I didn’t know any better, I would have mistaken this office to be a spa where people walk around in bathrobes with towels on their head to the steam room, all day long.
The assistant called my name to lead me into a familiar looking medical examination room, except the exam table was in an upright chair-like position than its usual bed position. I put on the usual hospital gown I noticed a white bathrobe hanging on the door. Maybe there is a steam room! I sat myself onto the exam table after grabbing one of the three pristine displayed lifestyle magazines laid on the table next to me. Right by the sink, in an enclosed glass box, was a display of different types of implants. Although tempted to check them out, I thought I should wait for Dr. B to open the display box.
Dr. B came in with his usual pleasant disposition and we began reviewing what I needed done. I reminded him we were using the 3D camera for breast photos today. Before he started the usual examination on me, he announced, “Now, just so we’re clear! We are not doing anything to this breast. Right? This is a perfectly fine breast. Right? We’re not touching it. Right?!!” I gave him an eye roll and told him, yes, we had already discussed this in our last appointment. We both chuckled and I took the opportunity to tell him how Landau, the radiology tech who took my ultrasound and mammogram, raved about the mound he had started for my breast reconstruction. He seemed pleased.
To begin, Dr. B explained again how he felt the amount I have in my expander was the correct volume. Since my recent weight gain I was actually feeling the same way but I suspected the extra pounds was throwing me off in determining if my boobs were even. I told him I had gained from 15 to 20 pounds since chemo had started and if this would affect any breast changes with the volume or shape of the expander. The weight gain during chemo apparently was normal and would not be an issue with breast volume. However, there would be long wait times before the actual surgery. If I was uncomfortable he was happy for me to revisit and re-photograph my breasts after I shed some pounds back to my normal weight.
I also pointed out to him, I had recently noticed if I raised my arm over my head, my expander seemed to be aligned correctly with my other breast, which led me to believe the expander was inserted while my arm was still over my head on the surgery table. My friend, Amanda, who had worked on a breast augmentation documentary, warned me to make sure the surgery team sat me up while aligning my implant. Dr. B assured me he does this ALWAYS, even when he had inserted my expander. But then why was my expander not exactly where it was suppose to be? He explained because it was an expander, it’s not full when it’s initially inserted, so it’s hard to tell if it will align properly later on. Ah, okay.
We also took this opportunity to discussed the reconstruction of my nipple. Dr. B asked me how I felt about using part of the one I already have. Clutching my remaining breast I told him I liked my remaining breast just fine the way it was. As I have already lost partial feeling on my chest from the mastectomy I wasn’t ready to lose more sensation from my other breast. He explained a procedure where he would take half my remaining nipple. Imagine slicing down from the top of a cake then folding half the cake over, but this would be half my nipple of my breast folded over, while using the other half to graft in place on my new breast. If you need a more detailed account of this procedure, please google it because I’m just as woozy having to write about this, as having heard Dr. B explain it to me in detail. Not knowing all the medical terms he was using, I got the gist of what Dr. B needed to do to make a nipple. I told him the procedure kind of grossed me out and asked what the alternative would be. He explained it would involve taking skin from my labia and then forming it to nipple size and grafting it onto my breast. When he asked how I felt about this latter procedure I told him it grossed me out even more than the first! He left me with those two options to ponder for the next few months.
I turned to the glass box by the sink to ask if those were the implants. He pulled them out to show me. There are different textured implants to use depending on where he places them. Smooth textured implants he places on top of the muscle under breast tissue. Tacky textured implants he places under the muscle, I would probably be a candidate for these implants. I feel the round silicone mound which seems denser than breast tissue and then I feel the saline implant. The saline literally feels like a water balloon. It pissed me off knowing this was my only alternative to a silicone implant. Tossing the saline mound back to Dr. B, I tell him it’s nothing but a balloon. He nodded, acknowledged my concern by giving me a half eye-roll, which assured me I probably wouldn’t be getting any saline implant. I asked him how the silicone would leak, if it does, and how my chest would be cleaned if it ever happened. Dr. B pulled out a sample silicone implant which was sliced in half to show me the gel-like interior which was sticky but did not really ooze, unlike saline which when leaked would just be absorbed through the body. I asked if he ever used those implants which were being recalled all over the news. He was quick to explained those were implants from a company in France whose product was never approved here in Canada. The recall was basically for anyone who may have had breast surgery in Europe. It was a good conversation to have with him, as it helped ease my mind about the safety of breast implants.
Dr. B excused himself to grab the camera but returned with his Nikon point-and-shoot. The same camera he used last June after he measured me for my expander. I stopped him before the lens cap came off and told him I thought we were doing the 3D images. He assured me we would be doing those photographs but he still needed some more with the point-and-shoot. While he sat 3 feet away from me, I, with my hospital gown off, stood facing him. Then I faced 45 degrees from him, and then 90 degrees from him, twice – right and left, while he snapped pictures of my chest and torso. When we finished, I quickly put my hospital gown back on. Dr. B. asked if I was ready before he opened the door and we walked down the hallway to the 3D camera room.
“Nice offices, by the way!” I tell Dr. B after passing by the lavishly decorated offices propagated through their successful elective surgeries. We arrived to the small room which was bare except for a grand 4 foot by 4 foot camera/machine on the far wall and a computer on a small desk at the adjacent wall. I felt special and privileged as Dr. B told me, their offices, so far, was the only one in Canada which used this the new technology. A marker on the floor indicated where I would be standing. I disrobed once more. Dr. B positioned my arms parallel to the ground as I face this machine in front of me. I stand straight. There would be a huge flash. I choose to shut my eyes. Dr. B snapped the picture, massive flash goes off and we are done. We waited for the image to upload before we saw the black and white 3D image of my chest and torso on the screen. Dr. B would now be able to maneuver my image 360 degrees to determine which points to make incisions, where to place the implant, along with deciding on volume amounts. It was all very sci-fi.
I returned to the other exam room to get dressed before going to the front desk to ask about surgery dates. As I walked back into the reception area a couple of men were sitting on the couches waiting. I automatically assumed they were waiting for their spouses or girlfriends. As the days went by, I thought to myself, they were probably there for themselves just as I had been. Dr. B’s waiting room is a far cry from the Breast Centres at WCH or PMH. Patients in this waiting room, for the most part, actually WANT to be here.