Difference Between Breast AUGMENTATION & Breast RECONSTRUCTION – C’mon People, It’s Not a Free Boob Job!

So you get lots of responses when you make a decision that some may consider life changing, such as a prophylactic bi-lateral mastectomy.  For me, my current breast size was somewhere between a an a-cup and non-existent – so the response I got from one person was “you’re finally going to have real sized boobs…” I’m sorry, do what???  Did you just hear what I said, I’m doing this because there’s a chance my breasts, at some point in time during my life, could potential develop cancer in the tissue, which could in turn potentially kill me.  I think I just stood there trying to say all these other things hoping this person would understand what they’d said, but that never happened.  Apparently this isn’t a one-off kinda thing, it appears it’s a common occurrence.

A friend of mine, who has metastatic breast cancer had her double mastectomy two days before I had mine, some of her friends were just as confused as to what exactly the difference was – and my surgery was a bit different than hers.  We got to texting back and forth about it and they just couldn’t understand the difference – so here we go, high-level, because I am NOT a doctor or an expert – I am also approaching this comparing a prophylactic procedure to breast augmentation.

For starters, it wasn’t done because we wanted to enhance the breasts we already have, we made the decision because either a genetic test or family history led our oncology teams to believe we were high-risk for developing breast cancer at some point during our lives.  We did this because there was a chance our life could be on the line.  We did this because there was a chance we’d have to have chemo (again), or radiation, or some other treatment, and ultimately, we’d end up having the same procedure done and it wouldn’t be nearly as easy after being diagnosed.  So for me, I did it in order to stay alive, not to have a more enhanced chest – it wasn’t for appearance sake.

All of our breast tissue is removed – let me say that one more time – ALL of our breast tissue is removed.  That’s right, a hollow pocket, skin and muscle remain – for me, that space was filled by an expander (this is different than some women diagnosed with breast cancer – some have to wait for the reconstruction process to begin).  During the enhancement process, the implant is used in addition to the tissue, thereby making a more natural appearance.  For me, I walked out of the hospital with barely filled expanders, drains coiled up that you could see, not implants designed to make my breast size look larger.  I felt like I’d gone a couple rounds in a ring – ribs, chest, sternum, back and under arms all sore.  The surgery was no joke – comparatively different and more simple than my debulking for ovarian cancer, but still a no joke procedure!

In some cases it takes multiple procedures, it’s not a one and done kind of thing. That’s right, we go back again, and sometimes again…I’m scheduled for two procedures.  My initial was to remove all breast tissue and place expanders, the second will be placing implants and fat grafting to try and fill the areas where tissue may have been to help with rippling and making them appear more natural.  Where they’re going to try and get that from has yet to be determined.

Yeah, we’re not guaranteed to have perfectly perky looking breasts, as one hopes when they have breast augmentation.  We’re promised a lower chance of being diagnosed with breast cancer in our lives.  We’re promised they’re going to do the best they can through reconstruction to have as natural of looking breasts as possible based on what the surgeons are left with once all of the tissue is removed.  I have all of the confidence in the world with my plastic surgeon, she comes highly recommended, she’s one of the best, she takes time to listen to me, and she just might be one of my training partners for Pedal the Cause next year – she’s taken the time to try and connect with with me on a higher level than just a patient that walked in the door.

I have no feeling in my breasts at this point in time – I’m not sure that I will again and if I do, how long that will take.  So I’m numb…it’s like my expanders and skin are there, but that’s all I can really tell you about the whole thing.  When the tissue is removed, so are a lot of nerves, leaving it more difficult for regeneration.  But, it’s really the least of my worries at this point – so I can’t feel my boobs, okay, whatever.

Now, for those of you reading this that have been diagnosed with breast cancer, I know what you’re possibly thinking – you forgot one of the main differences, but that’s also one of the differences from prophylactic and a mastectomy due to having breast cancer – I was able to have skin sparing and nipple sparing, meaning my incisions are under my breast – the full “half-moon” under each breast, but it’s not across the middle, removing my nipples.  For those of you reading this that thought this was a free boob job…let that sink in for just a minute.

So although I’ll end up with perky, larger than before breasts, it’s not a guarantee as to what they’ll look like.  It’s not as simple as enhancing your breasts – I didn’t go home the same day, I had to stay over for observation, we all do.  I have no breast tissue remaining and will more than likely only have a thin layer of skin between the implant, not tissue to make it as natural as possible, but we’re hoping to suck some fat from somewhere.  But ya know what was the same – it was both our choice.  This time, it was my choice…just remember, it’s not a “free boob job,” please don’t compare our procedures to yours, just like I won’t compare my procedure to women who have been diagnosed with breast cancer.


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