My bellybutton is too high??? First Plastic Surgery Consult

02/08/17
9 days after my surgical oncology consultation, I went to the Plastic Surgery office for my first meeting with Dr. O and his nurse.  

Another pink gown

This was my first time in a plastic surgery office...and very unlike any doctor's office I've been in before!  It is a nice facility and every time I go, there is some little take-home "gift". This first visit I was given paperwork to fill out (just keep your insurance cards in the front of your wallet and a pen handy...there is always paperwork!) along with a pink pen and a pink chapstick (both with their logo).  

Shortly after arriving, I was escorted back to an exam room to wait.  They gave me a soft, knit patient gown to wear....pink, of course.  I was told to keep my jeans on and just take off my top and bra.  

The room looked like any other exam room except one entire wall was a mirror. A big wall mirror...like in a gym.  It also came with the standard fluorescent lighting....not exactly flattering!  Considering all of the reasons folks come to a plastic surgeon, a big mirror makes sense, but it certainly wasn't appealing to see myself in it.  

Once Dr. O arrived, he began the visit just by going over my recent history to find out what I already knew and what I didn't.  I knew he was an expert with the natural tissue reconstruction and I was hoping that he would tell me that I had enough belly fat to make a DIEP Flap procedure possible.  Something I did not know from my reading and was pleasantly surprised to hear:  During Stage 2, the scar revision and "make it pretty" phase, there is the opportunity for fat grafting...which could add an additional half-cup size if needed!  This was reassuring to me because I was worried about being too small with the natural tissue versus implants.  I am currently a big B-small C.  I definitely don't want to be much smaller.

After going over the DIEP Flap procedure, Dr. O had me stand at an angle in front of the wall mirror while he sat on a rolling stool in front of me.  Yikes!  He took measurements and called out the numbers while the nurse recorded them on her laptop.  

This is when things got amusing...at least to me.  I'm standing there half-naked and looking quite pale in that lighting that shows every flaw. All the while, Dr. O is looking very serious and pinching and pulling.  I am by no means thin and feel that I have plenty of belly fat to spare.  It was amusing to me that as Dr. O is pulling handfuls of my tissue, he says: "Well, you don't really have much fat here." My response:  "You're kidding, right?" He cocks his head to one side and says: "The only thing is.....well, did you know your bellybutton is a little high for you?"  Me: Ummmm.....nope.  Then, I looked over in the mirror and thought, "Well, rats, it IS high!. How'd I never see that before??"  Ugh.  

They are perfectionist by nature, I think, and artists whose canvas is the human body.

I've joked now that if you didn't have body issues before your visit to your plastic surgeon, you definitely will after!!  

Anyway....he was a really nice man and I felt quite positive after the visit.  He told me that I have enough belly tissue to create at least my current size or maybe a little bit smaller.  But, I will have the fat grafting option at Stage 2 if I don't feel that I am big enough.  He performed a Doppler of my abdomen to look for the vessels he will need for the reconstruction.  All in all, he said I was a good candidate for the DIEP Flap and he thinks I will be happy with the outcome. This was great news!

Image from www.uptodate.com

Here's how it is supposed to go....

Stage 1:  Reconstruction using my abdominal tissue.  I will have a hip-to-hip incision and a "lollipop" incision on each breast, plus whatever skin grafting incisions are needed.  This will be done immediately following my mastectomy by Dr. K.  Dr. O said to plan on at least 10 hours in the OR because of the delicate nature of microvascular surgery.  I will stay overnight for 3-4 nights.  I will most likely go home with 3-4 JP Drains that will stay in for 2-3 weeks.  I will have to be off of work for 6 weeks!

Stage 2: Scar revision, liposuction, shaping, fat grafting, and nipple construction.  This will take place approximately 3 months after recovery from Stage 1.  This will be day surgery.

Stage 3: Tattooing of the new nipple and areola.  This is an in-office procedure that should take place 3 months after Stage 2.

The office called me later that same day with a surgery date.....I was put on the schedule for Monday, March 6, 2017!  Good news:  I have a surgery date.  Odd news:  It happens to be on my 41st birthday!  

Those of you who have been following along already know what happened next....I spent more than a week dealing with an insurance mistake and had my surgery cancelled.  In the end, I got it taken care of and even got March 6th back.  You can read that post here. 

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K

02/08/17  Consultation with Plastic Surgeon