Monday, October 27, 2008

Aureolas—Ouch

This was a more complicated surgery and recovery than I anticipated, but naturally I was still up and running as soon as we got home from the hospy. For reasons psychologically unexplored by me, I seem to be unable to sit still post-op. Odd, considering that on a normal night I'm perfectly content to chill on the couch. Especially when Gossip Girl is on. What a surgery day treat. Like candy, that show. And I devoured the first book in less than 24 hours this weekend. Anyway. Arrived at hospy 8:30 a.m., only to have them running an hour late. It's so utterly bizarre to me that I have more anxiety on a normal day than I do pre-surgery. Think that's a good topic for Dr. L. this week, no?

When Plastic Surgeon came in to prep me, he brought a worn, plastic box stocked with his tools of the trade: washers from Home Depot and Sharpies.

Adding the aureolas—which they spelled areola on all the official papers—is a skin graft. They excise the skin from just above your pubis. As in, right above your hairline. You can probably guess where I'm going with this.

He began by drawing in the skin graft area, a horizontal, inch-deep, three+-inch wide, half-moon shape. (JKD, I need help with compound modifiers, FYI.) He takes the skin, then stitches up the remaining skin together in a modified tummy tuck fashion. (Unfortunately, this area is below the chemo-baby roll of flab.)

"You'd better not give me hairy nipples Doc," I said. That really can happen. Can you even imagine?

"Well, you've kind of thrown me off by shaving."

"Oh," I said, "I thought that would help." I don't know why that came out, suddenly I'm modest? I'd debated on whether to shave or not; in the end vanity won out as usual.

"My friend joked the other day that if I really wanted to revolutionize the way people viewed things I should start adding nipples to butt cheeks."

"Eww." Plastic Surgeon has an even drier sense of humor than me.

He then proceeded to draw in different nipple sizes on the girls. I told him at this point, the less skin he took the better, and I trusted his judgement on size. Plus, hawk-eyed mom was assesing the size as well. I had no mirror and was merely looking down. He drew and drew, editing in his beneficial perfectionist manner. Moving them to the left and right, up and down. Mom just now reminded me that once we decided to go smaller, he switched out the washer for a totally ghetto, used roll of surgical tape. Love it—a complete dichotomy of high and low culture, perfect for your's truly.

Once the nip-size was decided, he then traced them within the graft space. So you can imagine what a considerable amount of flesh we are talking about from Down There. Laura had told me that the excision site would be really sore and tender because the nerve endings were exposed, so I sort of knew that would be the worst part of recovery. Remember, I have little to no sensation on the girls. Thus, no real pain at the site of the placement. So we have the skin graft, the shaping of the actual nipples—"like little tents of skin," he described—and the liposuction of the flanks. And this is the unfortunate part for me—the wound dressings are nearly as extensive for this surgery as they were for the mastectomy. Because you can imagine the precision and delicacy of the nipple area. Oh, I nearly forgot that he also did a little corrective procedure on the bottom of the left boob. So we're talking four separate procedures in one shot today. He really took his time, in a good way; it lasted nearly three hours.

What this means is seven days of wound dressings that are in tube-top formation, not to mention the one under the underwear. And get this—the bandages on the actual aureolas are sewn onto my skin. I couldn't even believe. Have you ever even heard of this? I was blown away. Anywho, it's sponge-bath time again for seven days. Sucky for many reasons, mostly because this week I have like two benefits to attend on Wednesday and a friend's annual Halloween bash Saturday night. This totally throws off wardrobe. I got my 'sexy'—a relative term regarding me these days—nurse costume already, which will now be rendered even more graphic thanks to the bandages that will be poking out.

Oh, I forgot the best/worst part. I have to wear a bra again for like three weeks for compression purposes to help the lipo! A bra! Well, I never. Not since February anyway. Said bras will be stuffed on the sides with "camping" foam—as if I knew what the fuck that was. Again, the mix of incredible and basic technology. All things considered, this whole mastectomy and reconstruction process is staggeringly impressive and amazing from the perspective of "can you believe what they can do nowadays?"

Percocet makes me speedy and I'm completely wired yet I should be resting for Neiman's and Saks retail therapy tomorrow. So if this post seems even more rambling than usual, it's the drugs.

And for the record, I have been camping.