Still Under Construction

I’ve been trying to think of a delicate way to say this, but I’m not having much luck. So I’m just going to say it. I drove into Philadelphia this afternoon for nipples. Yep. You read that right. I saw my plastic surgeon and he somehow fashioned nipples for me. It was a very strange experience.

I think I’ve mentioned this before, but Dr. Serletti is one of the best breast reconstruction surgeons in the country, one of several handfuls who do the particular surgery I had in December. He’s the head of his department at the University of Pennsylvania – a teaching hospital, which means very rarely do I ever get to see just him and a nurse.

When I had my surgery there would be flocks of student plastic surgeons coming in my room to essentially feel me up and make sure I had good blood flow to my breasts. Modesty is not something a person can afford in a teaching hospital. Besides, when I reminded myself it was actually my displaced tummy they were poking and prodding it wasn’t so humiliating.

Today, however, was just the doctor, the nurse and a fellow surgeon. Apparently my doctor was showing the other doctor how HE does nipples and I’m a great candidate because I have two different examples for him to work with. The left breast had been removed by a radical modified mastectomy a year and a half before reconstruction, while the right breast was a skin sparing mastectomy done at the time of reconstruction. This probably doesn’t mean a whole lot to most of you, but trust me. There’s a fairly significant difference.

I’ve decided the ability to draw with a felt tip pen is a prerequisite to being a plastic surgeon. It seems like every time I go in there he’s leaving little drawings on me. Today I had to stand there with my ridiculous gown around my waist while he drew X’s on my chest, stood back to eyeball his artwork, and then drew tiny spokes out of the X’s, all the while Dr. McSomething-or-other looked on approvingly.

After that it was up on the table where he shot my feeling-less boobs with lidocaine “just in case”. That was a breeze because I couldn’t feel the needles. Just the way I like it. Then he draped a pad over my chest that had a three inch-hole for him to work through.

So I’m laying there, trying to figure out where I should look because I’ve got three people standing over me and if I’m not looking at one of them then I’m staring into the bright light, when the doctor makes his first incision. That was freaky because, while I may not have any feeling in that area, I could feel the pressure and the “pop” when he made it through the skin. Even now I’m shuddering just thinking about it.

I’m not complaining, though. The way they usually do nipple reconstruction any more is to pull up some of the fat and fashion it with the tissue and skin. In six weeks or so I’ll go back and get everything tattooed. But the way they USED to do it was a skin graft from either the inside of the upper thigh or… or… oh, I can’t say it. It’s much too painful to even voice out loud. Just think of the MOST delicate area of the female anatomy and you get the picture. If they still did it that way I would be using Todd’s idea of gum drops because there’s no way. NO WAY!

Dr. Serletti is as professional as they come. He’s very nice, but he’s all business. In a bizarre chain of conversations, however, he started talking about Caddy Shack as the funniest movie of all time. In fact he hikes up to a cabin in the Adirondacks with a friend of his and they take a VHS of that movie every time. It was shocking to learn he has a sense of humor.

I don’t think I can impress upon you enough how strange it is to be laying on a table with three people hovering over you: one of them sewing a nipple; one of them snipping the sutures and blotting the blood; and one of them watching the happenings with clinical interest; all the while talking about movies and books and generally chatting about things you would otherwise discuss over coffee.

After everything was plumped up and sewn into place, the doctors left and the nurse dressed me so I still have no idea what they look like. It will be another four days before I get to see the handy work. I have no doubt things will look a bit weird, but probably no weirder than they’ve looked for the last two years.

I go back in three weeks and at that time we’ll discuss the tattooing and also more revisions to the left breast. Because it was a delayed reconstruction Dr. Serletti had to use an approximately 3” by 6” scrap of belly skin to make the breast mound and the incisions are a bit jagged. So instead of a round breast I have sort of a trapezoid. At least I’m unique! But he’ll smooth those edges out to make things look a bit more normal.

Foolishly I always thought – if I ever really thought about it – that reconstruction was a surgery and then you were done. Boy was I wrong! Which makes me all the more glad that we put off Hawaii until next year. I should be completely finished with all this by then.

This morning I started back into my “healthy” mode, drinking a lot of water, walking two+ miles on the treadmill, counting my points, etc. But, as I’ve said before, any type of medical procedure induces a craving for something of the java variety – hot, cold, whatever. The best I could do was a cold bottle of Starbuck’s Mocha Frappuccino for the ride home. I should have known I’d need at least two, but I only bought one.

Probably better that I only bought one since they’re more points than I should have had. **sigh** Thankfully, tomorrow is another day…


  1. Gretchen on August 20, 2007 at 11:08 pm

    On a different note…all about me…I remember learning to nurse, and having the RN say, “make sure the baby latches on to the WHOLE nipple, areola and all. Well, this set me up for big-time failure because either my children have tiny mouths, or my “gloreolas” (remember Seinfeld?) were bigger than life. My poor son was gagging as I tried to “do what the nurse and all the books say to do” and shove that thing in his mouth. Perhaps I should’ve had a recon job just for nursing sake…Just sayin… :)Seriously, I’m so glad that you had a few days off and that you are embarking on a healthy you, top to bottom, nips and all. I’m so proud of your focus on your WW points and your exercise. xxxooogretchen

  2. Rosie on August 20, 2007 at 11:30 pm

    You know Jen this sound similar to my breast reduction surgery. Marking, cutting, moving and stitching. Of course, it was 4 1/2 hours long so they had me take a nap but before the procedure there were about six people, three for each side, having a conversation about my breasts…very strange experience.I think it’s so cool they you keep forging ahead and keep on keepin’ on. Damn you’re inspiring! : )What is the appropriate beverage for post nipple surgery? All things considered what’s a few points after that? So, Scarlet, tommorrow is indeed another day.

  3. Swishy on August 20, 2007 at 11:30 pm

    Wow, what a day. You SO deserved the frap! You are awesome.I read your first sentence, and the first thing I thought–and I hope you laugh when you read this–was, “Well, I guess there won’t be any pictures with this post!”

  4. Mailyn on August 21, 2007 at 12:15 am

    I’ve decided the ability to draw with a felt tip pen is a prerequisite to being a plastic surgeon. It seems like every time I go in there he’s leaving little drawings on me. Today I had to stand there with my ridiculous gown around my waist while he drew X’s on my chest, stood back to eyeball his artwork, and then drew tiny spokes out of the X’s, all the while Dr. McSomething-or-other looked on approvingly.LONFLMFAO!!!!!!!!!!! That is THE funniest shit I’ve ever read!!! I’d be careful. If he gets too much into the drawing he may giveyou a butterly or a tribal tatoo or something. ;-P

  5. CindyS on August 21, 2007 at 12:50 am

    I would have asked to be knocked out 😉 What is a huge deal to us is just another day at the office for them. Our hospital is also a teaching one so I had a bevy of young chipper students running around when I have my lower GI – for anyone not in the know, they shove a tube up your bum and blow air and pink stuff inside and ask you to hold it in. It’s like the most painful gas feeling ever.Then when it’s all over they tell you you can use the washroom to the left where you sit and blow out farting sounds that would have teenage boys rolling on the ground. Since I could hear them talking I figured they could hear me tooting. Not fun.CindyS

  6. Lynilu on August 21, 2007 at 1:03 am

    Wow, what amazing things can be done these days! 25 years ago I assisted a plastic surgeon on occasion, and I was amazed then at what was possible (he did a lot of limb reattachments), but your description of your procedure today, is just awesome. Thanks for sharing.

  7. Dorky Dad on August 21, 2007 at 1:08 am

    Well, I hope you enjoy your new nipples.I still can’t believe they can do that. It seems so … unbelievable that they can give you a new nipple.

  8. April on August 21, 2007 at 1:11 am

    Jenster,Leave it to you to make something so serious–funny. Your humor reminds me so much of my sister, Greta. You are so entertaining. You often have me laughing at my computer. I even read your post to my hubby tonight. BTW, we are still waiting on Todd’s blog, Reid might enjoy the male version of Jenster Musings a little more. LOLOn a more serious note, I pray you are well and that your reconstruction goes smoothly. I am so encouraged by your spirits through all of these trials. Keep looking to the Lord, my friend. BTW, have you thought about doing your own sketching with felt tip pens before your appointment…I was thinking maybe a funny face with two big eyes. LOL

  9. Becky on August 21, 2007 at 3:46 am

    Jenster,LOVED your column today…especially the opening sentence! You are a wonderful writer, and handled a very delicate topic with great applomb and good humor. And I laughed until I had tears running down my cheeks at CindyS comment! Good stuff, Jenster!Becky from Gists house of Gab.

  10. Monnik on August 21, 2007 at 7:00 am

    What a great post. You had me giggling throughout most of it – which is just how you are, because this is serious stuff! You did earn that frap. WTG on the 2 miles!! Keep up the good work.

  11. Jenster on August 21, 2007 at 7:51 am

    Gretchen – gloreolas – Bwahahahaha!!!Rosie – My initial surgery was actually about 8 hours so you can bet I was good and asleep for that one. They wait several months after before reconstructing the nipples and that’s a pretty simple procedure – obviously. lol I drove myself in and home.Swishy – Trust me! You guys didn’t want any pictures. :o)Mailyn – I was thinking of asking for a little extra something when I go in to have the color tattooed in. I figure if I’m going to get a tattoo I may as well get it somewhere there’s no feeling!Cindy – You never cease to make me laugh out loud. I guess I am happy I wasn’t making any such noises. That would have been REALLY embarrassing considering they were working on my boobs and not my bowels.Lynilu – Assisting with limb reattachments must have been fascinating!Dorky Dad – It truly is amazing what they can do these days.April – I’m honored to be compared to Greta. :o) Your comment of doing my own drawing made me think of my Winking Pirate – another post for another day. But it’s the same idea.And as for Todd’s blog – don’t hold your breath. I think he just uses that as a threat against me. lolBecky – Thank you!Monnik – I DID earn that frap, didn’t I?? I’m stretching out my fingers right now before I go walk this morning. :o)

  12. radioactive girl on August 21, 2007 at 11:29 am

    I agree with everyone else when they say that you earned that Frappuccino. Seriously…getting new nipples while fully awake! You can’t do that without some kind of reward!

  13. Shauna on August 21, 2007 at 12:30 pm

    Oh Jenster, I laughed. I just had to! You are toooo funny! But congrats on the nips!Swishy, I admit to thinkin’ the same thing. 🙂 CindyS, I have three boys and your comment had the tears rolling!!

  14. slackermommy on August 21, 2007 at 2:06 pm

    Congratulations on your new nipples! I know what you mean about feeling weird about a plastic surgeon eyeing my naked body and drawing on me with a marker. It feels weird to me even though as a nurse I’ve been on the other side. It feels like such a personal area for them to work on to you but to the doctors and nurses it’s a medical procedure like any other. That’s why medical professionals have to make a conscious effort to remember that it isn’t just another procedure to the patient. I’m so happy things are looking up for you. I know it’s been a long road.

  15. Jenster on August 21, 2007 at 3:35 pm

    Radioactive – I know! I should have bought two!!Shauna – Thanks! I can’t wait to see them. lolSlackermommy – As a patient you try to be all cool and clinical, but it’s hard when people are staring at you and drawing on you. lol

  16. Jodi_Lee on August 21, 2007 at 4:36 pm

    Yay, you have nipples!! Did you get to pick what size you got??? LOL Maybe I will start calling you Nipster instead of Jenster. 😛 Isn’t it amazing what doctors can do now?

  17. Dance Chica on August 21, 2007 at 6:38 pm

    Mocha Frappuccino’s are like potato chips: you can’t have just one. I know because we like them in our house, too, and I ALWAYS want another one after I finish. In fact, this post has given me a craving for one now!Also, that’s cool you went to the Baltimore Aquarium, recently. I haven’t been in a while but I love to go there because it’s so nice. And that Barnes and Noble IS awesome, isn’t it? 😉

  18. Cmommy on August 21, 2007 at 8:12 pm

    You inspire me. Thank you for sharing your journey with us. This post might be just the kick-in-the-butt I need to visit my treadmill–if you can do it after surgery, then I can do it in your honor!I’m thrilled that you are visiting my blog! Thanks for commenting today; Cinderella is deep! :-)Chrissy

  19. Pokey Puppy on August 21, 2007 at 9:08 pm

    Every post amazes me. Your strength, perservirence and heart… You are an amazing woman.

  20. Jenster on August 21, 2007 at 10:07 pm

    Jodi – No – no say in the matter. I will, however, be able to tell him later if they’re not what I want and he’ll revise them. I’m thinking I’ll just keep what I’ve got, though!Dance Chica – Yes, that B&N is awesome!!Chrissy – I only walked 1 mile today instead of 2 and I have no good excuses. :o(Pokey Puppy – Thanks.

  21. Nikki H. on August 21, 2007 at 11:14 pm

    Jenster, your storytelling is amazing. You are such an inspiration!

  22. susan on August 22, 2007 at 2:50 am

    It’s so amazing that they can do that. I’m really curious though….are they just flat or permanatly erect or ??? (I’m hoping you won’t be offended at the question as you already told us so much)

  23. Jenni & Me on August 22, 2007 at 1:20 pm

    My Lovely Wifey – Please do not use the term “several handfuls” when talking about boobies… cracks me up (hehehehehehehehehe)!!!

  24. Boobless Brigade Master on August 23, 2007 at 1:15 am

    Yeah.My idiotic doctor would only do the old skin graft method.And he messed them up to boot.Now, I can’t find anyone to fix me!Hug your Doctor.Hug him tight!And congrats on the new nips:)

  25. Lainey-Paney on August 23, 2007 at 10:07 pm

    a few things…when I had my D&C…in the room was me, the OB, the RN, & the anesthesiologist. They sat around looking at me, making small talk, and waiting for me to fall asleep. so yes, i get that weird part of just being there w/ all eyes on you…Glad you have nipples.:)

  26. In-Between Panic Attacks on August 25, 2007 at 10:01 am

    Kudos to you for going for reconstruction. My aunt had a mastectomy on one breast two years ago, and my family pretty much talked her out of reconstruction- she’s 45 or so, I don’t see any reason for her NOT to go through reconstruction. Maybe its shallow and superficial, but part of what I like about being a woman is cleavage. I think reconstruction supports vitality… and it sounds like you have a great attitude about all that you have been through to do it. More power to you and your nipples!!! Just a question, and this is probably fairly disgusting, but I’m curious… is there any way for them to …um… get ‘donor’ nipples? People can donate their eyes. Surely there’s a female passing away somewhere who would want a breast cancer survivor to have her nipples. See, now that is a gross, yet interesting thought, isn’t it? Hmmm….

  27. PJ on April 16, 2008 at 9:36 pm

    Jenn, I have only ONE nipple constructed with a tattoo making the areola. THe other one is still the original. The reconstruction looks so good, the gynie was confused last time I was there, “Which one is the reconstruction?” He asked in a puzzled voice! And that black Sharpie that the plastic surgeon wields is indeed an important instrument. Good luck on your return to good health…I’m still struggling with all the weight gain from chemo!Great post. I hadn’t read this before. (I haven’t been brave enough to use the word “Nipple” in my blog…yet!)

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