Care instructions from my best friend to my teenage kids the night of my surgery. 🙂

Two weeks ago I had breast reduction surgery.  After 35 years of walking through the world with an enormous bust and associated neck and back issues, I was ready. 

I shared this with friends online because I didn’t want to have the have-you-lost-weight conversation over and over, and I wanted anyone considering this very common surgery to consider me as a willing resource.  Just after the surgery, social media was an easy home for my euphoria, relief, and compulsion to joke about it.  But elective surgery is no joke, and here is a fuller picture of my experience so far.

The choice:

My breasts developed before I was out of grade school, and I was a DDD cup before I got to high school.  Back and neck aches were standard.  I was also an incredibly anxious kid, storing tension in those same trouble spots with no self awareness I was doing so.  I knew breast reduction was a thing, and a thing people like me justifiably sought.  

I’ll wait until I have kids, I thought, make sure I’m able to breastfeed.  Three kids and no success at breastfeeding.  I mean, these things were worthless!  

I’ll wait until my kids are older.  It’s such a risk to have elective surgery when they are so young.  I was also on the heels of back to back c-sections, so that was probably a good call.

Then a healthy and fit friend of mine died from complications of what should have been a very routine surgery.  Then my only thought became, Oh hell no.  So I tabled the notion for a decade.

Over the last 18 months my recurring back and neck issues inflamed my shoulders.  First a pinched nerve in my back and sharp pain in my shoulder, and the discovery of a bulging disc at the top of my spine.  Then when I worked through the pinched nerve, a frozen shoulder developed on the other side.  I had a minimal strength training routine – light weights, exercises I could do at home, to avoid those very issues.  Even those efforts were hampered.  It came to the point where I wasn’t sure I could keep facing these issues as my body aged.  The bulging disc was not severe enough to warrant its own surgery.  It was just one more piece to the whole puzzle.  

I asked around, got some names of surgeons, and went for the consultation.  The surgeon explained in great detail the process and potential complications.  I learned breast reduction has one of the lowest rates of complications among plastic surgery types, which I was relieved to hear.  And I was ready.  My months of orthopedic and physical therapy visits made me a slam dunk for insurance approval.  We scheduled the surgery three months out, and I waited.  

The surgery:

I went into this surgery with a great deal of fear.  My initial relief to have it behind me was enormous.  And by fear, I mean I almost shoved a copy of my will in my best friend’s hand on the way to the surgery center.  I decided not to dump my worst anxiety on her at the 11th hour.  Listening to my incessant nervous joking before and dealing with me high as a kite after was enough responsibility for one day.

I was both terrified and so ready.  I prepared myself to be miserable and in pain, because surgery will do that.  I went from an F cup to a C, so I expected my body to feel it.  My pain was minimal, even the night after the surgery.  Even my doctor’s staff was surprised at the check up how little pain I had.  Maybe it was the comparison to my last surgery, a c-section, after which I had a toddler and twin babies in my care.  

Anesthesia and narcotics make me nauseous, which has made recovery from previous surgeries very difficult.  This time they managed to give me enough of whatever that this was not much of an issue.  I got home and went right back to sleep. When I woke up I was plenty sore and tired, but felt no serious pain.  I took some ibuprofen just in case and alternated that with tylenol only on occasion for the next few days.

Two days later I could shower, which meant removing all the gauze stuffed around me.   I’m squeamish and hated this part.  I have a boatload of stitches and the gauze stuck to them.  After a lot of patient and gentle tugging, and even a call to the nurse line, I got them off.  This was an issue everytime I removed gauze until I could do without it for comfort (just over a week later).  I still have to apply and remove fabrics gingerly as they are still prone to sticking.

Then there was the cost. My share is about $3,000 and friends who have messaged me for more information have been given a similar estimate from their health plans, so this seems fairly consistent across commercial, employer-sponsored health plans. Only in very recent years could I have afforded it. If you are considering this surgery, make no assumptions. Call your health plan and get an estimate of your cost share.

Today (two weeks post surgery):

I have a lot of swelling and need to be careful with the (dissolvable) stitches.   I still use an ice pack occasionally for the swelling.  I have numbness in some spots and have to watch that closely.  It is too soon to say it “went fine.”  The first couple of months after surgery is when most wound related complications can occur.  The overall healing and settling is expected to take 9-12 months.

The week after surgery my neck and back muscles were so inflamed.  Maybe this is a normal body reaction to the invasion of surgery.  Maybe it is the extra lying down and resting.  What I have found, though, is I have to relearn a new posture.  My center of gravity is displaced.  Hell, that is why I did this, but I am surprised by the dramatic change.  This surgery extends some relief, but it is no quick fix.  I have a lot of work ahead to strengthen and retrain my long troubled muscles.  And the anxious kid who stores tension in her back and neck?  There is no surgery for that, and she is still in here too.  

I was sent home with a cotton sports bra and found it challenging to find other bras that were comfortable and didn’t irritate my incisions.  Even today I will change or remove it 4 times a day because the entire area is very sensitive.  Sweat and premenstrual bloating are acutely felt in this sensitive area.  It is a damn good thing I am working from home. 

My body:

Before and after the surgery, I have never looked in the mirror so much.   A real narcissism has taken hold here.  I am hardly thrilled with my appearance in general, but I would have never undergone the risks of surgery for purely cosmetic reasons.  I’ll admit, though, I like them.  

Now that I’m not afraid to look at the incisions, I stare for long periods.  They look great to me at times, and weird at others.  Sometimes they look so odd I can’t help but chuckle.  I am struck by how my response to my own image in the mirror can change from day to day, now and before this surgery.  Maybe I will always wrestle with the image I see and how I feel about her.  I am glad to be single right now because I have no room in my psyche for anyone else’s feelings about this change and its long healing phase.

As a woman, breasts are simply a prominent feature, regardless of size, because we are so damn obsessed with them.  Having such large ones sucks on many levels.  You can wear baggy clothes and just look round, or you can wear fitted ones and put them on parade.  I’ve worn a fully covering fitted shirt and had an employer tell me not to wear it again.  

As friends reach out (not all of them women) hoping for reduction at some point, this is the number one concern I hear:   “I should lose weight first.”  Maybe, maybe not.  Let a medical professional assess that.  We do not need to earn medical relief, we only need to take appropriate precautions to avoid risks, and surgery is not always the solution.  But we don’t have to suffer alone.  Physical therapy and massage have been huge supports for me long before this surgery, and what I learned from both will forever help me better care for myself.

Today I can say taking this action was a huge step for me, and an empowering one.  I am very glad I did it.  But there are no easy paths for long term physical discomfort.  We have to find the actions that work best for each of us.