• The Great (Reconstruction) Debate: Silicone vs. Saline


    This week I met with the plastic surgeon to discuss my final reconstruction surgery.

    Here’s the current surgery plan. The surgeon will:

    • Removing the chemo port from the left side of my chest.
    • Lift my left breast so it matches the right reconstructed breast.
    • Replace the issue expander on the right side with a silicone or saline implant.

    Removing the chemo port

    This was the easiest decision of the three. I barely notice the chemo port anymore. I mean, I’m aware it’s there but it isn’t a regular part of my life now. It’ll be a relief to have the port taken out.

    I have to get the thing maintenanced every six weeks. And by maintenanced, I mean the same ginormous butterfly needle used for chemotherapy is inserted and the port flushed with (I think) saline and Heparin to make sure the device doesn’t develop a blockage.

    Noooo blockages, please and thank you.

    I still have numbing cream from chemotherapy so the needle stick doesn’t hurt. It’s just a giant pain in the ass to have to visit the chemo ward every six weeks to have the port flushed.

    I could have had the port removed at any time after treatment ended. My oncologist had no further use for it (which, thank God). But I was tired of being poked and prodded and cut into.

    So at the time it was easier (read: less intrusive) to keep the port instead of going to the hospital, being knocked out and having doctors cut into my chest.

    I’ve had enough of cutting than you very much.

    I was relieved when the plastic surgeon said the port could be removed during my reconstruction surgery. IMHO, one surgery is waaaaay better than two.

    Lifting the left side so it matches the right

    This was a decision I had to work myself up to. I’ve gotten used to the asymmetry of my breasts. Yeah, the right one is a hard, tissue expander Barbie boob and the left is a normal kid-ified boob.  This bothered me at one time but it’s amazing what you get used to when you don’t have a choice.

    Now I’m just grateful to have my one functioning breast and nipple. And now I’m pretty protective of my left breast seeing as it’s the only one I have left. So when the doctor suggested a lift to make the girls match I hesitated.

    My right breast, what remains of it, is completely numb from all the cut nerves during my mastectomy. My armpit and partway down the inside of my right arm is numb, too. I’m not as hypersensitive to this numbness as I used to be but I’m leery of cutting into the left side that has normal feeling.

    Really, I said to myself, how many topless photos are you planning on doing?

    *phone rings*


    (None, Mom. Okay?! The answer is none. Sheesh!!)

    When I got down to it though, I still care about symmetry a little. I’m okay with what I see in the mirror today, but I would not be opposed to having semi-matching breasts again. This is my opportunity, so I’m going to take it.

    I could have done any number of things to make my breasts match. Depending on what size I wanted I could have gotten implants on both sides and made them larger (*ahem* Justin’s preference). But ‘bigger’ meant more than one surgery and a longer recovery time.

    My goal is to have minimal surgeries and the least amount of recovery time possible. A lift on the left makes them match and it all happens in one surgery.

    Replacing the tissue expander with a silicone or saline implant

    Ah. The great breast implant debate. I never wanted breast augmentation so I didn’t know much about saline versus silicone breast implants. Oh, but I got a crash course.

    I don’t have enough tissue elsewhere on my body to do a flap reconstruction (where muscle and tissue is taken from, say, your stomach or thighs to reconstruct the breast). I didn’t really want that anyway. It increases the recovery time and I’m kind of attached to the muscles in my thighs.

    So the reconstruction choice I’m left with is using either a silicone or a saline implant.

    For anyone as ignorant of the differences between saline and silicone implants as I was, here’s some Breast Implant 101:

    Saline implants are basically bags of salt water. They show more wrinkles and don’t look like natural breasts. But a saline implant will still look and feel better than the hard, tissue expander Barbie boob that I have now. If a saline implant breaks, the breast deflates but the worst thing turned loose in the body is salt water.

    Silicone implants, on the other hand, look and feel more like natural breasts. If a silicone implant breaks, the silicone stays where it’s at. Think of splitting open a gummy bear. The gummy bear guts don’t spill out everywhere. They are gel-like and stay within the bear shape. That’s how silicone implants are. The gel stays within the shape of the implant. It’s hard to tell when a silicone implant breaks, so doctor’s start doing MRI’s every 3 years to assess the state of the implant.

    Also (I had to resign myself to this) all implants are going to break. Someday, some way, I will have to have this thing replaced in the future.

    Here’s where I got stuck in choosing between silicone and saline: There is a small percentage of people with silicone implants throughout the world who develop a form of lymphoma (a type of blood cancer) called ALCL, or Anaplastic Large Cell Lymphoma from silicone breast implants.

    The doctor said there were only 200 ALCL cases worldwide so I had a better chance of getting struck by lightning twice than getting ALCL if I chose a silicone implant.

    Except, having been diagnosed with Stage 3 breast cancer at 34, I’ve already been struck by lightning.

    I have very little control over what happens to my body in the future. I don’t get to pick if the cancer will come back. This one tiny thing, selecting saline over silicone, is something I can control. And if I can eliminate even the tiniest risk of getting another form of cancer then I’ll do it.

    So that’s this week’s episode of As Meghan’s World Turns. I have to let the surgeon know I’m choosing a saline implant and surgery is being scheduled for early 2016. I don’t have a date yet, but it’s not happening before the holidays.

    Merry Christmas to me!



    Ps. I love comments! Don’t want to leave a comment? Send me an email at gettingthewordswrong (at) gmail (dot) com.

3 Responsesso far.

  1. Mom says:

    Decisions, decisions! Have to have your daddy read this to help me think about it. It’s your body! I am glad that you have the brains to get it done anyway. Will the boobs look the same (except for the nipple anyway)? How often will it pop and then you have to have another surgery to replant it? I guess you will have the perfect boobs all the time. I am very very glad that you look into these things because It would make zippo sense to me. Would you like me to come down when you have this surgery? I’m always good for a laugh or two or is that your line?!!!!!!! Anyway, you are beautiful anyway they put you back together, you are still one beautiful woman! Love you lots, Mom

    • Meghan says:

      The plastic surgeon said that he’ll do his best to make them match, but they’ll never really match. I’m okay with that. As for how long the implant will last, time will tell. He said I could go ten years with no problem with the implant. Or I could have problems before that. So it’s a gamble no matter what. My boobs will never be perfect. One has no nipple and a six inch scar through the middle. But I trust that my surgeon will make them match as best he can. His ‘good enough’ is good enough for me.

  2. Kristel says:

    I would have picked the saline implant too. Hugs

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