Build-a-Boob, From the Mound Up: My Prophylactic Plan

I have BRCA2. I do not have cancer. This offers me the convenience of making a plan, instead of being forced into making decisions. This is my plan as it stands today, but as we all know, plans change as more information becomes available.

I’m opting to have a double mastectomy. I’m more scared of cancer than spending a week in the hospital and a month or two of recovery time. Since my original “reveal” blog,  I have met with the plastic surgeon and discussed my options.

When you get a prophylactic mastectomy, you have many choices for reconstruction and then you have even more choices, once you make choices.

LEVEL 1. Reconstruction Material

  1. No Reconstruction. Not really my first choice. NEXT.
  2. Reconstruction with Implants (under the muscle). The idea of implants has never appealed to me. In my case, I would have a mastectomy and during surgery, expanders would be placed under my chest muscles. Those expanders would be filled with saline until they reach the size I wanted. A later surgery would swap out the expanders for implants. Those implants would have to be replaced when they “go bad” and only when they “go bad”. Yes, they wait until you have complications to replace your implants. No thank you. I need something with less maintenance since I can barely keep up with my hair appointments. NEXT.
  3. Reconstruction with my Own Fat. Um, yes please! I have plenty to spare. The DIEP Flap reconstruction fit me and my body type the best. This is where they take the fat from the lower abdomen and use it to create breasts. Essentially, I will be having a tummy tuck, but instead of throwing the fat into the trash, it will be reconnected to my body. I’m now referring to my stomach as my “future boobs”.

LEVEL 2. What to Keep

Since I do not have cancer, they can save my skin and even my nipples (although all feeling would be lost). Based on our conversation, I decided to lose the nipples. It would allow me to have breast shaped however I want, not replicas of what I currently have. I don’t know about you, but if my house burned down, I wouldn’t take the insurance money and rebuild it with all the things I don’t like about it.

I say, go big or go home! Perhaps, that wasn’t the best choice of wording. Point being, I’m not going through all of this to look the same when I have the option to make improvements.

LEVEL 3. The Finishing Touches

Nipples. If I’m getting rid of my nipples, then there are 3 more options.

  1. Nothing. Again, this sounds pretty boring and half-assed to me.
  2. 3D Nipple Tattoo. Now we are talking! This is a tattoo that appears to be a regular nipple but is completely flat. It’s incredible what they can do! The benefits are two-fold: no more procedures and no bras required.This video shows some amazing work:
  3. A Reconstructed Nipple (made from my own skin). A tattoo can be applied to make them look as natural as possible. Having nipples made of my own skin would require a third procedure – possibly one where I’m wide awake.

The good news is, Level 3 choices do not have to be made immediately. They can be made at any time after my reconstruction. I could go years with mannequin boobs and then decide I want 3D Nipples. So, I’m not going to worry too much about this decision now.

The nurses are still trying to schedule my MRI (which will have to be completed within 6 months of surgery). The MRI is to ensure no cancer cells are present.  If I do show signs of cancer, my surgeon would need to take lymph nodes during surgery.

I also met with my friend, Erika (pictured with me above), who just had a mastectomy and is in the process of having reconstruction with an implant. Her story is a little different since she does not have BRCA, but did have breast cancer. Luckily, she just found out her treatment doesn’t require any chemo or radiation! I’m so thankful she reached out and shared her story with me. She is super brave!

Erika took the time to answer all the questions I had about her MRI, hospital stay and even gave me some pink pockets (pockets that hold your drains after surgery)!

Talking with her put me at ease since we shared many of the same fears about surgery. “What if I don’t wake up from anesthesia?” “What if I wake up during surgery and can feel everything but can’t say anything?”

We laughed at how irrational we both were, but it was still nice to hear we weren’t alone in our thinking.


11 thoughts on “Build-a-Boob, From the Mound Up: My Prophylactic Plan

  1. Hi Christina, so glad you’re sharing your thoughts and fears about BRCA2 and having a positive attitude about it. Looking forward to the next steps after the surgery is the way to go. Better boobs, girl! I’m around if you have questions about the surgery, recovery, etc.


  2. I’ve just found your blog. I’ve recently found out I have the BRCA2 mutation and am going to see my surgeons for the first time this week. Nice to see there are other people sharing their journeys too x


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