As a man, I thought I’d never have to consider having a breast implant put in my body, much less in my neck. Leave it to modern medicine to change that notion. Breast implants are essentially tissue expanders, silicone balloon like devices inserted under the skin to stretch and grow new skin. Tissue expanders are most commonly known for breast reconstruction, but they have also gained popularity for use in burn survivors. As a burn survivor, this concept was advocated in 1989 for the treatment and remedy of the severe scar contractures in my neck. The belief was a sizable tissue expander (insert breast implant) would be inserted under my unburned skin on the left side of my neck. Over a period of 2 months the tissue expander would be inflated to full capacity, basically a softball projecting from my neck (see sample pic below). After the expander was fully inflated, it was believed it could be removed and the excess skin could be stretched to the right side of neck, thus allowing for the removal of about 7” of restrictive burn scar tissue.
This methodology had achieved miraculous results in other burn survivors. I distinctly remember seeing one kid who had 2 of these, though little smaller in size, inserted in the top of his head. Lucky or unlucky for him the location of these expanders made him resemble Mickey Mouse once fully inflated. For this particular kid, they were able to replace 4” of his scalp that was ridden with burn scars with fully normal skin. When finished, he had a normal hair line again. Utterly amazing. There were other comparable success stories that made this procedure seem like a perfect fit for me. One thing that couldn’t be predicted was my skin’s inelasticity and keloid scarring.
The Procedure
Inserting the tissue expander required the surgeon to cut me from ear to ear and then back to my left clavicle – basically a large sideways V across my entire neck. The expander was positioned directly in the center of the left side of my neck with a port buried under the skin beneath my left ear. The port was where they would insert a syringe and inject salt water in the expander every week. The resulting incision scar rivaled those of Frankenstein. You can only imagine the stares I received returning to high school, a freshman at that. It was almost comical the stories that circulated. The best was probably the story of me riding a motorcycle in a pasture and accidentally running into a barbed wire fence. Story has it that my head was almost severed from my neck but by some miracle I was able to hold it together and ride back to safety. I’m not sure how the story was propagated but I could have had some influence.
Over the years, I have learned you need to embrace your shortcomings and be able to laugh at yourself. If you can’t laugh at yourself, life will be pretty miserable.
Over the next 8 weeks, I would go to a plastic surgeon and have him insert copious amounts of salt water into the tissue expander. Each time, the expander was inflated to the point of discomfort and borderline unmanageable, feeling like my skin was going to explode at any minute. After a couple of days, the skin would stretch and the discomfort would go away just in time to have the next series of injections. I endured this routine for 8 weeks. Besides the pain of having a balloon stretching your neck, I also had to be careful not to do anything that would cause the expander to bust – i.e. wrestling with friends, falling down riding my bike or getting hit with a basketball. Busting a tissue expander is not a common phenomenon but there were stories of them breaking and the fragmented pieces being circulated in the body – one such incident required open heart surgery to remove from a patient’s heart. Surprisingly and obviously not my brightest decision in life, I would often play basketball during our lunch recess thinking I was safe since all I was going to do was post up and take a few shots. That careless thinking came to end after a ball was deflected and hit me square in the neck. I remember going home that afternoon, obviously not saying a word to my parents of my stupidity, and thinking the expander would start leaking fluid into my body while I slept, making the surgery a complete failure. Luckily God was just reminding me of my stupidity and gave me a 2nd chance. As a kid who has underwent many a surgery, the hardest part of recovery has always been refraining from physical activity. I think my inability to sit still as an adult is a direct result of being told as a kid for months on end that I couldn’t do anything. If you’re like me, tell me I can’t do something and I want to do it even more. Fortunately, it seems my kids have inherited that trait as well.
Right or wrong, the inability to be distracted from what you want in life is something I think everyone should pursue. I call that PASSION.
It’s all about perspective
Life is so interesting. Everything is always a matter of perspective and I think we should remind ourselves more often. As some of my friends say, many of our problems are ‘first world problems.’ My peers were worried about pimples, bad hair or their feet looking too big and here I had a softball protruding from my neck. Needless to say, everywhere I went people stared and did double takes. Let’s be honest, it’s not every day you see a big softball sticking out of someone’s neck. I could tell many people were confused and unable to process what they were seeing. I had to keep reminding myself it was temporary and the long term benefit far outweighed the pain and discomfort – or so I thought.
After 2 months of pure misery and constant anticipation of enjoying a life without the scars limiting my neck mobility, the day finally came. I had envisioned in my head what it would look like with normal skin on both sides of my neck. I had envisioned being able to turn my head in both directions without my right eye and mouth pulling down. I envisioned being able to hear again out of my right ear when I turned my head to the left. In hindsight, perhaps the surgeon should have given me more tempered expectations but if he had I’m not so sure I would have agreed to the procedure. This was truly sold as a life changing event as it had been for so many other burn survivors. I saw the lives of those who were transformed and knew there’s a risk to any surgery.
Unfortunately, the surgery and overall procedure was not as successful as what they anticipated. It was estimated roughly 7” of scar tissue could be removed from my neck. Instead, less than 2” was removed. The surgeon was baffled at my skin’s inelasticity. There were no complications during the surgery and all the injections/inflation of the expander were performed as scheduled. In short, we were left with a medical mystery. No one could explain why my skin didn’t stretch like everyone else. Some things in life just can’t be explained or predicted and that was what I was left with. All in all, I was now left with a permanent scar that went from ear to ear and back to my clavicle with no distinguishable improvement in the mobility of my neck. And let’s not forget that I keloid, meaning the incision scar thickened to 1/2” and was bright red for several years. As a far as any doctor was concerned, the procedure was a failure and those were 10 weeks of my high school freshman year that I will never get back.
The Next Chapter
After the final sutures were removed, I assessed my new reality and tried in vain to make sense of the situation. As previously mentioned, this wasn’t the first time a surgery didn’t go as planned. Basically, the burn scars on my neck looked the same, excluding the addition of the new scar which now looked like someone tried to cut my throat, and I had still had the same limitation of mobility. If I was in a gang, this new scar would be perfect and I’d for sure have street cred. No doubt I could easily circulate stories of a knife fight that left one man standing (me). However, I was just a 15 year old high school freshman trying to find his way in the world and resume a life of normalcy, or at least normal for me. The more I prayed and contemplated the inevitability of my situation, the more I realized some things are just out of my control and some things just don’t work out no matter how hard you try. That doesn’t mean you don’t try again or curse the system. You just accept the outcome and chalk it up to a learning experience. I’ve done a lot of learning in my years and I truly believe God has used these experiences to strengthen my fortitude and to not focus on the superficial things in life.
Eventually, you build your self-confidence around being the best version of yourself and ignore the naysayers who are always looking to tear people down. You also learn as tough as things may seem, someone else always has it worse and yet they still find a way and the willpower to be successful.
There is another silver lining in this story. The surgeon gave me the tissue expander (breast implant) as a souvenir. What else would a 15 year old boy do but take it to school and show it off to his friends? I can safely say that no one else had one of these to pass around at lunch. As always, thankful for the memory.
ABOUT SHAY
Shay is an All American and World ranked triathlete, burn survivor with scars over 65% of his body and is a sought out national motivational speaker. Despite being told he’d never compete in sports again at the age of 8, Shay is living testament to “Anything is Possible”: 4x Ironman, 4x member of Team USA, ranked top 1% of Ironmen worldwide and has competed in 9 triathlon world championships, including the Ironman World Championships in Kona, Hawaii. His mantra has always been to not merely be a “finisher” but to be a “competitor.” If you enjoyed this article, I encourage you to check out my other posts.