Breast Kept Secrets: Breast Reconstruction

*Disclaimer: I am (obviously) not a doctor. I do not represent an actual medical opinion.**

The one silver lining of a breast cancer diagnosis is that you don’t have much choice in your course of treatment. From day one of your diagnosis, a team of doctors is telling you what steps to take, what chemotherapy regimen to be on, and you, the patient, simply have to show up. (Might I add on time to appointments…which is something I struggle with.)

Unlike other cancers or rare diseases in which there are hundreds of options and the patient has to advocate for their choice, breast cancer comes with tried and true staples of treatment.

That is until…reconstruction.

Technically I have a choice about doing a lumpectomy, unilateral mastectomy, or bilateral mastectomy. But that decision came very easy for me: bilateral mastectomy. I had my mind made up since day one.

But then we get into a second set of decisions. To reconstruct or not reconstruct? Which leads us to:

Breast Kept Secret #5: Reconstruction

Photo: Ivory House Photography

I am well endowed, there is no hiding that. And while some may enjoy the benefits of boobs, I mostly see mine as a nuisance. I am a runner, specifically, a distance runner. These DD’s only cause pain and frustration in my book. Finding sports bras that work, chafing, second guessing going sans tank top in the summer; it just doesn’t work for my athletic pursuits. I’ve said on more than one occasion if I could chop off my breasts and get smaller ones, I would. And as fate would have it…I got breast cancer. So, for my own peace of mind and selfish pursuits, a double mastectomy was a no brainer.

My surgeon referred me to a plastic surgeon in Bend, one that came highly regarded. I wasn’t nervous for this appointment. In fact, I was pretty excited for it. I already knew what I wanted for reconstruction: forego silicon implants and use my own tissue from my stomach to reconstruct perfectly small A cups. If I get anything out of this shitty cancer business, it’s smaller boobs!

My visit with Dr. V went anything but smoothly. Five minutes in I could tell things weren’t going the way I wanted. First, I don’t have enough fat on my body to use my own tissue for reconstruction (I know, cry me a river.) This meant implants were the only way to go.

Second, because I am getting radiation after my mastectomy, a delayed reconstruction was going to be my best option. That meant waiting 6–12 months after this whole ordeal is over and getting one or more surgeries to reconstruct.

Third, there’s no guarantee of how reconstruction is going to go, especially since I’m getting radiation. I’ll spare you the science but radiation removes part of the DNA of the skin cells, making it more difficult to have that skin heal properly. The complication rates Dr. V spouted off with women who have radiation and do reconstruction wasn't pretty.

And perhaps what scared me the most: the scarring. I had never seen photos of women who had reconstruction. Up until a few months ago, I didn’t know that most times they can’t save the nipple with a mastectomy. The photos of women who had reconstruction were….terrifying. I’m not saying Dr. V did a terrible job with his patients. I’m saying I wasn’t prepared for how abnormal reconstructed bodies looked. I think the plastic surgeon could see my total shock and said something key:

“Breast reconstruction is not about making you feel normal naked. It is about making you feel normal under clothes.”

And that’s when it hit me: no matter what option I chose, I would never look ‘normal’ again. I would have scars across my reconstructed chest. I would get my perfectly small A cups…but I still would hate my breasts. I would hate them because I knew looking at those photos of other women that I didn’t want that. I didn’t want to undergo yet another surgery, prolong this journey, spend more money, risk complications….just to not feel or look normal.

I think that’s where my head space was wrong prior to visiting the plastic surgeon. I thought I would come out of reconstruction like a Barbie. I would have the perfect boobs that I wanted and they would look great and life would go on. But that isn’t the reality. There are scars. There are risks. There are chances of multiple procedures. And because I’m young, there is upkeep for the rest of my life. Yet again it was a new normal I would have to get use to. It was just another thing that was being stripped away from me.

Again, this is where I remind you that this is my journey, and my choice. There is no right or wrong choice when it comes to reconstruction. I do not judge women who choose to. I do not judge women who choose not to. Bodies are beautiful no matter what.

I was devastated after this doctor’s appointment. I called my mom and two good friends and hashed out what had happened. I hated that I had to make this decision at 27. It felt cruel and unfair.

I don’t know what happened to flip the switch. Maybe it was the good cry I had in my car. Maybe it’s because I’ve learned to take emotions out of any decision surrounding cancer. But a few hours later, I had made my final decision.

I won’t be getting reconstruction.

It’s called “going flat” (which I have my thoughts about…) and there are varying statistics of how many women choose this route, anywhere from 40–50% of women. I was pretty shocked at this statistic, I imagined it would be somewhere around 10%.

I know I will never look normal again, reconstruction or not. I know that I will have scars no matter what. I know that later in life, I can make the decision to do reconstruction. But for now, I’m going to embrace going flat. Because a year from now, I want to be sitting on a beach in Cinque Terre enjoying my 9 day solo trip in Italy. A year from now, I want to be running at full capacity with my clients again. A year from now, I want to be able to run a marathon in a breast cancer survivor shirt. A year from now, I want to wear all the fun colored, strappy sports bras that never worked with my DD’s.

I’m choosing to live my life scars and all; flat-chested and proud.

Navigating breast cancer at 28 through humor + napping