The female form had long been defined by curves and shapely silhouettes. Young girls have long had to deal with the plight of being either “flat-chested” or overly endowed with “ample bosoms”. Fortunate are those who have the perfect pair of breasts. Our breast size really is written in our DNA code and we have our parents to thank or be disgruntled about this phenomenon. These days whatever one may feel short changed about in the anatomy department can be discussed and altered in a plastic surgeon’s clinic. All over the world, people seek perfection by body sculpting and surgeries both big and small. To each his own in this realm. For me the creator made no mistakes, we are who we are; perfect in every way. It sometimes takes a sudden change in life’s trajectory to make you reassess what is important.

Growing up I was never discontented with my body and honestly, it had never crossed my mind to seek perfection by doing any plastic surgery or Botox to alter or enhance my appearance. I also don’t judge anyone who has decided to alter their body through plastic surgery. It is a personal decision and if it makes you happy to undergo the painful procedure and recovery, then by all means power to you. Never did I imagine that I would actually have to meet a plastic surgeon last year as I moved into the second stage of my breast cancer treatment following the end of chemotherapy in August last year. Unlike those who decide on a cosmetic enhancement procedure, my inquiry was a fact finding mission to understand what a breast reconstruction post breast cancer mastectomy would entail.

Having breast cancer can sometimes feel as though you’re in a movie or in a dream. It can feel quite surreal to be in scenarios which you never expected to be experiencing. Hospitals, various medical procedures and consultations can be overwhelming and exhausting. It’s important to make notes after visits or journal some details as you can easily forget details. I spent six months doing chemotherapy and then I was given a month to allow my body to rest and recuperate in order to move forward to the second phase of my treatment. I knew that August 2021would be a very emotionally charged one for me as I had to make a decision which I quite honestly had been unable to decide.

 My oncologist surgeon called me in to brief me on the surgical procedure which I had known for months. I was going to do a mastectomy and remove most of the lymph nodes in my underarm. This procedure I had made peace with and knew that there was no way to save my right breast. Due to the invasive nature of the cancer, there was no way to simply remove the cancerous tissue and tumors. The breast cavity would have to be scraped and cleaned. It was important for me to make a decision on whether I was going to reconstruct as the surgeon needed to know whether to leave a skin flap for future reconstruction or to go flat and remove all excess skin from the amputated breast. I spent countless hours trying to wrap my mind around this eventuality and what I wanted to do. I just could not make up my mind about the type of breast surgery I wanted to do.

Early on in my diagnosis, someone said to me…”After all of this cancer stuff, you can luckily get the perfect pair of breasts!” I had forced a smile and thought to myself, “is this how people view breast cancer?” This person had not been through breast cancer herself and was trying to make light of the topic. In retrospect, she had no clue of the complexities of the situation and what it is to go through this harrowing process. Having new breasts to me was never seen as the “icing on the cake” after the ordeal. I would find myself coming back time and again to this thought. The pursuit of perfection and how we are perceived by others and most critically; by ourselves. Would I regret not leaving a flap for reconstruction if I decided to go flat? What if I hated the way I looked after the mastectomy? How would my clothes fit? Would I feel less feminine? Would my husband still love me? Would I feel maimed and self conscious?

I used to look at myself in the bathroom mirror and cover my breast, imaging my body without it. I think this helped as I had already begun to visualize my body with one breast and not the pair I had known throughout my adulthood. I consoled myself with the fact that I had been fortunate to have had three beautiful children and that I had breast fed each of them. My breasts had provided them with important nourishment during the first 9 months of their lives. My daughter had been exclusively a breastfed child and I nursed her for 18 months as she refused to take a bottle. I was most thankful for this grace as many women with bigger breasts than mine were unable to produce the copious amounts of milk that I was lucky enough to have done for my children.

 For me at this conjecture in my life, motherhood and breastfeeding superseded all the other things like feeling sexy or wearing clothes that accentuated my breasts. I was mentally ready to amputate my breast. I had even considered doing a double mastectomy. This changed when I mentioned this to my surgeon and she explained that the left breast had exhibited no signs of cancer and therefore did not need to be removed. The recovery and rehabilitation she said would be hard enough on the body. There was no need to needlessly tax or for their by removing a perfectly healthy breast. Had I had a triple negative breast cancer diagnosis, it would have been highly recommended to remove both breasts. Women like Angelina Joli have opted to do this even without a cancer diagnosis as they carry a recessive gene which is highly aggressive. She did breast reconstruction after voluntarily removing her breasts as a preemptive procedure. I counted myself fortunate and no longer burdened myself with the idea of doing an unnecessary double mastectomy.

The one conflict that still remained for me was whether on not to to reconstruct. I spoke with several women and heard their experiences about the pros and cons of reconstruction. Everyone was different and individual to each person. Most said that it was important for them to reconstruct their breast after a mastectomy. I heard all of the pitfalls of procedures gone frightfully wrong, as well as success stories. Some women were happy with the outcome as they felt whole again; they all worried about a recurrence of breast cancer. One friend recounted her story of going through the long process and being disappointed with seemingly perfect implants which she subsequently removed. I am most thankful to have heard these personal accounts and I am appreciative to those who shared their stories and their feelings so candidly. The bottom line was that I would have to decide what was best for me independently of anyone else. 

My surgeon sensed my uncertainty and urged me to make an appointment with a plastic surgeon who was well known for his reconstruction post mastectomy. I thought that this would be an unnecessary visit as in my mind, any cosmetic surgeon would urge me to do a reconstruction and not truly give me an unbiased outlook. In retrospect, visiting him that day was the best thing that I could have done as I left his office at the end of August with a definite answer on what I had been so ambivalent about for the 3 months prior.

My consultation lasted well over an hour,  as I listened to the procedure and the entire reconstructive process which he explained would take about 18 months. Several surgeries to remove skin from areas such as the thighs or stomach would have to be done to create a skin graft which would be stretched to cover a new breast. I asked him what he would advise his wife or sister if they were in my situation. He said quite simply that with my type of cancer, the most important thing to ensure was that I was in good health and cancer free. I deeply appreciate that response from my visit with the plastic surgeon. I had spent weeks trying to come up with the right response to give my doctors and it wasn’t until a week before the surgery to remove my breast that I gave my surgeon my definite answer. I wanted to live my life again as soon as possible. I would wear my scars proudly as a reminder of the battle I had come through. I decided not to reconstruct my breast as I did not want to spend the next 18 to 24 months in and out of hospital doing various surgical procedures in an effort to reconstruct a breast. I wanted a viable life without unnecessary hospitalization and procedures. I wanted to just focus on getting over cancer and living days with my family cancer free. Reconstruction was not for me.

The surgery day went well. It was a silent and anxious 5am trip to the hospital. It would be my first ever major surgery. Once again strict Covid restrictions would demand that I have no family with me. Sadly, my beloved husband dropped me off in the parking area and a nurse came out for me. He asked if he could stay but was told it best to return home. The surgeon would contact him after the mastectomy was complete. The hospital staff at UM was just awesome. They ran me through the post op procedure and then my rockstar surgeon came by. This was THE BIG Day. The last thing I remember was the countdown after the anesthesiologist administered the shot and being on the gurney…10,9,8 and I was out. Eight hours later I had completed the surgery removing my breast and 23 lymph nodes from my underarm. I was groggy but felt no real pain at that moment. The reality would come in a few hours and one of the most excruciatingly painful nights of my existence would ensue.

Pain is truly different to each of us. I consider myself to have a high pain threshold. Natural childbirth was painful but the joy of holding your newborn erases all of the memories of pain. This however was a new pain which I had never felt before. I thought I could move and realized that my upper body just had no power to do what my brain commanded. I went home early the next morning and spent the next month recuperating from the surgery. The 2 bags of draining fluid hanging from my upper body were a necessary fixture on me. I would have to empty at least twice a day and record the quantity and color, until the flow ceased. They were uncomfortable and bulky under my clothes. I could not lift my arms or hold anything over a few pounds. The pain was undeniable and I was bound tightly for weeks. Getting out of bed was difficult, but a wedge pillow helped a great deal. The bandages hid the amputation area. I was curious but could not truly see the wound or scar beneath. There was a brief mourning period, but it was a sacrifice for a greater good. 

After a month, I felt better. When I finally saw the cut across my entire breast area, I admit I gasped. It seemed like an ugly, dark, crooked line with stitches that ran from my sternum to just under my armpit. I felt so maimed at that time, but I would soon come to grips with my situation. I was bald, no eyelashes or eyebrows post chemo and now here I was imperfect with one breast. How would my clothes fit me? I would have to change my dress style, I thought. As ridiculous as this may sound, these are human reactions and I had to go through that initial key to move forward. Today, I am confident and I am happy with my decision as I know it was the right one for me. 

Time really does heal situations both physically and mentally. My laments did not linger for long and I did not allow myself to become weighed down by self doubt. In time the seemingly ugly scar would look less and less imposing to me. I have now grown accustomed to it and it has faded quite a bit. My oncologist surgeon did a fantastic job on me and in her wisdom and expertise had sewn me neatly and done her utmost to take care that the lymph node removal would not severely impact the drainage system of fluids and cause lymphedema. I had no excess swelling, and thankfully do not have to wear the compression sleeves to ease the effects of being unable to drain lymphatic fluids from the arm.

It has been 8 months since my mastectomy. I wear a prosthesis when I dress and I am satisfied with that. I have fully accepted my body. I have mourned the loss quietly but retained all of my dignity and self love for the woman I am today. I am a mother, a wife, a breast cancer survivor and a proud woman. I am a warrior, a peace maker, a lover of life and I have a strong desire to live and flourish. I wear my scar proudly, it has become a part of who I am and a daily reminder that I overcame adversity. Our bodies take the wear and tear of life. Some of us lose limbs and parts during life’s journey. For me, the important thing was that once I can function in my daily life with the capacity to work and thrive. I can never change my diagnosis but I am in control to a great extension how I deal with the outcome. I am proud of myself and I would never change my choice. I am thankful for having been able to be treated for this most abominable disease that Cancer is. I had the loving support of my husband, children, parents, siblings and friends through this journey. They gave me unconditional support and courage to fight hard. As the song which became an anthem to me by Indi.Arie, I learned that “ I am not my hair, I am not this skin, I am not your expectations of me” I am not my breast or my body, I am truly “the soul that lives within”.