Friday, March 23, 2012

Reconstruction Disruption

I'm feeling a little upset, my equilibrium disturbed, as it often is when I try to understand mainstream culture. I feel so out of the loop, like I must be unclear on the concept, or just plain really odd because I just can't fathom the way I'm "supposed" to be and feel. I've never quite fit in, I don't get how it works.

Every medical person I've been in contact with {and this is many} is really {really} hot on reconstruction after mastectomy. It's not if, but which kind and when. Which seems straightforward enough until you learn that the options for that go from bad to worse. I want to be really clear, that I have nothing but respect and admiration for anyone who goes through this experience and whatever options they choose. We're all different, we all have our own needs.

I'm not comfortable with implants, with putting a foreign object inside of me, one that will need to be replaced over the years... and the process of stretching out the skin with "expanders" over weeks or months to accommodate the implants, no thanks.

Then there's the Trans Flap which reconstructs your breasts using skin, fat, tissue, and muscle from your belly. This leaves you a belly with few if any muscle, permanent weakness which leads to bulging and hernias which require surgical repair. I would also suspect that without these stomach muscles {which are there for darned good reasons}, your whole core goes off kilter, leading to back problems and one ache and spasm after another.

The newest surgery is called a Diep Flap, this is similar to the Trans Flap but spares the muscles... hopefully. But no worries, if they don't get what they need from the hip to hip incision in your belly, they start taking stuff from your back. It's a 14-hour micro-surgery with a very difficult recovery and on an irradiated breast, the surgery could fail, meaning you lose the new breast and are right back where you started from except all sliced and spliced.

I'm sorry, but this all strikes me more like extreme mutilation, as opposed to "reconstruction". There's no way I'm spending the rest of my life in search of breasts, and I won't sacrifice another piece of my body willingly, optionally.

After convincing everyone I wasn't having reconstruction, which I'll admit, I might have done if I could have done it during my mastectomy -- one surgery... but mine would have to wait 6 months to a year after radiation... I'm told matter -of-factly where to get a prosthesis. No consideration that I might not want strap on fake breasts, pretend breasts. I just can't imagine wearing strap on fake boobs, or why I would want to? There seems to be such an entrenched belief that you are not whole without breasts, it's surreal. There's not a lot of support for someone who doesn't buy into that system. Am I missing something? I just want to be alive, enjoy every minute of every day and it doesn't seem like fake boobs will either help or hinder that goal... where's the respect for my choice?

I'm as vain as the next gal, and if I were in a fire or accident and my face was disfigured, you bet, I'd be having reconstructive surgery, but for a flat chest? It seems extreme, and is instead almost societally required.

I've read stories of women on-line, barely healed from mastectomies, strapping on their heavy prosthetics. They exchange tips on how to bear it and make it more comfortable and it makes me want to weep. There are nightgowns for sale with built in falsies, so you don't have to lounge around your own home, or sleep with a flat chest. Why can't we just be comfortable and natural? It is what it is, be what we will be. Our bodies change regardless. A mastectomy isn't a natural evolution and it's a bit extreme, but we are adaptable creatures if people, if culture, if I don't know who... ourselves? would just let us.


  1. Oh my gosh! Kim, I had no idea. I think you are so right on. As a full-time flat chested person I can testify: it's not that bad.

  2. i've always thought flat-chested women were really attractive. i'm just hoping not to be concave or lumpy... some of the on-line pix are scary, but i have faith in my surgeon... i think she's going to do a really good job.