Back to normal (looking) after a double mastectomy

November 9, 2015

Cohesive gel implants, also known as gummy bear implants, are growing in popularity in place of older silicon breast implants like the one pictured above.

When I see my breasts in the mirror, Iím still surprised.

More than a decade ago, lousy reconstructive surgery after a double mastectomy left my chest looking less like what had suckled my babies and more like my kidsí kindergarten clay projects. I never bothered finishing the job with the nipples and areolae, which struck me as lipstick-on-a-pig-ish. That my breasts were more porcine than porcelain wasnít evident in clothes, and I liked my more compact size ó sportier, less inclined to draw attention. Without nipples I could go braless, with no indiscrete nibs pointing to the fact or fiction of what was underneath. Besides, the process that most surgeons use to create nipples ó grafting skin from the darker pigmented upper inner thigh ó didnít appeal to me.

I was beyond it all; beyond the notion that properly shaped breasts topped with a few raised centimeters of skin would add meaningful dimension; beyond a culture hungry for images of a wardrobe malfunction.

But not beyond self-consciousness, Iíll admit. Even in a womenís locker room, I huddled in the corner to undress. If my breasts hadnít looked muddled, if Iíd had straightforward mastectomies, maybe I would have stood proudly, showing off my scars as a testament to my survival.

With a shirt on, though, I was confident. I was healthy, vigorous and fulfilled ó that was what mattered.

Until my friend Gail showed me her reconstructed breasts with nipples that look like the originals. "Theyíre spectacular!" I exclaimed. Oh, to have natural-looking breasts with nipples hinting their presence under my shirt! Iíd never coveted a friendís flip-flops, let alone bodily assets, yet suddenly I longed for breasts as splendid as Gailís. I was ready to schedule an appointment with her plastic surgeon.

Gailís surgeon had crafted her nipples ingeniously from breast skin using small cuts, origami-like folds and dozen of microstitches. She had been awake during surgery (mastectomies remove nerves, too) and said that as the surgeon created each nipple, she grew happier.

I envisioned that for myself. But why? I wouldnít be recouping something serviceable like my pre-menopausal memory or knack for a witty retort. No one except my husband and I would even see my nipples. Maybe thatís part of the allure of nipples: something to hide. Terra incognita.

I would feel the electricity of a set of "on" buttons, even if the circuit wasnít fully connected.

"Iím going to have nipple reconstruction!" I told a buddy whose wife had undergone a mastectomy. His response: "Why bother? Just stick a couple pieces of chewed-up gum there and be done."

My husband, too, though less glibly, said that this breast stuff doesnít matter: "I think youíre beautiful and sexy. But it seems important to you, so I think you should go ahead."

He was right that what I lacked was lacking mostly in my mind. How could I be so unevolved? It felt greedy, too, to want breasts when here I was, alive and well. I tried to understand why this was so important. Yet I never wavered in my decision.

When I awoke from the brief procedure to revise my reconstruction, I fumbled to pull away my hospital gown. I looked down at my chest, gasped and burst into tears. Hoarse from the breathing tube, I rasped: "Normal! Theyíre shaped like normal breasts!" I sobbed and looked again because maybe Iíd imagined them, and then I sobbed more.

"Look!" I showed the nurse. "Look!" I showed my husband. Another nurse came by. "You have to see how beautiful they are! I canít believe it!" I had to restrain myself from showing the guy down the hall with the hernia. From the recovery room I called my daughter, who couldnít understand me through my blubbering, and when she finally heard me, she started crying, too.

Three months later I got my nipples. I emailed Gail: "Itís like a dream!" The scars on my skin were no longer the whole story but indications that thereís rich reading between the lines.

My refurbished breasts necessitated some wardrobe adjustment, and I savored shopping for bras to conceal what I called "the situation" saluting through my sweaters. After years of avoiding sexy lingerie, I tried on racy numbers and admired the way the plunging cups exposed my restored cleavage and the lace revealed my nipples. Alone at a private pool, I skinny-dipped for the first time since my mastectomies.

In another three months, I returned to my doctorís office to get my areolae tattooed: imperfect circles with color variations, like natural ones. My breasts are not perfect, but they are perfect to me. They have color, dimension and proportion, and they are splendid. I even have sensation, with some nerve regeneration in the tissue. Itís stunning to get back a part of me lost more than a decade ago.

I was shaped by loss, real loss: my motherís extended illness with cancer and her death at 48, when I was 17. Coming out of my cancer diagnosis in my 40s ó misshapen but healthy and here for my children ó was the ultimate win.

Yet getting my breasts back was not meaningless. Thereís no recouping the deep losses in our lives, the ones that scar the soul. So feeling as though Iíve reclaimed a fragment of something long lost ó thatís something beyond bonus points.




McClatchy-Tribune Information Services