The Menu of Mastectomies & A Dinner Party from Hell

Coming to terms with losing a breast or two is no easy task. It is my great hope that at some point, possibly within my lifetime, our medical technology will advance to the point where removal of the breasts to treat cancer will come to be considered a barbaric practice that will be eradicated by using some other method that we have not yet discovered.  While we have made tremendous strides in our understanding and treatment of this disease, this is unfortunately not the case in today’s world, and I don’t have time to wait.  While the practice does feel a bit barbaric, I’m a Game of Thrones type of gal, so let talk tits, specifically their removal by blade, a be-titting.

Since this nightmare began I’ve always know this day was coming.  It was definitely a question I’ve been asked quite regularly through the process.  Are you going to whack one or two? (Sounds like a mafia hit.) Everyone seems to have an opinion on the matter.  They seem to know what they think they would do. But, I think breast removal may be slightly more in the category of abortion or performing a mercy killing, you don’t quite know what you would do unless you are actually in the position of having to make a choice-less choice, a position I unfortunately find myself in.

Having to choose is probably the worst part.  Some women don’t have a choice, their cancer and/or their genetic testing is such that “the right thing to do” is clear.  For me, the right thing is a little more ambiguous.   I wish there was a right and simple answer, one that could be deemed the clear winner and better choice.  Like so many things we tend to oversimply complicated situations and go for the extreme, “I’d just slice them off,” when the reality is so much more complex.

One thing I never thought to consider prior to my diagnosis is every woman has a different relationship with her breasts.  I spoke to a friend early on who explained to me that growing up her breasts where never really a part of her self-identity. For her, the decision wouldn’t be as complicated.  To her, her breasts are a mere side-note to who she is.  They are on the smaller side and not a feature that she routinely accentuates when she dresses or even tends to even think about.  They simply aren’t a huge factor in her self-image or sexuality.  On the other hand, I spoke with a different girlfriend who was on the extreme opposite end of the continuum.  She has much larger breast and they are very much a part of who she is as a person and what she considers when she looks in the mirror.  To her, her breasts are central to self-image, as well as her sexuality.  So when considering breast mastectomy surgery and “the right thing to do,” the psychological experience alone is deeply personal and very much unique to every woman who has to do it.  There are many factors to consider that are much more complicated than the decision to simply lob off a breast or two.  The decision is a permanent one that affects so much more than some surface area skin.

Regardless of the close personal relationship each woman has with her breasts, the decision to have surgery is also a complicated one.  Before this happened I didn’t spend much time thinking about the difference between breast enhancement surgery and breast removal surgery.   I have come to realize how very different these are.  Breast enhancement or augmentation surgery (as painful as they may be) are elective and performed for the purpose of looking and/or feeling better.  Plastic surgeons discuss how they can hide the scaring so that you will never know, and what size breast will look and feel the best.

Breast amputation surgery, a.k.a. mastectomies are more like a complicated menu written in a foreign language.  As you attempt to muddy your way through the menu you realize there is absolutely nothing that sounds like a good option.

Psychological effects aside, surgery brings its own risks.  The time spent in surgery and under general anesthesia, the risk of infection post-surgery considering the surface area that needs to be removed and the skin grafting required to replace the affected area. Then there are the joys of dealing with the healing process after having the area removed, including pain, draining tubes, and general self-care, as well as incredible permanent scaring (and a variety of scaring patterns to choose from) written across your body like surviving a slasher film, forever.

Reconstruction is essentially the dessert menu from hell, of which one has to decide if you want to partake in any at all.  This too is another painful and ridiculously difficult decision.  Should you choose to elect for some reconstructive dessert, you must realize this is not a menu of delicious rewarding chocolate porn-tits but rather much more painful options of implants under the muscle to stretch the skin, removal of nipples and permanent loss of sensation in the breasts.  It also begins a battle for attempted symmetry no matter what size and shape you are hoping for, which may or may not be your original size or shape. Should you choose to have only one side completely amputated and then attempt reconstruction, you are guaranteed surgery on the other side to achieve some semblance of symmetry which is likely to fade over time as age and gravity takes its toll.

The reconstruction dessert doesn’t end with expanders placed under the muscle to stretch the muscle tissue.  After that (in a second surgery) you have to determine if you want to use any of your own tissue to reconstruct the breast and if so, what part of your body would you like to hack into?  The preferred method is to use your stomach (and no, it’s not a two-for-one tummy tuck situation) and your back as back-up.  Both procedures of course leave their own set of scaring.   Then you must consider a third surgery (we’re now talking two years down the road) regarding the placement of aesthetic nipples, not to mention any future tattoos you might elect to add in order to color the nipples and/or hide the scars.

I’ve heard of four-course meals lasting an entire evening, breast cancer is the dinner party from hell and it seems you never get to leave.  I for one have had my fill and would like to be done now.  Sadly, chemotherapy was just the appetizer.


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