Now I’m Trendy, Dammit
The NY Times published a piece last night:”’Going flat’ after breast cancer,” about the nascent movement towards openly having a boobless chest — which is very different than a flat chest. (Brace yourself for the comments there — Frankenstein references, etc.) And here I thought I was doing something courageously original! Turns out I’m just an early adopter, not an innovator.
When I first found out I needed a double mastectomy, I searched online for stories from women who had and who hadn’t gotten reconstruction. Overwhelmingly, those who hadn’t seemed to have far fewer problems, both physically and psychologically, and they managed fine with external prosthetics. So for my first appointment with the surgeon, I was firmly committed to a boobless chest. And I didn’t want any prosthetics. I was glad that I had a choice at all, though. Many don’t due to radiation or other complications. It feels more empowering to choose it rather than to have it the default.
But the doctor got to me. He appealed to my vanity, and I faltered. The one area of my body I’m insecure about and try to hide is the little flap of belly skin that developed after my third child. Tucking it into bikini bottoms and ensuring it stays tucked means always feeling self-conscious at the beach. And I only wear really long shirts in class in case I lift my arms and suddenly expose the horrors of a skin flap to my young charges. I admit I’ve googled “tummy tuck” previously but was deterred by the $10,000 price tag. Now, without boobs to keep a shirt out from my body far enough to stop it from clinging to my belly bulge, I worried it might be more of an issue for me feeling repulsive.
As I sat on the examining table, topless but with jeans on, the doctor grabbed my flab with two hands, gave it a good shake like he was shaking out a towel and said, “You could get rid of all this fat! Just move it up top, and you’ve got a flat stomach again. It’ll just add half an hour to your surgery, and it’s all covered by OHIP because it’s reconstruction!”
I hadn’t thought of myself as fat until that minute.
My resolve wavered, and I made an appointment to see a plastic surgeon.
But my surgeon was wrong about how it works. Something that surprised me along the way — but really shouldn’t have — is that everyone involved knows their own job really well, but doesn’t really understand everyone else’s expertise. Really, why should they? I’m not sheepish that I can’t teach calculus even though I’m a high-school teacher and took it once over thirty years ago. I can send people to the right place to ask those kinds of questions; nobody expects me to answer them myself. Except… I don’t ever try to answer them and give the wrong answers with confidence. That might be a bit of a problem that warrants half a star off my doctor’s otherwise stellar rating.
The plastics guy was fantastic for telling me all the possible problems and pitfalls. The Times article suggests that plastic surgeons “aggressively promote reconstruction,” like you might picture from TV stereotypes of greedy, superficial cosmetic surgeons, but this one didn’t at all. He explained that there are two different types of procedures. The one using belly fat is done with micro-surgery that requires moving blood vessels around, and it’s a 12-hour procedure that can’t be done at my local hospital. It’s great because the fat grows and shrinks and ages with you, so it doesn’t look like a different entity, but it’s a separate, 12-hour procedure!! AND, right away he told me I don’t have enough fat for even one small boob. It’s all skin. Somehow, that didn’t make me feel any sexier.
The other procedure, that just adds half an hour to the surgery, is with an implant. We played with the saline and silicone boobs on display, but he just uses “gummy bear implants” — solid silicone that won’t be damaged by being punctured and can’t leak. It feels exactly like a gummy bear. BUT the surgery doesn’t all end with just that additional 30 minutes in the O.R. That’s just to put in a skin-stretcher: a balloon-thingy that they add to with an injection every week so the skin can slowly expand enough to fit an implant. THEN, weeks later, you have to go back under again to get the actual implant added. AND there are so many complications with scaring and rejection and dimpling around the prosthetic. As he said, it’s not a breast implant, it’s a prosthetic implant. I can barely tolerate plastics in my life, much less in my body. I thanked him so much for telling it like it is, tucked my flap back in my jeans, and went on my merry way.
At my next appointment, I asked my surgeon how long I should wait before getting a tattoo. I already have vines up each arm and now I can have them join in some wonderfully delicate display on my chest. The only grieving I did before losing my breasts was when I’d think about losing my butterfly tattoo. I got it decades ago when I was trying to wean my son from breastfeeding. He was already three and showed no signs of giving it up willingly, so I was working on getting him through longer and longer periods without. But the little monkey would sneak into my room at night to nurse while I slept dead to the world! I tried wearing a bodysuit to bed, but he was able to get around anything this side of a suit of armour. So I got the tattoo to mark the transformation from my breasts being purely functional to being beautiful again, and, most importantly, to make sure I’d wake up from the pain for the first few days and stop my little snuggler in the act. It worked! And then it became a memento of that precious time of my life with my little ones.
When I was waiting to go into the O.R., my kids asked if there was some way we could keep that bit of skin, and we made some pretty sick jokes involving pressing the butterfly in a book even though there are much better ways to save tattoos. But with the surgeon being pretty old-fashioned about aesthetics to begin with, I suggested they could ask him. I had too much else on my mind. And it can always be re-done among the vines.
My doctor didn’t really answer the question about how long to wait to be inked, but advised I wait a good, long while in case I reconsider getting reconstruction. “You’re still young!” was his primary argument as if giving up breasts means giving up romance or life itself. I guess it’s his experience that women change their mind afterwards, and that it helps them to look like themselves again, but I’d still like my question answered! I know I’m not quite dead yet, but I think I can muster the courage to make it through my remaining years without looking traditionally female. We can totally rock a boobless chest, despite misgivings from the Trumps in the crowd! And maybe the work of art on my chest will be enough to distract from that extra bit of skin sneaking out of my bottoms at the beach. Maybe.