I’ve been praying about and asking for prayers about making a decision for surgery and reconstruction. And through our prayers, I have reached a decision that I am comfortable with. I’ve had countless conversations, done quite a bit of Googling, and had a few appointments to get the information I needed to figure out what to do.
It’s been a process to get to this point. Even when I look at my blog posts from earlier on this journey, I have come a long way in my feelings and understandings about my current situation. At first, I viewed the idea of surgery as “may as well get rid of them both and get a perkier set”. Back then, I was almost in denial about the fact that my body, after surgery, would never be the same. I assumed that if I did reconstruction, it would replace what I currently have and the replacements would be almost better. But actually, I was wrong about that. When you have a mastectomy, they take all the nerves, along with the tissue, so there is no feeling left when they’re done. It took me several weeks to come to the conclusion that a new, perkier set with no feeling was definitely not an improvement from my current body. In fact, it took me several weeks to realize that no matter which reconstruction option I chose, it would solely be for cosmetic purposes.
My only chance to have any feeling was to keep the left breast because they didn’t give me the option of keeping the right. They shared with me that my chances of ever fighting breast cancer again with a double mastectomy (actually called a bilateral mastectomy) was 5%. Because I never hope to fight this again, the idea of a bilateral mastectomy was appealing. I asked lots and lots of breast cancer survivors, as well as people in the prosthetic industry and my surgeon’s assistant about keeping one breast. The overwhelming majority said that many women feel lopsided when they keep one breast. Many women who reconstruct just one side feel unmatched. Knowing myself and my fondness of symmetry, I decided to go with my gut and reduce my chances of ever fighting breast cancer again. I am choosing to have a bilateral mastectomy. I am completely comfortable with the idea of removing both breasts. My girls have served their purpose. I’ve nursed two babies and quite frankly, they’ve seen better days. The recovery for a single vs a double is not much different. More drains, but the recovery time and restrictions are the same. I don’t think keeping one breast will bring me any comfort as I go through the emotional experience of losing one. I feel like there’s more to be gained by having a bilateral mastectomy than there is by keeping one breast. So coming to this decision wasn’t too difficult for me and I’m at peace with it.
Once I decided to have a bilateral mastectomy, I then began the decision-making process of whether or not to reconstruct. I began this process by researching the options available to me if I decide to reconstruct. To get my questions (over 3 pages of them) answered, I spoke to several breast cancer survivors, as well as met with a plastic surgeon that works with my breast surgeon. I quickly discovered that there are 2 main choices. You can use your own body fat or you can use synthetic materials. In either case, at the time of the mastectomy surgery, they place expanders on top of the muscle, under the skin. These expanders are then inflated after your body heals in an effort to stretch the skin back to the cup size of your liking. When you’ve been “expanded” you go in for a second surgery to remove the expanders and put in the body fat or saline/silicone. Each of those options has its own drawbacks. If I chose the synthetic materials (implants) I would have to undergo replacement surgery every 10-12 years. Since I’m only 37, I could be looking at 3-4 or more future surgeries after this. If I chose to use my body fat (the procedure is called diep flap) it is a permanent fix, no future surgeries required. That being said, the diep flap surgery is a big one. The surgeon said they “slice you from hip to hip” taking more flesh around the belly button. During surgery, they reposition your belly fat and reattach the blood vessels to create new breasts. It is a rough recovery, taking about 6 weeks with several restrictions. To be honest, none of these options sounded very appealing to me. I didn’t like the idea of more surgeries and more recovery time. I also didn’t like the idea of foreign objects in my body. I didn’t like the idea that if my cancer reoccurred in my breast area, it may be more difficult to detect because of my reconstructed breasts.
A third option is to go flat, which means you don’t reconstruct at all. If I chose this option, I could live flat on a daily basis or I could wear prosthetic breasts during the day to give me the curves of a woman. I researched this option by making an appointment at a prothesis store and by talking to a young girl who chose this option. I got her information through my breast surgeon and she was so kind to answer all my personal questions when we spoke on the phone. I asked my surgeon to put me in touch with someone who is young, did not reconstruct, but regularly wears prosthetics. I have a few connections with people who did not reconstruct who live flat on a regular basis, but I knew for myself that if I chose this option, I would not want to live flat. After my research, it seemed that for my personal situation, the main drawbacks of not reconstructing were mostly related to my own insecurities. If I didn’t choose to reconstruct, I worried about the impact it would have on my marriage. I also worried about how comfortable I would be in my own skin. I didn’t want to emerge from the shower feeling like I need to get dressed quickly because my body would be something I was ashamed to look at or let my family see. I worried how it would affect my girls that their Momma doesn’t have a body like everyone else’s Momma.
By the time I got this far in my research, I told Ryan that I feel like I have to choose between bad and worse, but I just can’t figure out which is bad and which is worse. I continued to pray and continued to deeply examine myself. I felt so much pressure to decide what I could live with for the rest of my life. But the plastic surgeon and my breast surgeon’s nurse both told me that I don’t have to decide right now. Whatever I choose right now can be changed later. The plastic surgeon even said that if I’m not completely comfortable with my choice, then don’t reconstruct. He said that it only saves you one surgery of placing the expanders if you opt to wait and decide to reconstruct later.
I mulled around the idea of going flat for now and allowing myself time to decide if I want to reconstruct later. And to be honest, this thought set well with me. If I go flat and can’t get used my new body or don’t like strapping on my prosthetics, then I can begin the process of reconstruction at that time. If I go flat now and find that I am able to adjust to life with prosthetics, then I’m in a good place. Honestly, I have a very strong feeling that this will be the case for me. I have never been a girl who shows off my cleavage, so I don’t think I’ll have trouble dressing my new body. Additionally, I’m the type of person that takes the time I need to process new situations and then once I “get over” my hesitations, I never look back. I’m pretty black and white in that way. So I think it will take me some time to feel comfortable in my own skin with no breasts. But I know that there will be a day when I am completely at ease with my breastless body. I’m no longer worried about how my kids will handle the change in my body. Gracie and Hattie have shown me through this journey that they’re pretty resilient. I know my flat chest will be different for them, but similar to my bald head, I think they’ll get used to my new body. Ryan has been so supportive and honest through this journey and decision-making process. Early on, I worried that I could make the wrong choice and it would negatively impact my marriage. But I quickly realized that I married a very good man. He adores me and wants me to do what’s best for me. While I’m getting used to my new body and trying figure things out, Ryan will be doing the same thing. Because we’ve had some deeply honest conversations through this process, I know that I can be open and honest with him and that he can be open and honest with me as we figure things out. And that is comforting to me. I no longer feel worried about how going flat will impact my marriage. We both know that some things will be different and we’re both ready to stick together while we get adjusted to a new normal.
For those of you who’ve made it this far in the post, thank you for reading. I wanted to put into words the process I went through to make this decision. I’ve been an open book through this journey because it’s just who I am. If other people are in this situation in the future and can learn from my experience, I am happy to share. I know there will be people who think I’m making the wrong decision, people who will judge my choices. And that is okay, but know that I am completely confident that I’m doing what is best for me at this time. I appreciate all of your prayers and support in this journey so far. Please continue to pray for us as we anticipate the surgery in late October. I should have a firm date soon. Please pray for Gracie and Hattie because I think the first few weeks after surgery will be harder on them than they are on me. I’ll have more specific prayer requests as that time gets closer.
