I chose reconstruction, but not to “look good”

Making a choice

I chose a reconstruction for many reasons:

• I have had breasts for almost 40 years, and a two breasted person is how I perceive myself

• I do a lot of work in public. Women’s clothes are designed for two breasts and I didn’t want to feel self conscious when presenting

• Friends with prostheses say they are uncomfortable and heavy

• I live in a sexualised culture where a woman’s breasts are considered a prime signifier of her sex. As a feminist, there is an enormous amount to consider when understanding our relationship to our bodies, but I was eager to have the cancer out of me. I did not take a very long time to choose.

I did not choose a reconstruction because I wanted my breasts to look “good” or “better” but because I wanted to feel like myself and—after having cancer twice—that was important. To feel physically and emotionally like myself, not the disease.

Remember the inside as well as the outside

Yet everything to do with the reconstruction was discussed in terms of how my reconstructed breast looked. Even when the pulse flap was checked every hour for the first 24 hours, I was told my breast looked good—I did not ask for such comments, but this view was constantly volunteered. I appreciate that it was generously meant, but at the time, in pain, the last thing I wanted was virtual strangers’ opinions on how my body looked.

In the run-up to the surgery, despite the competence, compassion, and generosity of the plastics team, at no point did anyone tell me that my breast would feel physically different.

Despite a few complications my scars have healed well, but the breast still feels different—not only the lack of feeling in the flap and the immediate surrounding area, but inside too. I can feel, sometimes with pain, where the piece of rib was removed to remove the mammary aorta. I feel the places where the flap taken from my stomach is attached. The breast pulls from the mid-point of my chest. It feels like something else, it does not feel like a breast.

Language is important

To have been advised that breast reconstruction can result in patients feeling physically different would have been helpful to inform my thinking about my choices. A mastectomy is, in effect, an amputation. A reconstruction is a rebuilding. Language can help us understand how it might be for us. Different language, possibly more brusque, but certainly clearer, would have helped prepare me better.

We live in a society where an inordinate emphasis is placed on appearance, but reconstruction is not merely about appearance. We also, each of us, live in and through our bodies, and to ignore the physical feelings relevant to a reconstruction is to ignore a great part of the process.