Monday, November 12, 2012

We Can Rebuild Her

(Insert breast cancer patient's name here), a woman barely alive. Gentleman, we can rebuild her. We have the technology. We have the capability to make the world's first prefabricated woman. (Insert name again) will be that woman. Better than she was before. Better. Bigger. Perkier.

Watch this clip before reading further:


I had a little fun rewriting the opening to one of my favorite television shows from the 1970's, The Six Million Dollar Man. That is how I felt during the conversations with my doctor about breast reconstruction. That's how I felt and still feel when I see or read interviews with celebrity women who've had cancer and opted for reconstruction following a mastectomy. Sometimes it's just too difficult to look at my true feelings about cancer. Jokes make it easier to take.

I remember one television interview, in particular, with a husband and wife. I won't name the show or the celebrity because that woman's journey belongs to her. Everyone handles it differently. Everyone's spouse handles the anguish differently too. Judging them would be wrong. They were muddling through the experience like the rest of us. But, since it was a national interview, I feel I can comment on it. The interviewer asked the smiling couple about the wife's upcoming mastectomy and reconstruction surgery.

Here's where it got personal for me.

The woman responded that even though she only had a very small, contained lump (stage 1 cancer, if I remember correctly) in one of her breasts she'd decided to have them both removed.

"So you are having both breasts removed to minimize your risk of having breast cancer again?" the interviewer asked.

She answered, "Yes, but mainly I'm having both removed so that I'll get better results with the reconstruction. I want the girls to match."

Her husband joined in, "We asked for big ones this time."

Everyone on the set laughed. I threw a pillow at my television.

I am very grateful for advances in medicine. Treatments, after care, and prevention are so much better than they were for our mothers and grandmothers. I'm not complaining about breast reconstruction and the normalcy it affords women like me. I am complaining about the media  and the way it sells and spins reconstruction to women who've had cancer. In my humble opinion, it's perverted. A very serious set of surgeries are presented as a fluff piece in People Magazine or on network talk shows. Let me explain. Bullet points should work nicely. The infuriating statements I've heard or read in the media are in bold.

1) It's a quick trip to the plastic surgeon to get your breasts back.  No. No. No. I chose a reconstruction method using a tissue expander and a silicone implant. There are many other ways. I've had 4 surgeries related to reconstruction and expect to have at least one more to complete the initial process and it doesn't end there for me. I opted to keep my right breast, so if I want "the girls to match", I'll need additional mastopexies about once every 5 to 10 years. I'm in my forties. Let's do the math. 6 more surgeries are coming down the pipe if I live to be eighty. I don't think I'll care about the my sagging breast when I'm eighty but if I did...well, there you are.

 This is not a quick and painless process. I had my first surgery almost two years ago. I'm not finished yet.

2) Let's get excited about having a clean slate ladies. Isn't it great that you can pick your new size. Want to be a DD? Go for it! No, it's not great and no, I'm not excited. The reason I'm faced with this choice is because I lost my breast to an invasive disease. I was perfectly happy with my body before I got sick. I'd keep my breast and it's sister if I could, thank you very much.

It's true that, once faced with the problem, I could go as large as my skin would allow or smaller than I used to be. The first step in reconstruction is the placement of a tissue expander to hold the shape of the breast mound. This expander is filled with saline. On subsequent doctor's visits the expander is injected with more liquid until the patient reaches just a little larger than the size they want to be. This gives the surgeon a bit extra to work with while shaping the new breast, a margin of error of sorts. The skin stretching is a painful process. For the next few months after the tissue expander placement I felt like an elephant was sitting on my chest. Stretching my torso too quickly was jarring and painful. When my body finally adjusted to the process, I liken it to each time the orthodontist tightened my braces.

What a woman has to remember if she decides to go larger than her natural size is that she has no breast tissue under her skin to soften the look of the implanted device. The only thing under her skin will be the silicone bag (unless she goes with another method). The larger she goes the harder her breast will feel, the more the bag will weigh down her skin, and there is no way to hide the contours of the implant with such a thin (skin) covering.

3) Lucky you! You'll have brand new breasts! No. I have a fake breast where my natural one used to be. It looks good for what it is but it is not a brand new breast. It's more like a Barbie boob glued onto my chest.

4) Just get them both off while your at it. You'll look better in the end. I didn't do this. I felt very strongly that a bilateral mastectomy was not for me. My cancer was contained to my right side and I tested negative for the BRCA1 and 2. I am at low risk of this or a new cancer returning. My plastic surgeon told me that many women choose prophylactic mastectomy even when they have a low risk for recurrence. It's easier for the surgeon to give the patient symmetry. He was only trying to help, but for the life of me, I can't understand why I would want to lose two body parts just so I can have a matching set of prostheses.

Very few natural women have perfectly matching, symmetrical breasts. I'm in good company.

5) No one will ever be able to tell you've had cancer. You will be as good as new. This is sort of true. With my shirt on I look the same as every other woman on the street. I like blending in again and only talking about my past illness when it suits me. 

If I take off my shirt, well, that's a different story. You would know I've had cancer. I have significant scarring, which is the norm for women like me. One side is extremely firm. The other isn't. The reconstructed breast has an odd shape. And this result is with a very talented, highly recommended surgeon.

End of bullet points. Moving on.

I'm alright with these imperfections and happy with my decision to have reconstruction with an implant. What I object to is glossed over, cutesy half-truths and misinformation fed to us by the media to make women feel better, like cancer is no big deal and recovery from breast cancer is all about regaining your female sexuality, not saving your life. That is why I called it perverted.

I am a grown woman who suffered from a life threatening illness. Having stage 3 cancer is as close to serious as it gets. I needed full disclosure about what lay ahead of me in order to make the best decisions for myself and my family.

Eureka! This is it. I understand why this upsets me so.

The media, in general, treats women with cancer like airhead, child-like creatures who can't handle the truth. They are turning us into happy warriors instead of giving us the tools to be strong, capable women. They candy-coat their conversations with famous cancer survivors, women we should be learning from if they are going public with their illnesses. Instead of using the interviews as teachable moments, the media laments over the loss of the famous woman's sex kitten status and rejoices that we will soon be able to gaze upon new, improved breasts when the happy warrior poses for future issues of Maxim.

The media says they are covering breast cancer but they aren't. They refuse to look the disease square in the eye. They distract women with tales of "Oh, it's not so bad. You'll get through it and be better for it!"

I like to think this media slight of hand is not malicious. I like to think it's because, as a society, we chat about breast cancer all the time, but we are uncomfortable (and sometimes incapable of) talking about women's breast health in a helpful, nonsexual  manner.

The links I've added are important to the context of this post. If you have the time and inclination, please click on a few to see what I mean.


  1. An excellent post. Thanks, Lisa. By the way, I don't find it to be a "rant." You've made a good case for each of your points. I not only learned something, I gained fresh understanding for my own feelings of distaste for a lot of the media coverage of breast cancer and related issues. Thanks again for the insight.

    1. Megan,

      Thanks for commenting. I'm glad it didn't sound like a rant. I can get hot under the collar when I think too long about some of these things. I could feel it as I wrapped up the post.

      I'm glad you are reading and commenting. I respect you so much. Please keep in touch.

  2. My grandmother did not undergo reconstruction. Keep in mind that this was back in the early 90's,so she didn't have quite the same options as women do now. She didn't even get a special bra but just sort of accepted that this was what her body now looked like. My own opinion--and this from a woman who has NOT had to face the choice--is that I would likely follow my grandmother's example. Any of the reconstruction choice add complexity to an already rough surgical procedure. I don't think my interest in looking "normal" again would be outweighed by my aversion to the pain of additional procedures and the likelihood of complications. Again, I am projecting. I suppose I couldn't be sure until I actually faced such a choice--but I am terrified of hospitals and doctors, so I think I'd want to get past all of that ASAP.

    As for the media's seemingly superficial focus on breast cancer and reconstruction. I look at it as a result of something very positive...most women with breast cancer have positive outcomes. They survive. Being able to focus on reconstruction and aesthetics is such a luxury. This isn't true for most other cancers. So, that's what I see when I watch celebrity interviews about breast cancer. And, somehow, seeing them joke about their custom-designed "girls" makes me less afraid for my own future.

  3. Carrie,

    I think your grandmother's choice is a courageous one. I thought about it seriously and in the end I decided that reconstruction was right for me. I admire women who gracefully accept their new bodies. When the time came I wasn't quite there mentally.

    My husband told me over and over that he was fine with however I looked so I know my decision was all about me and my own body image.

    I respect you feelings about media coverage. One reason more women survive is early detection and treatment. For me, I'd like them to give more time to the nonsexual aspects of the disease. Aesthetics has it's place but it's over emphasized because we live in a breast obsessed least that's what I see.

    I hope and pray that you never have to find out what you'd do. Good health to you! Now and forever!


  4. Replies
    1. Thanks Linda. I need to call you. In fact, I'm going to do that right now.



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