This year more than 15000 Australian women will receive a breast cancer diagnosis and around 6000 of them will have one or both breasts surgically removed. After their mastectomy only one in ten will have reconstructive surgery.
In America one in two will have a reconstruction and in the U.K. it’s one in five.
After surgeons took my breast I swore I would never have a reconstruction, that was until the day I was at physio and I was asked if I’d been massaging my scar line.
SAY WHAT? As if I was going to massage the raw and painful scar! She explained that if I wanted reconstruction it would be beneficial to massage it and pull it away from the chest wall to stop adhering. Nuh uh, no way! I wasn’t going through more surgery and I certainly wasn’t going through reconstructions. My physio curled her lips into a smile and said “that’s what you all say’.
Fast forward a couple of years and eight surgeries later, I’m now proudly sporting two new boobs made from my back by incredibly talented surgeons.
So what changed? Well cancer is a journey, I knooooow there’s that freakin word, but I gotta say until I can find a better word ‘Journey’ it is.
Breast cancer is a rollercoaster ride of appointments, fear, weakness and the unknown and somewhere along the way all the negative was replaced with strength, will, pride and optimism. For me it was around the half way mark of chemo that my mindset changed and I had this ‘Aha’ moment that I might not die. Instead I realized that this shit they were pumping into me just might save my life, yeah….I was going to live.
It didn’t matter how long I lived for as long as I truly lived and made the most of my time. So mid- way through eighteen rounds of chemo I started thinking I might like to have a reconstruction. I didn’t like my prosthesis and I didn’t like not being able to wear the clothes I wanted to. I didn’t like looking down at my barren chest and thinking “I have cancer”.
Surgeons carved up my chest and my breast went to research, then radiotherapy seared my skin red raw. A month after radiotherapy was done the surgeons removed my ‘port’ and an appointment was made to see a plastic surgeon. I was diagnosed in September 2012 and in late August 2013 I had my first appointment with the plastic surgeon at the public hospital I was being treated at.
I met with my plastic surgeon every month for three months before I gave him the green light, he would discuss my options and tell me the risks and I would head home to research and digest the information.
I also met with my breast surgeons who gave me the green light to have my other breast removed and eventually a surgery date was booked for March 2014…for the first part of my reconstruction surgeries. See I wrote plural there. Yeah, it’s a long process!
People often ask me why I had my other breast removed. I chose that path as it was my original wish waaay back in the beginning, I had wanted both removed but the surgeons were hesitant. They knew I needed chemo and they also knew that a double mastectomy meant a longer healing time and double the chance of complications so recommended just a single mastectomy. I was cool with that at the time because I trusted them and I was of course shit scared.
Down the track, and every single day I would shower and look down at my breast that was left hanging on its own and wonder when it would turn on me. Was this remaining breast going to try to kill me too? I wanted it gone for future proofing my health and I also wanted it gone for vanity. Why would I want one reconstructed breast and one that been on my body for a very long time that was feeling the pull of gravity? I wanted them both to look as similar as possible.
Here’s the thing though, the doctors like to keep you in the dark a little. They don’t like to tell you all the gory details and after having my surgeries I can kinda understand why. Not all breast reconstructions are the same and recovery is an issue. There are a few different types of reconstructions available and they won’t all suit everyone and not everyone will be a suitable candidate for a reconstruction. Yup that’s right, the choice is snatched away from some women. Things like age, weight, skin condition, treatment undertaken and recovery all come into play.
I was young with time to recuperate but a few things came into play like my damaged radiotherapy skin, my gorgeous stretch marks on my tum (rendering that skin useless) and my weight. The only option my surgeon would consider was a bilateral Latissimus Dorsi reconstruction…it’s big words because it’s a ‘bloody big surgery’. Put simply two surgical teams would be involved, one to do the mastectomy and one to do the reconstruction.
It’s taking tissue and fat from your back and transplanting them to your chest, oh they also take your Latissimus Dorsi muscles and tunnel them through and do fancy stuff to create muscles on your chest.
While they’re in there they pop in a tissue expander which is like a balloon that is later injected every couple of weeks with saline to stretch your skin. Once it’s stretched enough (or to capacity) it’s removed and exchanged for implants. Then it’s time for nipples.
Reconstructions are not for the faint hearted, which is one of the reasons so few women have them. After all a breast cancer patient goes through it just feels impossible to face any more surgery…any more intervention.
For some women their choice is influenced by time to recuperate and whether they have support or can afford to take the time away from work. For some it’s financial, private surgery is expensive. You can have your surgery done publicly (like me) but depending on the state you live in the wait times can differ. Rural patients face even greater disadvantages and it can all feel overwhelming and just too much. There’s a lot to consider when considering a reconstruction.
The other thing to consider is reconstructed breasts look and feel very, very different to real breasts. I was hyper aware of this and prepared, but I meet many women who feel disappointed their breasts aren’t more like some of the pictures they see on the internet of perky boobs.
If you have the opportunity to ‘check out’ some actual reconstructed breasts, take it. I had a shop assistant eager to show me hers and I gotta say while I was a little shocked at some of the scarring I was also super impressed, seeing hers sealed the deal for me. I had seen some absolute shockers on the internet that left me worried about what I could end up with but after seeing some in the flesh it settled my fears.
I’m going to leave the details of my reconstruction for another post, today it’s about how I came to my decision, what’s at play and why it’s important to be informed. It’s ok not to reconstruct, it’s a good idea to shop around and you don’t have to make up your mind straight away. You can wait years before you make a decision but if you’re going public it may pay to get your name down quickly.
For the record I’m pleased I did reconstruct because these days I look down at my cleavage and say “I HAD cancer”…that right there makes it all worth it.