"Au revoir to the ta-ta’s"
The funny thing about breasts is that it doesn’t matter that one is usually bigger than the other, that
nipples can be facing inwards, protruding greatly or look like one has a lazy eye, heck they can be perky
or sharing an eyeline with your navel -they’re sometimes all of these in their lifetime- because they are
yours. They start swelling up in proclamation of your impending transition from little girl to young
woman. Some of us stuffed our training bras to speed along the process… shout out to my fellow
readers of “Are You There, God? It’s Me, Margaret”. Some of us tried to hide them under baggy shirts
because they felt like a lot of responsibility for all the things we were not yet emotionally ready for. We
lived through the boys-snapping-our-bra-strap era and through Phys-Ed-is-now-really-awkward stage,
too. Until one day, they were just a part of us. Our literal bosom buddies coming along on our life’s
adventures.
I developed quite early and I always loved my breasts… well, until they handed in their Perky
Termination Notice earlier this year when menopause decided to hit and they deflated faster than a
stomped-on balloon at a birthday party. Then we had our first real disagreement as to how this situation
was being handled. They were very much a symbol of femininity for me. I was used to looking like a
girly-girl. I was strong and curvy, always wanting to lose that “last 10-15 lbs” but I was comfortable in my
skin; feeling sexy and sensual most of the time. A huge -MASSIVE- part of my identity as a woman was
my breasts. I felt the betrayal of breast cancer to my core.
I have often had other well-meaning women say things like “they’re just boobs… who needs them
anyway?”. Me. I do.
“Your new ones are going to be so much nicer than your old ones”. I know they will be. I trust my plastic
surgeon implicitly. I’m sure I’m going to love the finished product very much but that does not negate
the painful feelings of having to say goodbye to my old ones, saggy or not. Such throwaway statements
left me feeling like I was being silly for needing to mourn the loss of them, like it was supposed to be no
big deal that parts of my body, that I was really fond of, were going to be lopped off and disposed of as
medical waste.
Goodbye to the ones that breastfed my babies. The bonding with them through painfully cracked
nipples because one child never latched on properly; through soaked shirts in public because I should
have moonlighted as a wet nurse, I produced so much initially; through the sadness of drying up after
only a few months and having to switch to formula. I remember feeding my twins at the same time,
football hold style, staring down at their teeny little heads with a light dusting of blonde hair on both,
and feeling my heart swell with love.
Au revoir to the ta-ta’s I rammed into barbaric contraptions we called push-up bras and hoisted them up
so high they were almost coming out of my neck because some of us… cough *me* cough… were
confused -for about a decade- thinking them resembling thyroid goiters equaled “sexy”. These same
boobs that made getting to “second base” possible despite not being sporty. The ones that contributed
greatly to sexual pleasure and knowing that I would never again be able to feel that.
When I was first diagnosed with breast cancer, the main mass and affected surrounding tissue were too
large to be operable and I was facing a complete bilateral mastectomy. I tried to mentally prepare as
much as possible for the extensive scarring that I would be left with but the only words that I heard
echoing around my mind were “mutilated” and “butchered”. The thought of the surgery was so
traumatic for me to contemplate, that I didn’t. I’m a voracious researcher when something comes into
my world that I know nothing about and I usually dive headfirst into learning as much as possible about
all of it. I hit a wall with this surgery and I couldn’t make myself read anything about it. Needless to say, I
was completely ill-prepared going into it.
However, I got lucky on one front.
I underwent neoadjuvant treatment (chemo and naturopathic) before surgery and was ecstatic to be
given the news that the masses and necrotic tissue had shrunk away from the tissue margins enough
that it was now more than likely I would be able to have a skin sparing bilateral mastectomy (with
immediate reconstruction) instead. This meant they would be removing my nipples and clearing out the
breast tissue through that space leaving me with very little scarring.
The “immediate reconstruction” is a bit of a misnomer. The reconstruction is not exactly “immediate”.
There are two options offered for a rebuild, if you will. Saline implants or what they call a DIEP Flap
(Deep Inferior Epigastric Perforator Flap) surgery. The implants require tissue expanders to be placed
under the pectoral muscles then Allomax (thoroughly cleansed cadaver skin) is secured on it. Yes,
cadaver skin. Believe me, I questioned why this little bit of a nightmare is necessary and was told that it
stops the expanders (and later the implants) from slipping into your armpit. That would make a great
party trick but is low on my list of what is considered a good time. “Put as much dead people stuff in me
as you need to” was my response.
The DIEP flap surgery, I’m less familiar with. The surgeon takes your abdominal skin and fat to create
your new, more natural, breast. The upside of this is as you gain and lose weight, your breasts get bigger
and smaller with you. They will sag and act like a normal breast would (minus nipple sensation as your
nipples are still gone). I know when it was mentioned as an option to me the nurse navigator at the
breast clinic said it’s basically getting a bonus tummy tuck. It is not. They are not going to do the muscle
tightening, the excess skin and fat tissue removal, and liposuction they typically do for a tummy tuck.
They literally just take the skin and fat they need to create the size breast you want and sew up the
incision on your tummy. This surgery is a great choice if you have extra of the aforementioned tummy
skin and fat available. I did not so my only option was implants.
My surgery did not go as smoothly as I anticipated. I’ve had multiple surgeries before and I rarely, if at
all, took painkillers to get through them. I truly believed that would be the case this time, as well. It
deluded me further when I was to be sent home the same day and the doctor told me that “some
women take a Tylenol and that’s all they need”. Cue the ego-smashing lesson… What was initially a day
surgery, turned into an overnight stay that extended to SIX days at the busiest tax-payer funded hotel in
the city. They could not get on top of my pain. I was a mess.
I was varying shades of black, purple and yellow from my collarbones to the bottom of my ribs. I had
bruised ribs and a bruised sternum. I developed a large and deep hematoma on the left side. I ended up
with what they referred to as “mild” subcutaneous emphysema so the skin all over my chest made
cracking and popping noises anytime it was touched due to the air trapped beneath (as will happen
when they lift your meat off your bones to insert the expanders). The tissue expanders necessary for
implants are a modern-day torture device. Forget waterboarding the bad guys just put some of these in
and they’ll be songbirds in no time flat. I have continuously experienced some seizing and contorting of
the muscles as they adjust to the expanders. It’s intriguing to watch the bandaged mounds on your chest
rearrange themselves into various shapes… it’s almost worth charging a ticket price to see. I’m
anticipating this being a relatively on-going phenomena as I get more saline slowly added until I reach
the size of implants I’ll be getting… well… implanted. The expanders are hard. They are not soft like a
breast AT ALL and could seriously be used as weapons of the clubbing variety.
I had been picturing the “skin sparing” part of the surgery as two empty sacks just limply hanging there
so my relief was palpable when finally coherent after surgery, I looked down and saw bumps. Glorious,
beautiful, bandaged bumps! This is the “immediate reconstruction” part of the process. My thoughtful
plastic surgeon had filled 180cc’s of saline into the expanders during the surgery. I came out
approximately an A-cup! I was expecting no alphabet at all so this made me very happy!
What I was decisively less enthused about was The Drains. A necessary evil that made me feel like a cow
attached to the milking machine 24/7 for weeks. Drains are the season’s least desirable accessory. I
tucked them into the waistband of my leggings when I had to go out but I lived in a low-level state of
anxiety that one would pop out and be swinging around as I walked and I would be none-the-wiser OR
by slipping them into my sports bra, they created such bulk that it looked like I was shoplifting. The
vision of being tackled to the ground by an overzealous security guard plagued me every shopping trip. I
give them 1 star but only because they are medically necessary. Drains are also the reason that I was
unable to have a real shower for TWENTY-THREE DAYS. No running water near the drain sites as an
infection could require removal of the expanders and we try again in 9 months to put them back in.
Sponge baths are a cold, desolate experience that leave you feeling not at all clean but exponentially
sadder.
I slept in a lazy boy chair for 12 days because you can only sleep on your back lest you risk rolling over on
your drains and pulling them out. Your arm mobility is so limited that getting them to shoulder height is
a goal (over my head… I dare not dream! Not for a few weeks anyway). No lifting anything over 5 lbs,
nothing heavier than a coffee pot, no lifting laundry baskets. No repetitive motions so vacuuming or
sweeping is out. You are pretty much dependent on your loved ones to do the life stuff for you and that
is simultaneously a nice break and extraordinarily frustrating. I don’t remember enduring a misery as
deeply embedded as the time frittered away in the chair with the tv barraging me with lights and sounds
but no fulfillment to be had.
The sun finally broke through the grey monotony when I was able to figure out a method of vacuuming.
I locked my arm to my side and rocked my entire body back and forth. I looked a fool but I was doing it!
After my raging success with dirt removal, I started concocting ways to do other things for myself and
gradually built up the strength and stamina to be independent again. I waited 6 weeks and started
attending Pilates classes again albeit at a lower weight resistance and less intensity than before but, oh
my goodness, it felt so good to be back! I refreshed my spirit by walking in large circles while my dogs
entertained themselves hunting voles at the dog park. Life is returning to… I’m reluctant to use the word
“normal” … perhaps “hopeful” is a better fit.
I am now two months post-surgery and was able to remove my bandages yesterday after I was given
clearance during my second fill appointment. My mobility and flexibility are returning at a quicker pace
now that I’m regularly moving my body. I’ve started the next phase of treatment and have completed 1
of 14 rounds of Kadcyla (Herceptin and emtansine, a chemo drug, combo that will be given every 3
weeks over 42 weeks) which I am tolerating very well. I have a couple more fills to go before I reach my
final size and then I need to heal for 6 months before I can have the implant swap surgery. My plastic
surgeon mentioned that I will more than likely need a fat graft done on my chest to try to smooth out
the very noticeable ridge line caused by a lack of subcutaneous cushioning and having implants. Fingers
crossed he can take it from the area just above my navel so my bellybutton can stop looking like a
squinty eye getting poked. We’ll see what happens though.
The next surgery after the implant insertion will happen 6 to 9 months after and it’s what I
affectionately call the Nipple Nub surgery. It’s a 30-minute procedure in Outpatients so the downtime is
negligible. This took a lot of thought to decide if I even wanted to do this part. A lot of women stay
smooth. They don’t bother with getting nipple projections or 3D tattooing. The idea of never having to
wear a bra again and not look like an extra wearing a thin t-shirt in a Porky’s movie (I really just dated
myself with that reference!) was VERY enticing as having nubs created means that they are always
visible. I’m not a fan of that look, however, I came to the conclusion that I would prefer to have the
appearance of natural breasts when they are freed from the confines of my clothes. Six months after the
Creation Of The Nubs, I will be pursuing the 3D nipple tattooing. I was quoted $500+ per nipple for the
tattooing when done by two local companies that the plastic surgeons recommend. My plastic let me
know that it’s covered by Alberta Health Care if HE does the tattooing but assured me that is the very
LAST thing that he would recommend I choose. Five hundred and up is quite cost prohibitive so I will be
checking in with my regular tattoo artist when it gets closer to the time and see if she will be willing to
do it for me at her rate. I’ve also been told that there are tattoo artists that do it for free, you just need
to ask around. All in, when everything goes smoothly with the surgeries, I should be rebuilt completely
around June 2025.
I know that this experience will be with me for the rest of my life. I will be under the watchful eye of my
medical oncologist for many years to come. The tests to monitor will be frequent, at least for the first
couple years. The fear of recurrence is one that I’m not certain ever goes away BUT I’m very much
looking forward to having this cancer journey in my rearview and enjoying a full, peaceful life with all of
this becoming a more distant memory with every rotation around the sun.
