Reconstruction in Breasts Cancer

Reconstruction in Breasts Cancer

If you have had a mastectomy, the wonders of modern technology mean that you can get
your breast rebuilt. It’s important to remember that breast reconstruction is not the same as
having a boob job. You are not someone on a bad reality TV show, looking to make up for
what Mother Nature couldn’t provide. This is not about vanity; it is something much more
profound than that. This is an attempt to make you whole, at least cosmetically. You will
actually become familiar with terms like nip, tuck, reduce, liposuction, fat graft, implant,
tattoos—all in an effort to rebuild your breast and, indirectly, you.

My advice is to look upon your plastic surgeon as an artist who works on individual
commissions, your very own Michelangelo. Every single breast he rebuilds is an original,
and he will treat yours as such. Soon enough he and everyone in his office is looking at
your breasts. He will ask you about size, shape, nipple, areola (that’s where the tattoo
comes in). He will describe how the rebuilding happens in stages.

Since it was unclear what treatment I would be going through, my doctors and I made
the decision not to reconstruct at the time of the mastectomy but to get a temporary implant
instead. It would be filled with saline solution, a little more each week to allow the skin to
stretch to somewhere near the size of the new breast. Spoiler alert. The temporary implant
feels awful. It rides high in the chest and is kind of hard. One friend described it as “like
having a Fisher-Price toy stuck in your chest.” That pretty much says it. The good news is
it is temporary.

As you think about reconstruction, your breasts will become the center of everything,
regardless of whether you gave them any thought before (see “B Is for Breasts”). They will
be touched by many people in the medical profession, and you will start to touch your
breasts more yourself. You will eventually look in the mirror more. Doctors will stare
intently and assess your torso like a blank canvas, artists or sculptors eyeing everything
before making the first stroke.

After your treatment (chemo or radiation, or both) is done, it’s time to get the permanent
implant, and the doctor takes to his canvas. He is creating a work of art he knows cannot
be completed in one sitting. You will discuss the size of the permanent implant and how the
contours of your new breast will fall. This may require several surgeries, and you prepare
yourself for that. Every time he operates on you, he proceeds like a fine architect or
builder. His drawings are done with the aid of nothing more complicated than a Sharpie and
experience, and your chest is where he will demonstrate his skills as an artist. He will mark
up what needs to happen on your chest—no measuring tapes or spirit levels, just his expert
eye. And when he takes the knife to you, it should be right the first time. A few months
after the implant he builds a nipple from your skin. After that he’ll tattoo an areola.

He knows he cannot replicate exactly what you had, but the effort to eradicate the visual
reminder of what has happened to you is quite extraordinary. You have lost your breast, of
course. There is no feeling. There will be no feeding. Other doctors will marvel at the good
work he has performed—clean incisions, tight stitching, fast healing. Every day you look in
the mirror, as the scarring begins to fade, it is not a deformity that faces you but a
remarkable work of art.