Matters of the Flesh

Shirtless and with the top of my jeans pushed down below my hipbones, I stood before the plastic surgeon’s studied gaze. Photos were taken from all angles. As he prodded gently at the flesh around my hips and buttocks to assess whether the fat there could be used to construct a new breast, I tried concentrating on the posters on the wall and feigned composure. But the most awkward moment was yet to come.

“Lie on the exam table and raise your feet and legs slightly,” he requested. He stood over me, both hands on my stomach, thumbs alarmingly close to my belly button, and pulled my fat up toward the ceiling. This is as scientific as it gets for plastic surgeons when it comes to judging the ability to use a patient’s own tissue for breast reconstruction, apparently. Never a fan of having my stomach touched even at the best of times, I focused all my energy on not squirming as he assessed his potential materials.

“The issue is that there is quite a bit of, er….volume in your breasts...” he began awkwardly.

“Oh! Right – no, no, I definitely don’t want to be as big as I am now,” I said, relieved that he had at last released his grip on my stomach fat. “Smaller is fine. In fact, I see the ability to stop needing to safety pin the gaps in my button-down shirts to be one of the big benefits to come out of this whole experience.” Once again, humor serving as my metaphorical hospital gown as I lie flat on my back, exposed on an exam table.

After each plastic surgery consultation, I have walked away reassured that I should be able to achieve a satisfactory cosmetic result from my reconstruction. But they have also featured moments of almost comical humiliation. One surgeon drew all over me with a Sharpie, à la Dr. 90210, pointing out that my nipples should actually be about an inch higher than they are. It took the better part of a bottle of rubbing alcohol and a pack of cotton balls to scrub away the marks from that one. Another described my breasts as “long,” not exactly the adjective one hopes would characterize these particular body parts at the age of 33.

And although my first surgeon described me as “too skinny” for the stomach fat transfer alternative (I thought about asking him to put that in writing so I could frame it for posterity), that did not stop him from being able to pinch what was clearly well over an inch as he stretched my belly fat skyward.

Now that I am nearing the end of chemo, with only 2 sessions left to go, I must make my decisions about surgery, which my doctors have advised me to schedule about 4-6 weeks after my final chemo treatment. Due to my genetic status, I will be having a bilateral mastectomy. Thanks to advances in medical techniques, I can have what is known as a “skin-sparing” mastectomy with immediate reconstruction, which means I will wake up from surgery with some sort of breasts in place. In theory, these can be made from either my own tissue or from implants. In practice, since I am having both breasts removed, implants are probably my best option.

But I still have an array of choices to make over the next few weeks, which means more appointments with more plastic surgeons. Michael and I are planning to celebrate the end of chemo with a trip to Miami in late March for the wedding of friends – despite these upcoming consultations, I will probably be able to muster the confidence to avoid spending all my time there in a giant flowered muumuu, but I will definitely be packing the rubbing alcohol and my most supportive underwire bikini.