Believe it or not, it has already been three months since my final revision surgery. So last night I finally got around to taking some photos of the final product. If you'd like to see them, please email me at [email protected].
Having the pictures caused me to take a critical look at the work product. Here I was thinking this entire time that things looked pretty good but the photos confronted me with incontrovertibe proof that (i) Lefty is still noticeably bigger than Righty, (ii) I still have quite a bit of "sag", (although I guess I'm to blame for that since I told my doctor to only do a modified breast lift since I still wanted to look "natural"), and (iii) Righty has a slight tendency to wander sideways, like the boob is craning its neck to view a train wreck on my right side. Weird.
Be that as it may, I have no intention of going under the knife again to correct these minor defects. I knew going in that I would have two surgeries and two surgeries is what I had. I have no need or desire for more. At this point, these defects are more amusing than annoying. And hey, my original girls were far from perfect in appearance too, not to mention their murderous potential. So I think I need to be more forgiving of my imperfect, docile replacements.
Seems like the question of when to call it a day on reconstruction has been on the minds of some of my fellow mutants out there. Steph considered further revision of her one-step reconstruction but ultimately decided that she was happy with things as they are. Teri has been so screwed over by complications and the existential crisis that said complications have provoked that she is considering foregoing her "second stage" (see below). Megs just had her revision surgery last week and you can see her before and after photos on her blog. She's already looking terrific. And another BRCA friend, Karen (not a blogger), had additional surgery last week to resolve a nagging pain in her right implant. Hope you're back to your vivacious self soon, Karen!
About the "Second Stage": Teri and I had the same type of reconstructive surgery - so-called "free-flap" reconstruction in which fat is harvested from another site in the body and transplated, blood vessels and all, to form new "living" breasts. (It's called "free" because the tissue is completely released from the body without sacrificing any muscle to sustain the blood vessels.) Most flap reconstructions are planned as two surgeries - although the mastectomy and reconstruction is completed in the first surgery (the "first stage"), the "second stage" gives the plastic surgeon the opportunity to further shape and contour the breasts and to create symmetry. In addition, during the second stage the plastic surgeon can also improve the outcome of the donor site -in my case, this involved liposuction on my thighs to bring my legs into proportion with my torso and scar revision on my hips as those scars had healed quite badly. Thus, when having a free flap reconstruction, at least one revision is typically part of the package.
After my first stage, I thought my reconstructed boobs looked pretty good. And if not for the thick and scaly scars on my back, I might have passed on my "second stage". But since those scars looked truly awful, I knew that I was going back for more. And once I was being put under anyway, I was happy to take the surgeon's suggestions for lifting and contouring the girls.
Well, I'm here to tell you that I was a fool. Now that I have my photos, I can see the dramatic difference between the results after my first stage and what we ended up with after my second stage. There is really no comparison. Despite the flaws detailed above, I am truly pleased. Not exactly my ideal - that would be Greta Gerwig parading around topless in Greenberg (that girl has seriously perfect tits) - but waaaay closer than what I had after my first stage.
So why do so many of us struggle with the question of whether we should pursue further revision when we're not completely happy with how our reconstructions look? Or worse, when the reconstruction is painful or seriously cosmetically flawed? Obviously, like Teri, we definitely get to a place of "surgery fatigue". Undergoing surgery is hard physically, emotionally, financially and logistically. Once the surgery isn't strictly speaking medically necessary, we may feel that taking all of that on just isn't worth it.
But on another level, I feel that perhaps we start to feel guilty about wanting "perfect breasts". Sometimes I think, "I did this to reduce my risk, not to have a perfect rack" so I should just be satisfied that I achieved that and shut up about about Righty wandering off the reservation. But then I think, why should I be forced to choose between avoiding cancer and looking good? Yes, I had mastectomy and reconstruction to reduce my risk. Yes, I "paid the price" of giving up my breasts in exchange for risk reduction. But how frickin high does that price have to be? I was prepared to keep on renegotiating this raw deal until I got a reconstruction that I was completely satisfied with. I came to believe that if benefitting from mastectomy somehow meant that I deserved to end up uglier than I started, well then it would just be slippery to feeling the need to explain and justify why I had reconstruction in the first place.
After all, many women have mastectomy without reconstruction. I have tremendous respect and admiration for them. Given my 1970s style unreconstructed (ha!) feminist sensibilities, I considered it. For like a nanosecond. In the end, I must admit that my decision to have a prophylactic mastectomy was inextricably linked to my expectation of a good reconstruction. I don't know if I would have been able to do it if I believed that I would be left looking significantly different. I know that I'm a mutant, but I masquerade in the world as though I were normal. I have no desire to look noticeably different from the average woman and I would feel horribly self-conscious trying to make my way in the world as a flat-top. Again, that's just me. Still, the relatively modest goal of "looking normal" could have been achieved without the extensive state of the art reconstruction that I had. But once I decided to have reconstruction, there didn't seem to be much point in "settling". I was going to have it so it may as well be the best state of the art reconstruction available today. I wasn't going half-assed on my reconstruction. I wanted the full ass and that's what I got. Yes, I am now officially built ass-backwards!
Perhaps there's something else at work here: Many of us who opt for reconstruction are not the kind of the people who would have plastic surgery for purely cosmetic reasons. (Well, I might but now I'm talking about you guys with the good value systems.) Thus, when faced with the possibility of additional revision surgery, we find ourselves walking on the thin line between the reasons we feel are a "legitimate" use of plastic surgery - namely the desire to feel "normal" and those that we don’t feel aren't justified ("I want to look fabulous. Perfect. You know, like Heidi Montag.") Well, I'm here to tell you, my friends and mutants, that the aforementioned thin line doesn't really exist. Not when it comes to reconstruction. Only you can decide for yourself how close to "perfect" you need to get to feel "normal". I feel quite normal with a side-wandering Righty but I wouldn't feel normal if I couldn't wear a bra comfortably or sleep on my stomach anymore. (One of the many reasons that I realized implants weren't going to work for me.)
I'm not saying that as mutants we should keep going back for more and more surgery until the surgeon attains some Platonic state of perfection. As soon as I felt good mentally and physically, I knew it was time to stop.
But a mutants shouldn't pass on revision out of fear that she's somehow turning into Janice Dickinson.
But more importantly, a mutant shouldn't pass on revision because she feels like she deserves to look worse than she did before as some sort of tangible, visible sacrifice to avoid the fate of her mother or her aunt.
Living with this fucking mutation day in and day out forever is sacrifice enough.
I know that you will surpass all the trials in your bout against breast cancer. But take those situations as part of the challenge. You're very courageous in fighting for your life and I hope many breast cancer patients are as brave as you are. You have my prayers and I wish you a smooth recovery. :)
Posted by: Allie Yaeger | October 17, 2011 at 07:46 PM