I'm A Mutant

Shallow on the outside, DIEP on the inside

Ok, I have to cop to a certain degree of disingenuousness in my last post. 

Despite my whole "rah, rah, rah, I'm such a feminist, screw the way I look, la, la, la", it really isn't as simple as all that.  I'm not immune to cultural pressures about how women are supposed to look.  Far from it.  In fact, I have to admit that I'm a rather vain and shallow mutant.  I'm reluctant to embrace ethnic stereotypes about certain types of American princesses but suffice it to say that I love clothes.  I love the way I look in clothes (at least when I'm in shape) and if I thought that having a mastectomy would leave me significantly disfigured, I don't think I could do it.

And at first I thought I wouldn't do it.  I rejected the idea out of hand and the fact that my paranoid doctors at CancersRUs weren't pushing it too hard seemed good enough for me.  But strictly out of curiosity I began to surf the net looking for information and photos of women who had had prophylactic bilateral mastectomies (PBM) and reconstruction. 

What I discovered truly amazed me.  This is not your mother's mastectomy.  Gone are the days of porn star implants that make women look like mail order blow up dolls.  Gone are the days of shocking horizontal scars that make women look like extras in slasher movies.  Gone are the days where reconstructions necessarily take weeks or even months.  Nowadays,  many reconstructions are done with tissue transplants and microsurgery.  For women having a PBM, the reconstruction can be done concurrently with the mastectomy in a single surgery.  These types of reconstruction procedures have acronyms like DIEP, GAP, TRAM and finally, no pun intended, the stacked DIEP.   

If I understand this correctly, after the real breast tissue is removed, living fatty tissue is excised from a woman's abdomen (or hips or tush, depending on where she has the most material) and moved into place to form the new breasts.  The tiny 2 mm blood vessels in the donor tissue are then microsurgically reattached to the original blood supply in the chest wall thereby creating new breasts that look and feel like the real thing because they are in fact made out of tissue that is quite similar to the original breast tissue that is removed.   Because excess fat is siphoned from other parts of the body and the body is recontured to make everything look good, many women actually come out of the surgery looking better than they went in.

Thus, in what strikes me as yet another highly ironic twist of fate, the rather primitive "treatment" of prophylactic surgery is matched, tit for tat (!), by cutting edge, state of the art microsurgery.

There is also the option of "nipple sparing".  For women who don't have cancer (and even for some who do), it is possible to have a mastectomy wherein the entire outside of the breast is preserved.  The availability of nipple sparing really provided the final plank in the bridge that I mentally needed to cross to come around to the idea of the PBM.  I came to appreciate the fact that if I chose to do this now, on my terms, I could avail myself of the best surgeons, the latest techniques for reconstruction and I could have "nipple sparing".  If I were to wait and I developed breast cancer, I would have to make all of these decisions "under the gun".  And the medical necessity of getting rid of the cancer would dictate what type of mastectomy and reconstruction I would have which would not necessarily be as aesthetically optimal as what can be done now when I do not have cancer.  

For me, knowing what I'm getting is better than waiting to find out what's behind door #3.

PBM with immediate reconstruction is a complicated and physically traumatic surgery.  I will probably be completely out of whack for about two weeks and unable to work for at least a month.   The PBM is going to change the shape and feel of my breasts and there will be (hopefully small) permanent scars, not just on my breasts, but also on the site where the donor tissue is taken.
 
But when all is said and done I know that I'll still be able to recognize myself in the mirror. 

Practically speaking, given a realistic expectation of a decent reconstruction, sacrificing the boobs seemed like a reasonable price to pay to avoid an 85% chance of getting breast cancer. 

Not exactly bargain basement. 

But still reasonable.  

My Body, My Mastectomy

I am going to have a double-mastectomy.

So much for indecision.

Over the past few weeks, the idea that I would actually commit such an act of violence against my own body has taken root, metamorphosing from a fleeting thought of revulsion to the full blown idea that I could do this, that it was the right thing to do, that I actually wanted to do this.  

The conviction that I feel about this, as opposed to my endless vacillation regarding oophorectomy, surprises me. That being said, I came to this conclusion for reasons that were both philosophical and practical. 

First, the philosophical:  As some sort of feminist (hard to say what a "feminist" actually is nowadays), the idea that I should NOT have a prophylactic bilateral mastectomy (PBM) began to bug the shit out of me.   

Suppose I told you that your fourth toe on your left foot had an 87% chance of turning into a disease that could kill you and even if it didn't, it would most certainly compromise your life significantly in many unforeseeable ways. 

Would you hesitate to amputate said toe?     

So what is so fucking sacred about a pair of tits? 

Why was it that these same doctors who would yank out my ovaries as if they were ingrown toenails, were so suddenly merciful towards my even more potentially rogue breasts? 

Yes, yes, yes, I know, I know, there are legitimate medical reasons  - ovarian cancer is much deadlier than breast cancer, much harder to detect, and oophorectomy actually prevents breast cancer.

But now that I have weaned my children, apart from holding up a bustier, do the boobs really have much more utility than that fourth toe?  

And given their limited utility, I couldn't help but wonder if there weren't cultural factors at work here as well.  Indeed, Dr. Statistics tipped his hand when he said to me, within minutes of our first meeting "of course, mastectomy is a much more emotional decision for you as it really goes to the heart of a woman's self-image".  In YOUR OPINION, Sir.  

Why are breasts assumed to be so intrinsic to a woman's self-image?  If we lived in a society that truly accepted that a woman's self-worth was independent of her cup size, would PBM even be such a big deal to begin with?    

At the core of any "ism", including feminism, lays the critical right of the individual to self-define.   

And so I claim for myself the right to say what does and does not make me attractive as a woman.   

With that framework in mind, I began to think rather seriously about how I actually felt about the old girls.  The truth is that I really do like my boobs.  I like them quite a lot.  I am a zaftig Jewish girl with a full C/D and despite the droop in recent years, I never would have sought any alterations if I hadn't turned out to be a mutant.  They look great in v-necks and clingy tee shirts.  They're soft and squishy and they are reliable supporting actors during intimate performances. 

But . . . 

As much as I like them, it simply does not rise to the level of personal necessity that would be required for me to risk life and limb to keep them.  

I can't even say that they are an essential element of what makes me feel "attractive."   

And they are most certainly not integral to my self-understanding as a woman.

In the final analyis, I needed these boobs like a fish needs a bicycle.