Mastectomy, Pathology Results And A Rhetorical Question

So it’s been one week since my preventative double mastectomy with immediate reconstruction because I have the BRCA gene mutation and it hasn’t been that bad. If having my intestines resected multiple times through a 13″ incision straight down the middle of my abdomen was a 10 on the pain scale, I’d rate this about an 8. Lifting my arms to brush my hair is impossible and so is reaching for the coffee cups in the kitchen cabinets in the morning. But its getting easier with every passing hour and I’m reminded again of the amazing resilience of our bodies to heal and mend. I stayed in the hospital two nights, got home late Thursday afternoon and have been taking it slow since then.

The plastic surgeons at UAB were quite pleased with themselves and they should be. The nipple-sparing technique they employed was successful, the surgery lasted less than six hours, the implants went in with no problem and each time they removed the bandaging in the hospital, they oohed and ahhed about their work. “Textbook” is how they kept referring to my chest and “This is the outcome we wish we could achieve for every woman,” they said. Clearly, they know something I don’t know because right now when I look at my chest, I can’t imagine that these will ever look like natural breasts. They have assured me that it will take a few months for things to settle into place and that they can make tweaks and adjustments without any additional surgery.

Some people suggested to me that having a preventative mastectomy was the same as having cosmetic breast surgery but I can assure them that it is not. Every bit of tissue was stripped away from my chest – the doctor called it “skeletonizing” the breast – and the result looks like what you would imagine…lots of swelling and bruising, odd puckers and folds on the sides and under my arms and at this point, I can’t imagine ever wearing a low cut blouse or bathing suit again. Every time I look in the mirror, I tell myself that at my age, I shouldn’t care. But I do. And I imagine most women who have a mastectomy care, too.

This morning, I returned to UAB for my first post-op check up and was thrilled that the doctor removed the drain tubes, which has me feeling much better already. He gave me a chest band to wear, something he says will help the implants drop to a more natural position and he emphasized that there are other tools in his arsenal, like fat grafting, that can improve the final result. It’s a process, he reminded me.

Knowledge is power and timing is everything. Once I had the knowledge that I carried the BRCA gene mutation, I was able to make an informed decision that was right for me. Even though I knew the risks – an 87% chance of developing breast or ovarian cancer within six years – it turns out my risk was even greater than that. The pathology report showed that all the tissue in my right breast was clear and healthy but the tissue in my left breast contained “a large concentration of atypical, pre-cancerous cells.” The breast surgeon told me on the phone that if I hadn’t had a mastectomy, I would have developed malignant breast cancer in my left breast within the next 12 months. I am so glad to know this because I’m sure I would have wondered for the rest of my life if this surgery was necessary or not. And I’m thankful to my husband, doctors and friends who urged me to make this decision now. If I had waited much longer, it might have been too late.

Yesterday, I read Angelina Jolie’s New York Times Op-Ed about her cancer scare and the surgery she had to remove her ovaries. Like millions of women, I am grateful for her willingness to talk about women’s health issues in such an intimate way. As she points out, these decisions are highly personal and are different for each of us. Like her, I hate to think of the young women who haven’t had children yet who are faced with these tough choices and am overcome with relief that my daughter does not have this gene mutation. The decision to remove my ovaries back in October was a no-brainer for me, but I’ve already had two children and have already gone through menopause. Women who haven’t had children or are too young to be forced into menopause by the removal of their ovaries have much tougher choices to make than I did.

As I thought about Angelina and her decisions, a rhetorical thought came to me. Why aren’t there more female plastic surgeons? And if there were more women plastic surgeons, would there be any impact on cosmetic or reconstructive breast surgery? I posed my rhetorical question to my plastic surgeon today and he said, “That’s a very good question and yes, when men are crafting women’s breasts, they are doing this with a particular bias.”

We talked about how for decades cosmetic and reconstructive breast surgery has been done primarily by men and how the cosmetic procedures we have done to our breasts are somewhat responsible for the perceptions about what constitutes “great” breasts. We talked about our culture’s obsession with breasts and about the taboos that have long been held regarding breasts, from surgery to breastfeeding.

I wonder…does a female plastic surgeon have a different take on what a good outcome looks and feels like?

Would our culture’s perceptions about breasts shift – even slightly – if the majority of breast augmentation or reconstruction was done by women instead of by men?

Am I looking at the results of my surgery through a woman’s eyes or through a man’s?

Or do men and women see the same thing when they look at women’s bodies?

Please comment below if you have an opinion on my rhetorical question! And thank you all for your prayers and support!

11 thoughts on “Mastectomy, Pathology Results And A Rhetorical Question

  1. Debra I am so glad to hear you are doing well. Praying for you and for your continued recovery. Take care and much love! Barbara Ellen

  2. Continued thoughts, prayers, and get well wishes for you as you heal. I’m so proud of you for sharing this journey with us all. Hugs and love, Mary Pat

  3. Delighted to hear about your progress. It seems you took action just in the nick of time! Take it easy and give yourself plenty of time to heal. God bless.

  4. I’ve been praying for you. And you did the right thing to go ahead and take matters in your own hands. I’m so proud of you and you give other women courage to do so also.

  5. So glad you are recovering nicely…I know it was a huge decision but thank God you made the right choice…In my opinion, men look at women’s breasts totally different than women looking at other women’s breasts…for instance, I think small breasts look better than big..
    Take care and hope to see you soon…

  6. Hi Debra, first thing I should say is don’t worry! I felt exactly the same as you, I couldn’t understand how what the surgeons were proclaiming as perfection would ever be something I could myself be proud of. But at 2.5 months down the line I can really see them settling and looking more normal. Dents will appear and things will harden and soften but ultimately they’re clever, they’ve seen most things and the final “jazzing” process, as my oncoplasty consultant describes it, will help enormously. And for what it’s worth, I have an all-female team and I feel exactly the same as you about mine, so I don’t think you will have suffered from any bias, positive or negative. Best of luck for your recovery, definitely take it easy for the full six weeks, you’ll be surprised how long it takes. X

  7. You were so brave to do this. I am thrilled and relieved that you are doing well! You are a gorgeous person, inside AND out, and would be- with or without the BOOBS! But it will surely be a relief to not have to worry about that potentially deadly demon! We love you!

  8. Thanks for this post. I’m adopted and have struggled with whether or not to get that test. You are an inspiration. Prayers for a speedy recovery.
    Stephanie.

  9. I haven’t had the pleasure of meeting you in person, but I know we have mutual friends and I have admired your work here in town for many years. I have followed your story on your blog, as I have a special interest in the subject. My husband is a specialist here for ovarian cancer (trained at UAB but started his practice here 11 years ago). We were shocked when his own sister was diagnosed at age 41 with cancer and then the gene (she is all clear now!). His other sister also tested positive and chose the route you have taken. Both had female plastic surgeons in different states, by the way! You raised a lot of great points about that. We were so relieved when my husband tested negative, as we have daughters and, as you said, would have been concerned about their future. My husband is now participating in some amazing research here – I hope one day we can meet in person and I can tell you all about it! I think it would make you feel inspired and encouraged. I am so thankful for your surgery being behind you. It is a process but you will get through this, and you will be around for a long time to enjoy the good work you do at Merrimack!! Praying for a smooth recovery.

    Here is a good food for thought question for today! – Wouldn’t it be nice if scientists could find a way to eliminate a woman’s risk of breast or ovarian cancer *without* having to remove all those body parts?!?!

  10. I haven’t had the pleasure of meeting you in person, but I know we have mutual friends and I have admired your work here in town for many years. I have followed your story on your blog, as I have a special interest in the subject. My husband is a specialist here for ovarian cancer (trained at UAB but started his practice here 11 years ago). We were shocked when his own sister was diagnosed at age 41 with cancer and then the gene (she is all clear now!). His other sister also tested positive and chose the route you have taken. Both had female plastic surgeons in different states, by the way! You raised a lot of great points about that. We were so relieved when my husband tested negative, as we have daughters and, as you said, would have been concerned about their future. My husband is now participating in some amazing research here – I hope one day we can meet in person and I can tell you all about it! I think it would make you feel inspired and encouraged. I am so thankful for your surgery being behind you. It is a process but you will get through this, and you will be around for a long time to enjoy the good work you do at Merrimack!! Praying for a smooth recovery.

    Here is a good food for thought question for today! – Wouldn’t it be nice if scientists could find a way to eliminate a woman’s risk of breast or ovarian cancer *without* having to remove all those body parts?!?!

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