Breast Cancer Awareness -- Part 4

The next week was crazy. I had an MRI to make sure my breasts were clear of cancer. I also had my first meeting with the plastic surgeon I'll call Doc PS. Doc PS had a nice manner about him. According to what I read about him on the internet (research, people, not stalking!) he was in his early 40s, a perfect age for a surgeon, I think. You want them to have a lot of experience, yet you don't want them to be so old that their hands shake. Seriously. He also went to NYU for med school and UCLA for residency. Not bad.

I appreciated the fact that Doc PS took his time explaining everything to me. I had the option of either implants or the stomach tissue transfer procedure. In fancy surgical terms, it's called a Deep Inferior Epigastric Perforator or DIEP reconstruction. DIEP is now considered the "gold standard" of breast reconstruction because you are using your own tissue, or, I guess I should just come out and say the "f" word here -- fat. The reconstructed breasts, created from my own stomach FAT, would look and feel like real breasts. Implants, though less invasive, require more maintenance and sometimes go awry. The bad thing about DIEP surgery is that it is very long -- usually over ten hours -- and the recovery is notoriously painful. Depending upon a woman's physiology (and surgeons can't tell what you have until they open you up) sometimes stomach muscle as well as fat has to be transferred and that is very, very painful. Ouch city!

After Doc PS discussed the myriad surgical pros and cons he brought in his handy dandy computer to give me a slide show. This "show" included graphic pictures of what happens in surgery, along with many before and after pics. Doc PS was enthusiastic, and I think his intention was to inspire enthusiasim in me, too. Looking at picture after picture of headless, scarred torsos, however, only made me more nervous than ever. A strange sadness overcame me.

After the computer peep show, he examined me. (Now this part is for girls only, so if there are any boys out there, you need to go away now!) Because my breasts were large and had seen some gravitational pulling, i.e. sagging, action over the last (over) forty years, Doc PS said he wasn't sure he could save my nipple area. I knew my skin would be saved, but I had hoped my nipple would be part of the plan. Then he gently pinched my stomach fat. "Whatever I can pinch, I will use," he said.

Finally, for the first time since this whole BRCA 1 business began, I started to cry. Doc PS was very nice and said I needed time to absorb everything and he would meet with me again before the surgery. He left the room. His nurse, who had been there for the examination, gave me a hug. "I've been through this, too," she said. "I know it's scary. If you need to talk to any other women who've been through this, I can arrange that." I thanked her. I felt a little better, I felt a little worse. I felt nothing.

Back at home, I went on the internet and looked at more pictures of breasts in a week than a pervert does in a year! Every now and then I'd see a set of reconstructed girls that impressed me. I even printed out a few pics to show my husband. "I want to look like her," I said, "she must be a B cup." He nodded his head. "As long as you're healthy...But if you want to be smaller, that's okay with me."

Then the epiphany came. My personal moment of truth: I really, truly wanted to be smaller. After a lifelong battle with DD boobs and backaches, I began to embrace the idea of a smaller chest. A flatter stomach would be the icing on the cake. If I was going to go through ALL of this to be cancer-free, I also wanted the cosmetic perks. Vanity won out.

Within a week I revisited Doc B and Doc PS. My MRI came back clear, thank goodness! I made lots of decisions. My ovaries would be removed at the same time as the "big" surgery and I met another surgeon who would take care of that procedure. I also opted to have my nipples removed altogether, and would have them reconstructed at a later date. I told Doc PS emphatically, "I want to be a B cup."

The date was set: July 6th. July 6th, my own independence day.