Breast Reconstruction: It's OK To Say No

Now that the active part of my breast cancer treatment is finished and my mastectomy scar has healed, several friends have asked when I will start reconstruction of my breast. 

I shrug and tell them that I will meet the surgeon in due course and explore options.  But I'm not in a hurry because I don't think I will follow that route.  I think I will leave my lopsided, scarred chest exactly the way it is.

I've been surprised by how shocked many people are by this response.  It seems that most of my friends didn't even think about whether I would undergo reconstruction.  They try and reassure me, thinking that I'm either afraid of the surgery itself or worried that the end result will not be what I'd hope.  Give her a bit of time, they seem to be thinking, and then she'll see sense. 

But I've had time to think about this.  Yes, I am afraid that the surgery would be a long and painful process.  Yes, I do worry about the end result because it will never be quite the way was before.  But this isn't just a negative 'I can't face any more procedures' kind of response - even if I could wave a wand and have my old breast back I might have to think about it (I have mixed views about breasts these days).  I completely respect women who decide that reconstruction is for them, but I also worry that society and the medical profession have a tendency to simply assume that reconstruction is just the next, inevitable step in the process of treating cancer. 

From my point of view, I am now as healthy as medicine can make me.  Surgery will not affect my chances of cancer recurring one way or the other and my scar has healed up nicely and doesn't need any medical intervention for health reasons.  So why would I undergo more surgery?

To be comfortable in public?  I can understand that a silicon prosthesis might simply not be a practical solution for larger breasted women: it can be heavy and uncomfortable and it's never going to offer a cleavage.  But for me, an A-cup girl, it works really well.  I have the best fitting bra I have ever had, it's comfortable and gives me a great shape and I never had a cleavage anyway.  I admit that it's a fairly solid bra so it limits evening dress a bit but I can live with that.  Even my swimming costume looks good.

So should I do it for my husband?  Well, maybe if he was seriously disturbed by my new shape and didn't find me attractive any more I'd have to give it more thought.  No doubt, if you ask him, he might confess that he'd prefer my old body.  But we're both getting a bit saggy and baggy and padded round the edges in middle age - I'd rather he still had the body he had ten or twenty years ago too but that's okay.  Our scars and extra baggage are reminders of the life we have shared together and that's not a bad thing.

And what about my kids?  We're pretty relaxed about nakedness in my immediate family so inevitably the kids have walked in on me coming out the shower and seen my new shape.  They've got used to it and don't really care one way or the other.  And I can't help feeling that it is a good message for my pre-teen daughter: yes, my body is not conventional but I'm comfortable in it and that's just fine.

So that just leaves me to strip away everything else and take a good long look at myself at the mirror.  I have to ask honestly, am I really happy with the way I look?  Can I live with the scars or will I always feel uncomfortable, however well I disguise them?  For some of us, the answer will be no.  And to them I say, that's just fine - surgery is, I hear, really great and will result in a shape that you can be proud of and enjoy.  Go for it! 

But for others, like me, we'll think we look just fine the way we are.  I don't mind looking in the mirror and seeing my scar.  More than that, I'm proud of it.  It marks a journey that I have made.  When I look at the space where my breast once was, I don't see that I am less, I am reminded that I have learnt more about what matters in my life and the blessings that I had all along but didn't always recognise.  

When the time comes, I will meet the surgeon, get all the information and make a final decision.  But I doubt she'll change my mind and I'm happy that I'm making a good, positive, informed choice for me.

So don't ask me when I will start reconstruction - ask me whether I will reconstruct.  There are good, positive reasons for either answer.  The most important thing is that society and the medical profession remembers that this is the question that needs to be asked first.